Walking the Line with Ticagrelor: Meta-Analysis Comparing the Safety and Efficacy of Ticagrelor Monotherapy after a Short Course of Ticagrelor-Based Dual Antiplatelet Therapy versus Standard Therapy in Complex Percutaneous Coronary Intervention
| Autor: | Giulio G. Stefanini, Francesco Condello, Alberto Polimeni, Riccardo Terzi, Matteo Sturla |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
animal structures medicine.medical_treatment Rate ratio law.invention Randomized controlled trial law Internal medicine complex PCI medicine Myocardial infarction ticagrelor monotherapy business.industry Brief Report percutaneous coronary intervention Percutaneous coronary intervention General Medicine medicine.disease dual antiplatelet therapy Drug-eluting stent Meta-analysis Conventional PCI Cardiology Medicine business Ticagrelor drug eluting stent medicine.drug |
| Zdroj: | Journal of Clinical Medicine, Vol 10, Iss 5506, p 5506 (2021) Journal of Clinical Medicine |
| ISSN: | 2077-0383 |
| Popis: | (1) Shorter-duration dual antiplatelet therapy (DAPT) followed by single antiplatelet therapy has been shown to significantly reduce bleeding events while preserving anti-ischemic effects in patients undergoing conventional percutaneous coronary interventions (PCI). Whether this strategy is also safe and effective in complex PCI remains elusive; (2) A systematic search of randomized controlled trials comparing a short course of ticagrelor-based DAPT versus standard DAPT in patients undergoing complex PCI was performed; (3) Of 10,689 studies screened, 3 were identified for a total of 4176 participants on ticagrelor monotherapy after a short course of ticagrelor-based DAPT, and 4209 on standard DAPT. The pooled analysis revealed no difference in the outcomes of major bleeding, myocardial infarction, definite or probable stent thrombosis and ischemic stroke. A significant reduction in the risk of cardiovascular death (incidence rate ratio (IRR) 0.52; 95% CI 0.28–0.96; p = 0.04), all-cause death (IRR 0.65; 95% CI 0.49–0.86; p = 0.003), and any bleeding events (IRR 0.62; 95% CI 0.47–0.81; p < 0.001) was seen in the shorter DAPT group; (4) Among patients undergoing complex PCI, ticagrelor monotherapy after a short course of ticagrelor-based DAPT significantly reduced bleeding risk without increasing ischemic risk. More data are needed to definitively explain mortality benefits. |
| Databáze: | OpenAIRE |
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