Aspirin Withdrawal Before 30 Days After PCI in Acute Coronary Syndrome and Early Myocardial Infarction Risk: A Systematic Review and Meta-analysis.
Khubaib Mohammad Murtafa, Sadiya Sajad Khanday, Mohammad Sameem Arif et al.
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In 30 seconds
This systematic review and meta-analysis evaluated the effects of aspirin withdrawal within 30 days after percutaneous coronary intervention (PCI) in acute coronary syndrome (ACS) patients. Analyzing data from three randomized controlled trials with 10,736 patients, the study found that early aspirin discontinuation was linked to a higher risk of myocardial infarction (OR, 2.12; 95% CI, 1.31-3.44) without reducing bleeding events.
Key findings
- Aspirin withdrawal within 30 days after PCI increased the risk of myocardial infarction (OR, 2.12; 95% CI, 1.31-3.44).
- No significant differences were found in other ischemic, composite, or mortality outcomes.
- Longer-term follow-up showed P2Y12 inhibitor monotherapy reduced bleeding outcomes without increasing ischemic events.
Why it matters
The findings highlight the potential risks associated with early aspirin withdrawal in ACS patients post-PCI, emphasizing the need for careful consideration of antiplatelet therapy during the critical first month after the procedure.