Early Aspirin Discontinuation Versus 12-Month Dual Antiplatelet Therapy after Percutaneous Coronary Intervention for Acute Coronary Syndrome: A Meta-Analysis of Randomized Trials.
Abhigna Kolupoti, Eduardo Itaya, Bryan O Perez Martinez et al.
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In 30 seconds
This meta-analysis evaluated the effects of early aspirin discontinuation versus 12-month dual antiplatelet therapy (DAPT) in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). The analysis included nine studies with 31,505 patients. Early aspirin discontinuation was associated with a significant reduction in net adverse clinical events (NACE) (OR 0.77, 95% CI 0.65 to 0.91; p = 0.002) while maintaining similar ischemic outcomes.
Key findings
- Early aspirin discontinuation reduced NACE compared to standard DAPT (OR 0.77; p = 0.002).
- Significant reduction in BARC ≥2 bleeding events with early aspirin discontinuation (OR 0.41; p <0.00001).
- No significant difference in MACE risk between early discontinuation and standard DAPT (OR 0.88; p = 0.19).
- Similar rates of all-cause mortality and cardiovascular mortality between the two strategies.
Why it matters
The findings suggest that early discontinuation of aspirin may be a safer alternative to standard DAPT in ACS patients post-PCI, potentially reducing bleeding risks without compromising ischemic protection. This could influence treatment strategies in managing patients after PCI.