Dual antiplatelet therapy duration after percutaneous coronary intervention with contemporary drug-eluting stents: A systematic review and network meta-analysis of randomized trials.
Admire Hlupeni, Mehran Jalilzadehbinazar, Rayvlin J Liceralde et al.
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In 30 seconds
This systematic review and network meta-analysis evaluated the effects of abbreviated dual antiplatelet therapy (DAPT) durations after percutaneous coronary intervention in 84,325 patients. Compared to the standard 12-month DAPT, shorter durations (1 and 3 months) did not significantly increase major adverse cardiovascular events (MACE) but were associated with reduced major bleeding. The 3-month DAPT strategy showed the most favorable profile for MACE.
Key findings
- 1-month DAPT showed no significant difference in MACE compared to 12-month DAPT (RR 1.03 [95% CI 0.88-1.22]).
- 3-month DAPT also showed no significant difference in MACE (RR 0.95 [95% CI 0.82-1.10]).
- 1-month DAPT significantly reduced major bleeding (RR 0.59 [95% CI 0.42-0.82]).
- The 3-month DAPT strategy ranked highest for MACE and the 1-month for major bleeding.
Why it matters
Understanding the optimal duration of DAPT after PCI is crucial for balancing the risks of ischemic events and bleeding. This analysis provides insights into how abbreviated DAPT strategies can be safely implemented in clinical practice.
What to keep in mind
The findings should be interpreted cautiously due to the limitations inherent to study-level network meta-analysis.