Optimal Duration of Dual Antiplatelet Therapy after Percutaneous Coronary Intervention in Patients with Acute Coronary Syndrome: An Updated Meta-Analysis of Randomized Controlled Trials.
Tuesday, May 21, 2019
Belmont Ballroom 2-3 (The Cosmopolitan of Las Vegas)
Amit Rout, M.D.
,
Sinai Hospital Of Baltimore, Baltimore, MD
Aakash Garg, MD
,
Newark Beth Israel Medical Center, Newark, NJ
Abhishek Sharma, M.D.
,
Rush University Medical Center, Chicago, IL
Ayush Arora, MD
,
Rutgers New Jersey Medical School, Newark, NJ
Marc Cohen, M.D.
,
Newark Beth Israel Hospital, Newark, NJ
Background:
Current guidelines recommend dual anti-platelet therapy (DAPT) for atleast 12 months in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). However, individual randomized controlled trials (RCTs) comparing short (S-DAPT) vs. long (L-DAPT) durations of DAPT have shown conflicting results.
Methods:
We searched different databases for RCTs comparing outcomes of S-DAPT (3-6months) vs. L-DAPT (≥ 12 months) in patients with ACS undergoing PCI. Random effects meta-analysis was performed to estimate odds ratio (OR) with 95% confidence interval (CI).
Results:
Eight RCTs were identified in which 11,014 patients were randomized to S-DAPT (n=5,499) versus L-DAPT (n=5,515). There were no significant differences in all-cause mortality [OR 0.98; 95% CI 0.75-1.30] and CV mortality [1.07; 0.71-1.61] between S-DAPT vs. L-DAPT groups. Compared with L-DAPT, S-DAPT was associated with similar risk of MI [1.21; 0.94-1.57], ST [1.48; 0.98-2.23] and major bleeding [0.80; 0.56-1.14].
Conclusions:
In patients undergoing PCI for ACS, S-DAPT is associated with similar ischemic and bleeding risks compared with L- DAPT.
