医学
经皮冠状动脉介入治疗
狼牙棒
急性冠脉综合征
内科学
传统PCI
阿司匹林
相对风险
心肌梗塞
随机对照试验
心脏病学
氯吡格雷
荟萃分析
置信区间
作者
Vijairam Selvaraj,Saurav Chatterjee,Taishi Hirai,J. Dawn Abbott,Chirag Bavishi
摘要
Abstract Introduction The American Heart Association/American College of Cardiology guidelines on dual antiplatelet therapy (DAPT) recommend at least 12 months of a P2Y12 inhibitor and low dose aspirin in patients with an acute coronary syndrome (ACS) treated with a stent. Since that recommendation, several randomized controlled trials (RCTs) have studied an abbreviated duration of DAPT in ACS. Therefore, we sought to perform a meta‐analysis of RCTs comparing 3‐ versus 12‐month DAPT in patients presenting with ACS undergoing percutaneous coronary intervention (PCI). Methods PubMed, Embase, and Cochrane Central databases were searched until July 31, 2022, for RCTs comparing 3‐ versus 12‐month DAPT in patients with ACS undergoing PCI. Outcomes assessed were major adverse cardiovascular events (MACE), cardiovascular mortality, all‐cause mortality, myocardial infarction (MI), stent thrombosis (ST) and bleeding. A random‐effects model was used to calculate pooled relative risk (RR) and 95% confidence intervals (CI). Results We included 5 trials comprising 16,781 patients with an ACS that underwent PCI. There was no significant difference in MACE (RR: 0.92; 95% CI: 0.76–1.11), cardiovascular mortality (RR: 1.26; 95% CI: 0.38–4.17), or all‐cause mortality (RR: 0.92; 95% CI: 0.48–1.77) between the 2 groups. In addition, there was no difference in rates of MI (RR: 0.98; 95% CI: 0.74–1.30), or ST (RR: 1.30; 95% CI: 0.55–3.05) between 3‐ and 12‐month DAPT. However, compared with 12‐month DAPT, 3‐month DAPT significantly reduced risk of major bleeding (RR: 0.53; 95% CI: 0.43–0.64). Conclusions In patients with ACS undergoing PCI, 3‐month DAPT reduced risk of bleeding without evidence of harm.
科研通智能强力驱动
Strongly Powered by AbleSci AI