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Efficacy and Safety of Dual Antiplatelet Therapy in Patients Undergoing Coronary Stent Implantation: A Systematic Review and Network Meta-Analysis

文献类型：期刊论文

作者Xu, Yi1; Shen, Yimin1; Chen, Delong1; Zhao, Pengfei2,3; Jiang, Jun1
刊名JOURNAL OF INTERVENTIONAL CARDIOLOGY
出版日期2021-05-06
卷号2021页码:9934535
ISSN号0896-4327
DOI10.1155/2021/9934535
文献子类Review
英文摘要Introduction. This network meta-analysis aimed to evaluate the efficacy and safety of different dual antiplatelet therapies (DAPTs) after percutaneous coronary intervention (PCI) with drug-eluting stents (DESs). Methods. Randomized controlled trials (RCTs) comparing longer-term (>12 months) DAPT (L-DAPT), 12-month DAPT (DAPT 12Mo), 6-month DAPT (DAPT 6Mo), 3-month DAPT followed by aspirin monotherapy (DAPT 3Mo + ASA), 3-month DAPT followed by a P2Y12 receptor inhibitor monotherapy (DAPT 3Mo + P2Y12), or 1-month DAPT with a P2Y12 receptor inhibitor monotherapy (DAPT 1Mo + P2Y12) were searched. Primary endpoints were all-cause mortality, cardiac death, myocardial infarction (MI), major bleeding, any bleeding, definite or probable stent thrombosis (ST), and net adverse clinical events (NACE). This Bayesian network meta-analysis was performed with the random-effects model. Results. Twenty-four RCTs (n = 81339) were included. In comparison with L-DAPT, DAPT 6Mo (OR: 0.50, 95% CI: 0.29-0.83), DAPT 3Mo + P2Y12 (OR: 0.38, 95% CI: 0.18-0.82), DAPT 3Mo + ASA (OR: 0.44, 95% CI: 0.17-0.98), and DAPT 1Mo + P2Y12 (OR: 0.45, 95% CI: 0.14-0.93) were associated with a lower risk of major bleeding. DAPT 3Mo + P2Y12 (OR: 0.58, 95% CI: 0.38-0.88) reduced the risk of any bleeding when compared with DAPT 12Mo. L-DAPT decreased the risk of MI and definite or probable stent ST when compared with DAPT 6Mo. DAPT 3Mo + P2Y12 decreased the risk of NACE in comparison with DAPT 6Mo and DAPT 12Mo. No significant difference in all-cause mortality and cardiac death was observed. In patients with acute coronary syndrome, DAPT 6Mo was comparable to DAPT 12Mo. Conclusion. Short-term (1-3 months) DAPT is noninferior to DAPT 6Mo after DESs implantation, while L-DAPT reduces MI and definite or probable ST rates. DAPT 3Mo + P2Y12 might be a reasonable trade-off in patients with high risk of bleeding accompanied by ischemia.
WOS关键词DRUG-ELUTING STENTS ; PRE-SPECIFIED ANALYSIS ; CARDIOVASCULAR EVENTS ; CLOPIDOGREL THERAPY ; ST-SEGMENT ; ISAR-SAFE ; DURATION ; INTERVENTION ; ASPIRIN ; TRIAL
WOS研究方向Cardiovascular System & Cardiology
语种英语
WOS记录号WOS:000665059900001
出版者WILEY-HINDAWI
源URL[http://119.78.100.183/handle/2S10ELR8/309389]  
专题新药研究国家重点实验室
通讯作者Jiang, Jun
作者单位1.Zhejiang Univ, Affiliated Hosp 2, Sch Med, Dept Cardiol, 88 Jiefang Rd, Hangzhou 310009, Zhejiang, Peoples R China;
2.Nanjing Univ Chinese Med, Sch Chinese Mat Med, 138 Xianlin Ave, Nanjing 210023, Peoples R China;
3.Chinese Acad Sci, Shanghai Inst Mat Med, State Key Lab Drug Res, 501 Haike Rd, Shanghai 201203, Peoples R China
推荐引用方式
GB/T 7714		 Xu, Yi,Shen, Yimin,Chen, Delong,et al. Efficacy and Safety of Dual Antiplatelet Therapy in Patients Undergoing Coronary Stent Implantation: A Systematic Review and Network Meta-Analysis[J]. JOURNAL OF INTERVENTIONAL CARDIOLOGY,2021,2021:9934535.
APA Xu, Yi,Shen, Yimin,Chen, Delong,Zhao, Pengfei,&Jiang, Jun.(2021).Efficacy and Safety of Dual Antiplatelet Therapy in Patients Undergoing Coronary Stent Implantation: A Systematic Review and Network Meta-Analysis.JOURNAL OF INTERVENTIONAL CARDIOLOGY,2021,9934535.
MLA Xu, Yi,et al."Efficacy and Safety of Dual Antiplatelet Therapy in Patients Undergoing Coronary Stent Implantation: A Systematic Review and Network Meta-Analysis".JOURNAL OF INTERVENTIONAL CARDIOLOGY 2021(2021):9934535.

入库方式： OAI收割

来源：上海药物研究所

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