P2Y12 inhibitor monotherapy after abbreviated dual antiplatelet therapy following percutaneous coronary intervention: a meta-analysis - PubMed
3 hours ago
- #meta-analysis
- #percutaneous coronary intervention
- #P2Y12 inhibitor
- P2Y12 inhibitor monotherapy after a short course of dual antiplatelet therapy (DAPT) post-PCI is safer with similar cardiovascular efficacy compared to continued DAPT, but optimal aspirin discontinuation timing is uncertain.
- Meta-analysis of 11 randomized trials (37,443 patients) found no significant difference in major adverse cardiovascular events (MACE) risk with aspirin discontinuation at ≤1 month or 3 months versus 12-month DAPT.
- Major and major/minor bleeding risks were significantly reduced with aspirin discontinuation at both ≤1 month and 3 months, with a more pronounced reduction in major/minor bleeding at ≤1 month.
- Net adverse cardiovascular events (NACE) were significantly reduced with ≤1-month discontinuation, with no significant differences between discontinuation timings.
- In acute coronary syndromes, early aspirin discontinuation increased stent thrombosis risk, especially with very early discontinuation (<1 month), though overall bleeding benefits were maintained.