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Optimal Duration of Dual‐Antiplatelet Therapy Following Drug‐Eluting Stent Implantation: A Meta‐Analysis
Author(s) -
Zhang Tuo,
Shen Linghong,
Hu Liuhua,
He Ben
Publication year - 2013
Publication title -
the journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.92
H-Index - 116
eISSN - 1552-4604
pISSN - 0091-2700
DOI - 10.1177/0091270012448398
Subject(s) - medicine , drug eluting stent , drug , cardiology , antiplatelet drug , meta analysis , platelet aggregation inhibitor , stent , clopidogrel , surgery , aspirin , pharmacology , restenosis
Optimal duration of dual‐antiplatelet therapy (DAPT) following drug‐eluting stent (DES) implantation remains uncertain. The aim of this study was to perform a meta‐analysis of trials evaluating the effect of DAPT duration on long‐term clinical outcomes after DES implantation. The authors searched OvidMEDLINE, EMBASE, and the Cochrane Library for both randomized controlled trials and nonrandomized studies that evaluated DAPT duration on long‐term clinical outcomes after DES implantation. The end point was the cumulative incidence of the composite of all‐cause death and nonfatal myocardial infarction (MI) at maximum follow‐up. Quantitative analysis was performed to estimate the pooled hazard ratios (HRs) for the effect of DAPT duration. The pooled effect of DAPT discontinuation before 6 months significantly increased risk of death and nonfatal MI (HR, 1.46; 95% confidence interval, 1.18‐1.80), but DAPT beyond 12 months did not reduce the incidence of the composite end point compared with drug discontinuation at 12 months (HR, 0.91; 95% confidence interval, 0.75‐1.10). In conclusion, the current evidence suggests that 6 to 12 months of DAPT may be optimal after DES implantation.