Abstract 14766: Short-Term Dual Antiplatelet Therapy Following Bare Metal Stent Increases the Risk of Ischemic Events- A Meta-Analysis of Randomized Clinical Trials
Background: Bare metal stents (BMS) are a reasonable option even in the modern era of superior outcomes with 2nd generation drug eluting stents mainly because of the need for short term dual antiplatelet platelet therapy (DAPT). Current guidelines recommend a minimum of 1 month of DAPT following BMS use. The safety of limiting DAPT to one month has not been clearly established.
Methods: We searched PubMed, Scopus and ClinicalTrials.gov databases till May 2014 for randomized clinical trials (RCTs) that compared short (<6 months) versus long DAPT duration (> 6 months) after BMS. Risks ratios (RRs) with 95% confidence interval (CI) for the composite outcome of cardiac death or myocardial infarction (MI) and for major bleeding were calculated using random-effects model.
Results: We included 3 RCTs in this analysis. A total of 2654 patients received short term DAPT and 2612 patients received long term DAPT (9 to 24 months). The rates of cardiac death or MI were significantly higher in the short-term DAPT group (9.1%) compared to the prolonged DAPT group (7.0%)which corresponds to a 30% increase in the risk of cardiac death or MI (RR: 1.30, 95% CI: 1.08 to 1.57; p=0.005, figure). On the other hand, short-term DAPT was associated with numerically lower major bleeding events (4.0% vs 5.0%) when compared with prolonged DAPT but this did not reach statistical significance (p=0.06).
Conclusion: Short-term DAPT as compared with prolonged treatment is associated with an increased risk of cardiac death or MI.
Author Disclosures: G. El-Hayek: None. A. Casso Dominguez: None. J. Tamis-Holland: None. E. Herzog: Speakers Bureau; Modest; Astra Zeneca, Daiichi Sankyo and Bristol Myers Squibb.. A. Benjo: None. S. Bangalore: None.
- © 2014 by American Heart Association, Inc.