Abstract 14933: Long (>12 Months) and Short (<6 Months) versus Standard Duration of Dual Antiplatelet Therapy After Coronary Stenting: A Systematic Review and Meta-Analysis
Background: Dual antiplatelet therapy (DAPT) is recommended for 6-12 month after drug-eluting stent (DES) implantation to prevent ischemic events and late stent thrombosis. The optimal duration of DAPT has not been established.
Methods: We performed a meta-analysis of the comparative effects of short- and long- vs standard DAPT duration on adverse cardiovascular and major bleeding. We conducted an EMBASE and MEDLINE search for studies in which patients were randomized to treatment with a different duration of DAPT.
Results: We identified 5 prospective randomized studies comparing short- vs standard DAPT and 3 comparing long vs. standard DAPT duration with a total of 28,343 patients. Short term DAPT has similar incidence of stent thrombosis, MI and death compared to standard DAPT whereas major bleeding was significantly lower in short DAPT therapy. Long term DAPT was associated with lower rates of stent thrombosis and MI but significantly increased major bleeding and all-cause mortality compared to standard therapy
Conclusion: We found that short DAPT is safer and as effective as standard DAPT in patients with second generation DES. Extended DAPT is associated with less ischemic events at the expense of high bleeding and mortality rates.
Author Disclosures: S. Sharma: None. A. Briasoulis: None. S. Mallikethi-Reddy: None. M. Palla: None. R. Sudhakar: None. F. Siddiqui: None. L. Afonso: None.
- © 2015 by American Heart Association, Inc.