We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
2015 - Review: After coronary DES placement, less than or equal to 6 mo and 1 y of dual-antiplatelet therapy do not differ for cardiac events.
- Authors
Bates, Eric R.
- Abstract
Question After coronary drug-eluting stent (DES) implantation, what are the efficacy and safety of ≤ 6 months vs 1 year of dual-antiplatelet therapy (DAPT)? Review scope Included studies compared DAPT for 3 or 6 months vs ≥ 1 year after DES implantation. Primary outcome was a composite of major adverse cardiac events (MACE), including cardiac mortality, myocardial infarction, and definite or probable stent thrombosis. Other prespecified outcomes included components of the composite outcome, all-cause mortality, stroke, minor and major bleeding, and target vessel revascularization. Review methods MEDLINE, EMBASE/Excerpta Medica, Cochrane databases, www.clinicaltrials.gov and other Web sites (www.tctmd.com, www.clinicaltrialresults.org, www.cardiosource.com), and proceedings from major cardiovascular meetings were searched for randomized controlled trials (RCTs). Investigators were contacted for original data. 4 RCTs (n = 8180; mean age 63 y; 66% men; 63% with zotarolimus-eluting stents, 22% with everolimus-eluting stents, and 15% with other types of stents) met the inclusion criteria and had individual patient data available for analysis. 2 RCTs compared DAPT for 3 vs 12 months, 1 for 6 vs 12 months, and 1 for 6 vs 24 months. Data for the latter RCT were censored at 12 months for analysis. All RCTs had adequate allocation concealment, blinded outcome adjudicators, and used intention-to-treat analysis. Main results DAPT for ≤ 6 months vs 1 year did not differ for any outcomes (Table). Prespecified subgroup analyses found that DAPT duration did not differ for MACE by sex; age; the acute coronary syndrome vs stable angina; or presence or absence of diabetes, multivessel disease, or left anterior descending coronary artery disease. Conclusion After coronary drug-eluting stent placement, ≤ 6 months of dual-antiplatelet therapy does not differ from 1 year of therapy for major adverse cardiac events.
- Subjects
COMBINATION drug therapy; CONFIDENCE intervals; CORONARY disease; HEMORRHAGE; INFORMATION storage &; retrieval systems; MEDICAL databases; MEDICAL information storage &; retrieval systems; LONGITUDINAL method; MEDLINE; META-analysis; MORTALITY; MYOCARDIAL infarction; MYOCARDIAL revascularization; STROKE; TRANSLUMINAL angioplasty; SYSTEMATIC reviews; RANDOMIZED controlled trials; TREATMENT effectiveness; TREATMENT duration; PLATELET aggregation inhibitors; DRUG-eluting stents
- Publication
ACP Journal Club, 2015, Vol 163, Issue 2, p2
- ISSN
1056-8751
- Publication type
Article