title: Optimal duration of dual-antiplatelet therapy following drug-eluting stent implantation: a meta-analysis.
abstract: 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.
authors: Department of Cardiology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors: Tuo
authors: T
authors: Zhang
authors: Linghong
authors: L
authors: Shen
authors: Liuhua
authors: L
authors: Hu
authors: Ben
authors: B
authors: He
mesh_terms: D002423:Cause of Death; D004359:Drug Therapy, Combination; D054855:Drug-Eluting Stents; D006801:Humans; D009203:Myocardial Infarction / Q000517:prevention & control; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*
chemical_list: D010975:Platelet Aggregation Inhibitors