title: Optimal duration of dual antiplatelet therapy after drug-eluting stent implantation: a meta-analysis of 3 randomized controlled trials.
abstract: OBJECTIVE
  The optimal duration of dual antiplatelet therapy (DAPT) after drug-eluting stent (DES) implantation is still unclear. We conducted a meta-analysis of randomized trials to assess the optimal duration of DAPT after DES implantation.
  
  
  METHODS
  Articles were identified through a literature search of EMBASE, Pubmed, Europubmed, and the Cochrane Library until November 2013. Data were independently extracted by 2 reviewers. A random effect model was used to calculate the pooled odds ratios (ORs) with 95% confidence intervals (CIs) of the clinical outcomes concerned.
  
  
  RESULTS
  Three randomized controlled trials with zotarolimus- or everolimus-eluting stents and 6679 patients were included. There were no significant differences between short-term DAPT and standard-term DAPT in the comparison of incidences of cardiac death (OR, 0.84; 95% CI, 0.53-1.35; P = 0.48), myocardial infarction (OR, 1.21; 95% CI, 0.83-1.75; P = 0.32), stent thrombosis (OR, 1.30; 95% CI, 0.50-3.39; P = 0.59), and target vessel revascularization (OR, 1.16; 95% CI, 0.89-1.52; P = 0.26). Short-term DAPT did not increase the risk of all-cause death (OR, 0.86; 95% CI, 0.59-1.26; P = 0.44), cerebrovascular accidents (OR, 0.88; 95% CI, 0.421.81; P = 0.72), and major bleeding events (OR, 0.59; 95% CI, 0.30-1.15; P = 0.12).
  
  
  CONCLUSIONS
  The results indicate that short-term DAPT do not increase the risk of cardiac death, myocardial infarction, stent thrombosis, target vessel revascularization, major bleeding, cerebrovascular accidents, and all-cause death at 12 months after implantation of DES compared with current standard-term DAPT. However, only 3 studies with second generation of DES are included in this meta-analysis. Further well-designed studies are still needed.
authors.affiliation: Departments of *Cardiology; and †Nephrology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, China.
authors.forename: Mao
authors.initials: M
authors.lastname: Liu
authors.forename: Jian
authors.initials: J
authors.lastname: Chen
authors.forename: Dan
authors.initials: D
authors.lastname: Huang
authors.forename: Jianting
authors.initials: J
authors.lastname: Ke
authors.forename: Wenyi
authors.initials: W
authors.lastname: Tang
authors.forename: Wei
authors.initials: W
authors.lastname: Wu
mesh_terms: D004359:Drug Therapy, Combination; D054855:Drug-Eluting Stents; D000068338:Everolimus; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D020123:Sirolimus / Q000008:administration & dosage / Q000031:analogs & derivatives; D013997:Time Factors
chemical_list: D010975:Platelet Aggregation Inhibitors; D000068338:Everolimus; C489443:zotarolimus; D020123:Sirolimus