title: [Meta-analysis of the combination of warfarin and clopidogrel after coronary stenting in patients with indications for chronic oral anticoagulation].
abstract: OBJECTIVE
  To investigate the safety and efficacy of dual antithrombotic regimen of warfarin and clopidogrel in patients who underwent coronary stenting and were with chronic oral anticoagulation.
  
  
  METHODS
  Two investigators independently searched Pubmed, Embase and Cochrane for all reported studies, and yielding 6 articles, published before April 2015, enrolling 4 825 patients, follow-up for at least 12 months. Two investigators independently recorded the data regarding interventions and the occurrence of major bleeding, ischemic stroke, myocardial infarction and death. RevMan5.3 was used to do analysis.
  
  
  RESULTS
  Patients on dual antithrombotic regimen had insignificant reduction in major bleeding (odds ratio[OR]was 0.73, 95% confidence interval[CI]was from 0.46 to 1.14, and P=0.16) as compared with triple therapy. While the risk of ischemic stroke (OR= 0.78, 95%CI:0.44-1.38, P=0.39), myocardial infarction (OR= 1.19, 95%CI:0.92-1.53, P=0.18) and the overall incidence of death (OR=0.95, 95%CI:0.56-1.60, P=0.84) were also comparable between the two regimens.
  
  
  CONCLUSIONS
  Dual antithrombotic regimen of warfarin and clopidogrel is comparable to the recommended triple therapy in respect to the prevention of thromboembolic outcomes of MI/ death and ischemic stroke, while the risk of bleeding is similar in those patients with indications for chronic oral anticoagulation undergoing percutaneous coronary intervention with stent implantation.
authors.affiliation: Department of Cardiology, the Second Affiliated Hospital of Zhejiang University Medical College, Hangzhou 310009, China.
authors.forename: Gaigai
authors.initials: G
authors.lastname: Ma
authors.forename: Miaomiao
authors.initials: M
authors.lastname: Du
authors.forename: Dongming
authors.initials: D
authors.lastname: Zhang
authors.forename: Yuping
authors.initials: Y
authors.lastname: Shi
mesh_terms: D000284:Administration, Oral; D000077144:Clopidogrel; D003327:Coronary Disease; D004359:Drug Therapy, Combination; D006470:Hemorrhage; D006801:Humans; D009203:Myocardial Infarction; D062645:Percutaneous Coronary Intervention; D010975:Platelet Aggregation Inhibitors; D015607:Stents; D020521:Stroke; D013988:Ticlopidine / Q000031:analogs & derivatives; D014859:Warfarin
chemical_list: D010975:Platelet Aggregation Inhibitors; D014859:Warfarin; D000077144:Clopidogrel; D013988:Ticlopidine