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J Clin Med. 2020;9(3):jcm9030652.

Efficacy and Safety of Long-Term and Short-Term Dual Antiplatelet Therapy: A Meta-Analysis of Comparison between Asians and Non-Asians.

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제1저자 기유정, 강지훈 · 교신저자 박경우

소속 (1)
  1. Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul 03080, Korea.

Abstract

While dual antiplatelet therapy (DAPT) is essential after percutaneous coronary intervention (PCI), the optimal duration is affected by various factors. However, the effect of ethnicity on DAPT duration has not been fully evaluated. In this study, we evaluated the different effect of DAPT duration by ethnicity. We searched Pubmed, Embase, Cochrane library, and relevant websites to search for randomized clinical trials (RCT) assessing the clinical impact of long term DAPT (L-DAPT) and short term DAPT (S-DAPT). Studies were divided by ethnicity, and we compared the efficacy and safety of DAPT duration in each ethnic group. Thirteen RCTs including 38,255 patients (five East Asian studies and eight non-East Asian studies) were eligible for analysis. For the primary outcome, L-DAPT showed a significantly lower rate of primary outcome only in non-East Asians (S-DAPT vs. L-DAPT, odds ratio (OR) = 1.16, 95% confidence interval (CI): 1.02-1.32, p = 0.02), while in East Asians, the effect of S-DAPT and L-DAPT were comparable. S-DAPT significantly increased ischemic events only in non-East Asians (S-DAPT vs. L-DAPT, OR = 1.24, 95% CI: 1.09-1.42, p <0.01), while bleeding events were decreased by S-DAPT in both ethnicities. These results demonstrate that the adequate DAPT duration after PCI may be different in East Asians.

Keywords

dual anti-platelet therapymeta-analysispercutaneous coronary intervention

Figures

Figure 1
Figure 1 Meta-analysis flow diagram. DAPT, dual anti platelet therapy; PCI, percutaneous coronary intervention; DES, drug eluting stent.
Figure 2
Figure 2 Primary outcome in randomized clinical trials. S-DAPT, short duration dual antiplatelet therapy; L-DAPT, long duration dual antiplatelet therapy; CI = confidence interval.
Figure 3
Figure 3 Ischemic outcomes in randomized clinical trials. S-DAPT, short duration dual antiplatelet therapy; L-DAPT, long duration dual antiplatelet therapy; CI, confidence interval.
Figure 4
Figure 4 Cardiac death in randomized clinical trials. S-DAPT, short duration dual antiplatelet therapy; L-DAPT, long duration dual antiplatelet therapy; CI, confidence interval.
Figure 5
Figure 5 Myocardial infarction in randomized clinical trials. S-DAPT, short duration dual antiplatelet therapy; L-DAPT, long duration dual antiplatelet therapy; CI, confidence interval.
Figure 6
Figure 6 Stent thrombosis in randomized clinical trials. S-DAPT, short duration dual antiplatelet therapy; L-DAPT, long duration dual antiplatelet therapy; CI, confidence interval.
Figure 7
Figure 7 Bleeding in randomized clinical trials. S-DAPT, short duration dual antiplatelet therapy; L-DAPT, long duration dual antiplatelet therapy; CI, confidence interval.

그림 출처: PubMed Central 공개 논문 (PMC7141296)

Conflict of interest statement

The authors declare no conflict of interest.

그 밖의 정보
출판 형태
Journal Article
저널
Journal of clinical medicine · ISSN 2077-0383
전자 출판
2020-02-28
참고문헌
34편