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To date, the optimal duration of double antiplate plate plate therapy (DAPT) after drug-washed stents has been placed in the coronary artery interventional therapy remains uncertain.
study compared the effects of short-term (-lt;6-month) DAPT follow-up aspirin or P2Y12 inhibitors single therapy, medium-term (6-month) DAPT, 12-month DAPT, and extended-period (-gt;12 months) DAPT therapy on patient prognosis.
DAPT intervention network screened 24 randomized controlled trials up to September 2019 through Medline, Embase, Cochrane libraries and online databases.
main endpoints were myocardial infarction and haemorrhage (which constituted a net clinical benefit).
meta-analysis of myocardial infarction and haemorrhage was 79,073 patients, with median follow-up for 18 months, and extended DAPT treatment was associated with a reduced risk of myocardial infarction compared to other duration OFT treatments (compared to a 12-month DAPT relative risk of 0.68 (95% CI), 0.54-0.87, with a relative risk of 0.61 (0.45-0.83) for medium-term DAPT and 0.69 (0.51-0.95) with short-term DAPT for aspirin monodriffs.
, the risk of haemorrhage from prolonged DAPT treatment was higher than in all other DAPT groups.
compared with 12-month DAPT, there was no significant difference in the risk of ischemia endpoint or haemorrhage between medium- or short-term DAPT aspirin treatments, except for the single treatment of short-term DAPT-P2Y12 inhibitors associated with reduced risk of haemorrhage.
there was no significant difference in mortality between the different DAPT programmes.
in acute coronary artery syndrome, the extended DAPT program was associated with a reduced risk of myocardial infarction compared to the 12-month DAPT program, and did not significantly increase the risk of haemorrhage.
Clinical prognosis This meta-analysis shows that compared with the 12-month DAPT program, the short-term DAPT combined P2Y12 inhibitor single treatment can reduce the risk of haemorrhage after the coronary artery intervention is placed into the drug escape stent, while the long-term DAPT treatment can reduce myocardial infarction, but there will be more bleeding events.
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