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Efficacy and safety of short-term dual antiplatelet therapy in East Asians: a systematic review and a meta-analysis of randomized clinical trials.
Journal of Cardiovascular Pharmacology  (IF3.105),  Pub Date : 2021-11-22, DOI: 10.1097/fjc.0000000000001181
Ying Ma, Peng-Yu Zhong, Yao-Sheng Shang, Nan Bai, Ying Niu, Zhi-Lu Wang

The optimal duration of dual antiplatelet therapy (DAPT) for patients implanted with new-generation drug-eluting stents (DES) in East Asians is currently still controversial. The purpose of this meta-analysis was to investigate the efficacy and safety of short-term DAPT in patients with those. In this study, randomized controlled trials from PubMed, EMBASE, and Cochrane Library were searched to compare the efficacy and safety of short-term DAPT (6- month or less) with long-term DAPT (12- month or more) in patients implanted with new-generation DES in East Asian from inception to September 2020. The primary efficacy outcome was all-cause death, the primary safety outcome was major bleeding, and the secondary outcomes included cardiovascular death, myocardial infarction, definite or possible stent thrombosis, and stroke.A total of six randomized controlled trials with 15688 patients met inclusion criteria, there were no significant differences in the incidence of all-cause death (RR 1.03, 0.76-1.39, P=0.856), cardiovascular death (RR 0.83, 0.55-1.24, P=0.361), myocardial infarction (RR 0.97, 0.72-1.31, P=0.853), definite or possible stent thrombosis (RR 1.52, 0.83-2.78, P=0.170) and stroke (RR 0.90, 0.61-1.31, P=0.574) between short- term and long- term DAPTs. However, there was a significant difference in the risk of major bleeding (RR 0.64, 0.49-0.85, P=0.002) between the two groups. Compared with long-term DAPT, the short-term DAPT can reduce the risk of major bleeding without increasing the risk of death or ischemia for East Asians (Registered by PROSPERO, CRD42020213266).