Abstract | BACKGROUND: older patients undergoing percutaneous coronary intervention (PCI) represent a growing population sharing both a high ischemic and bleeding risk. Dual antiplatelet therapy ( DAPT) reduces the incidence of thrombotic events but exposes patients to an increased risk of bleeding and subsequent mortality. Its optimal duration after PCI remains unclear. OBJECTIVE: to assess the impact of short-duration DAPT on both bleeding and ischemic events in the specific population of older patients undergoing PCI. METHODS: we performed a meta-analysis of randomised controlled trials comparing the safety and efficacy of standard versus very short duration (≤ 3 months, followed by P2Y12 inhibitor monotherapy) DAPT after PCI with a drug-eluting stent in older patients. RESULTS: four studies, representing 8,961 older patients, were finally included. Compared with standard duration, short-duration DAPT was associated with similar rates of major bleeding (relative risks, RR 0.70 [0.47; 1.05]) and the composite efficacy endpoint (RR 0.85 [0.63; 1.14]). There was a high level of heterogeneity between the studies (I2 = 68%) regarding major bleeding. CONCLUSION: our meta-analysis suggests that short DAPT may be a valid option in older patients after PCI but it also highlights the need for specific studies in such patients on optimal duration of antiplatelet therapy.
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Authors | Vincent Roule, Adrien Lemaitre, Wilhelm Pommier, Mathieu Bignon, Rémi Sabatier, Katrien Blanchart, Farzin Beygui |
Journal | Age and ageing
(Age Ageing)
Vol. 50
Issue 4
Pg. 1102-1107
(06 28 2021)
ISSN: 1468-2834 [Electronic] England |
PMID | 33755049
(Publication Type: Journal Article, Meta-Analysis)
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Copyright | © The Author(s) 2021. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: [email protected]. |
Chemical References |
- Platelet Aggregation Inhibitors
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Topics |
- Aged
- Drug Therapy, Combination
- Drug-Eluting Stents
- Dual Anti-Platelet Therapy
- Humans
- Myocardial Infarction
- Percutaneous Coronary Intervention
(adverse effects)
- Platelet Aggregation Inhibitors
(adverse effects)
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