Author + information
- Mohamed Morsy,
- Mark Heckle,
- Muhammad Shahreyar,
- Glenda Delgado,
- Kodangudi Ramanathan,
- Kelly Rogers and
- Rahman Shah
Background: The cornerstone therapy for patients with coronary artery stents is dual antiplatelet therapy. In 5% to 10% of these patients, oral anticoagulation (OAC) is clearly indicated. However, the optimal duration for triple antithrombotic therapy (TAT) in patients with drug-eluting stents (DESs) remains uncertain. Therefore, we conducted an updated meta-analysis of randomized controlled trials (RCTs) and observational studies to assess the efficacy and safety of shorter-duration (≤ 6 weeks) versus longer-duration TAT.
Methods: Relevant studies were included in random-effects models to determine pooled risk ratios (RRs).
Results: Ten studies involving 9746 patients were included. No differences between short-term and long-term TAT were found in the risks for all-cause mortality (RR, 1.01; 95% CI, 0.65-1.57; P = 0.943), MACE (RR, 1.13; 95% CI, 0.86-1.50; P = 0.362), stent thrombosis (RR, 1.04; 95% CI, 0.62-1.73; P = 0.880), or major bleeding (RR, 0.99; 95% CI, 0.79-1.24; P = 0.943). Sensitivity analysis using RCT data only did not change our findings.
Conclusions: In patients with DESs and clear indications for OAC, a shorter TAT (≤ 6 weeks) was associated with clinical outcomes similar to those with longer TAT. These findings need confirmation in a larger, well-powered trial.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Antithrombotic Therapy in Ischemic Heart Disease
Abstract Category: 3. Acute and Stable Ischemic Heart Disease: Therapy
Presentation Number: 1252-304
- 2017 American College of Cardiology Foundation