Cited 7 times in
Efficacy and safety of P2Y12 inhibitor monotherapy after complex PCI: a collaborative systematic review and meta-analysis
DC Field | Value | Language |
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dc.contributor.author | 김병극 | - |
dc.date.accessioned | 2024-03-27T00:49:53Z | - |
dc.date.available | 2024-03-27T00:49:53Z | - |
dc.date.issued | 2023-04 | - |
dc.identifier.issn | 2055-6837 | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/198741 | - |
dc.description.abstract | Aims: Complex percutaneous coronary intervention (C-PCI) is associated with an increased risk of ischaemic and bleeding complications. We aimed to assess the safety and efficacy of a 1-3-month dual antiplatelet therapy (DAPT) regimen followed by P2Y12 inhibitor monotherapy after C-PCI. Methods and results: We conducted a meta-analysis of randomized trials comparing a 1-3-month DAPT regimen followed by P2Y12 inhibitor monotherapy with standard (≥12 months) DAPT in patients undergoing C-PCI. C-PCI criteria and the co-primary bleeding and ischaemic outcomes were determined according to each trial. Secondary outcomes included major bleeding, all-cause death, myocardial infarction, and stent thrombosis. All outcomes were evaluated at 12 months after randomization. We used hazard ratios (HRs) and 95% confidence interval (CI) as a metric of choice for treatment effects with random-effects models. Among 8299 screened studies, five randomized trials fulfilled the eligibility criteria. In the pooled population of 34 615 patients, 8818 (25.5%) underwent C-PCI. As compared with standard DAPT, a 1-3-month DAPT regimen followed by P2Y12 inhibitor monotherapy reduced the bleeding risk in C-PCI (HR:0.66, 95% CI:0.44-0.98) and non-C-PCI (HR:0.60, 95% CI:0.45-0.79) patients (P-interaction = 0.735). Furthermore, the risk for the primary ischaemic endpoint was similar in patients randomized to either arm, with significant effect modification by PCI complexity showing an enhanced benefit of 1-3-month DAPT in patients undergoing C-PCI (C-PCI, HR:0.69, 95% CI:0.48-1.00; non-C-PCI, HR:1.04, 95% CI:0.84-1.30; P-interaction = 0.028). Conclusion: As compared with a standard DAPT, a 1-3-month DAPT regimen followed by P2Y12 inhibitor monotherapy reduced bleeding complications after C-PCI without increasing the risk of ischaemic events.PROSPERO-registered (CRD42021259271). | - |
dc.description.statementOfResponsibility | restriction | - |
dc.language | English | - |
dc.publisher | Oxford University Press | - |
dc.relation.isPartOf | EUROPEAN HEART JOURNAL-CARDIOVASCULAR PHARMACOTHERAPY | - |
dc.rights | CC BY-NC-ND 2.0 KR | - |
dc.subject.MESH | Aspirin / adverse effects | - |
dc.subject.MESH | Hemorrhage / chemically induced | - |
dc.subject.MESH | Humans | - |
dc.subject.MESH | Myocardial Infarction* / therapy | - |
dc.subject.MESH | Percutaneous Coronary Intervention* / adverse effects | - |
dc.subject.MESH | Percutaneous Coronary Intervention* / methods | - |
dc.subject.MESH | Platelet Aggregation Inhibitors / adverse effects | - |
dc.subject.MESH | Purinergic P2Y Receptor Antagonists / adverse effects | - |
dc.subject.MESH | Randomized Controlled Trials as Topic | - |
dc.title | Efficacy and safety of P2Y12 inhibitor monotherapy after complex PCI: a collaborative systematic review and meta-analysis | - |
dc.type | Article | - |
dc.contributor.college | College of Medicine (의과대학) | - |
dc.contributor.department | Dept. of Internal Medicine (내과학교실) | - |
dc.contributor.googleauthor | Johny Nicolas | - |
dc.contributor.googleauthor | George Dangas | - |
dc.contributor.googleauthor | Mauro Chiarito | - |
dc.contributor.googleauthor | Carlo A Pivato | - |
dc.contributor.googleauthor | Alessandro Spirito | - |
dc.contributor.googleauthor | Davide Cao | - |
dc.contributor.googleauthor | Gennaro Giustino | - |
dc.contributor.googleauthor | Frans Beerkens | - |
dc.contributor.googleauthor | Anton Camaj | - |
dc.contributor.googleauthor | Birgit Vogel | - |
dc.contributor.googleauthor | Samantha Sartori | - |
dc.contributor.googleauthor | Ko Yamamoto | - |
dc.contributor.googleauthor | Takeshi Kimura | - |
dc.contributor.googleauthor | Byeong-Keuk Kim | - |
dc.contributor.googleauthor | Usman Baber | - |
dc.contributor.googleauthor | Roxana Mehran | - |
dc.identifier.doi | 10.1093/ehjcvp/pvac071 | - |
dc.contributor.localId | A00493 | - |
dc.relation.journalcode | J03339 | - |
dc.identifier.eissn | 2055-6845 | - |
dc.identifier.pmid | 36564015 | - |
dc.identifier.url | https://academic.oup.com/ehjcvp/article-abstract/9/3/240/6958797 | - |
dc.subject.keyword | Antiplatelet therapy | - |
dc.subject.keyword | Aspirin | - |
dc.subject.keyword | Complex percutaneous coronary intervention | - |
dc.subject.keyword | Drug-eluting stent | - |
dc.contributor.alternativeName | Kim, Byeong Keuk | - |
dc.contributor.affiliatedAuthor | 김병극 | - |
dc.citation.volume | 9 | - |
dc.citation.number | 3 | - |
dc.citation.startPage | 240 | - |
dc.citation.endPage | 250 | - |
dc.identifier.bibliographicCitation | EUROPEAN HEART JOURNAL-CARDIOVASCULAR PHARMACOTHERAPY, Vol.9(3) : 240-250, 2023-04 | - |
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