Optimal Duration of Dual-Antiplatelet Therapy Following Drug-Eluting Stent Implantation : A Meta-Analysis

作者：Zhang, Tuo; Shen, Linghong; Hu, Liuhua; He, Ben^*

来源：JOURNAL OF CLINICAL PHARMACOLOGY, 2013, 53(3): 345-351.

DOI：10.1177/0091270012448398

• dual antiplatelet therapy
• drug-eluting stent
• meta-analysis

Optimal duration of dual-antiplatelet therapy (DAPT) following drug-eluting stent (DES) implantation remains uncertain. The aim of this study was to perform a meta-analysis of trials evaluating the effect of DAPT duration on long-term clinical outcomes after DES implantation. The authors searched OvidMEDLINE, EMBASE, and the Cochrane Library for both randomized controlled trials and nonrandomized studies that evaluated DAPT duration on long-term clinical outcomes after DES implantation. The end point was the cumulative incidence of the composite of all-cause death and nonfatal myocardial infarction (MI) at maximum follow-up. Quantitative analysis was performed to estimate the pooled hazard ratios (HRs) for the effect of DAPT duration. The pooled effect of DAPT discontinuation before 6 months significantly increased risk of death and nonfatal MI (HR, 1.46; 95% confidence interval, 1.18-1.80), but DAPT beyond 12 months did not reduce the incidence of the composite end point compared with drug discontinuation at 12 months (HR, 0.91; 95% confidence interval, 0.75-1.10). In conclusion, the current evidence suggests that 6 to 12 months of DAPT may be optimal after DES implantation.

• 出版日期2013-3
• 单位上海交通大学