Abstract
Dual antiplatelet therapy (DAPT) is used in patients after drug-eluting stent (DES) implantation to prevent stent thrombosis and ischemic events. The ideal duration of DAPT in patients after DES implantation is a topic of debate among clinicians. In the past, many research studies were published related to an optimal duration of DAPT after DES implantation.In common practice, DAPT should be continued for one year or more after percutaneous coronary intervention (PCI) followed by DES implantation. The duration of DAPT is significant as long-term DAPT has beneficial effects but is associated with side effects like bleeding. On the other hand, short-term DAPT has a lower risk of bleeding, but it increases the rate of stent thrombosis or ischemic events. Our aim in this systematic review is to solve the dispute regarding the duration of DAPT after DES implantation. So, we tried to find the efficacy and safety of short-term (six months) DAPT by compiling data from randomized control trials (RCTs). We conducted this systematic review following the guidelines defined in the preferred reporting items for systematic reviews and meta-analyses (PRISMA) checklist. We searched for our data from multiple databases like PubMed, Web of Science, ScienceDirect, and Google Scholar. We reviewed 10964 studies and then applied inclusion/exclusion criteria and PRISMA guidelines. Finally, we were left with only 21 studies regarding the optimal duration of DAPT after DES implantation. Our systematic review will help determine the non-inferiority of short-term (six months) DAPT to long-term (12 months) DAPT. Furthermore, we also noticed with short-term (six months) DAPT, there was decreased incidence of bleeding as compared to DAPT for long-term. But more studies were required to establish the safety and effectiveness of short-term (six months) DAPT compared to long-term (12 months) DAPT in patients after DES implantation.
Highlights
BackgroundAround $219 billion in 2014 and 2015 was spent in the United States on heart diseases, including pharmaceutical and health care services related to heart disorders [1]
There is a critical trade-off between the dangers of ischemia and bleeding that must be carefully considered when determining the duration of Dual antiplatelet therapy (DAPT) [5]
This study data showed that the participants who presented with myocardial infarction (MI) and had drug-eluting stent (DES) implantation benefited from continued DATP beyond one year by decreasing the chance of stent thrombosis
Summary
BackgroundAround $219 billion in 2014 and 2015 was spent in the United States on heart diseases, including pharmaceutical and health care services related to heart disorders [1]. According to figures from the American Cardiology Association, 365,914 people were diagnosed with coronary heart disease in 2017 [2]. Dual antiplatelet therapy (DAPT) is prescribed to 1.2 million patients each year following drug-eluting stent (DES) implantation. Coronary artery disease (CAD), peripheral vascular disorders, and transient ischemic attack (TIA), DAPT is commonly prescribed in more than seven million patients globally [3]. Drug-eluting stent (DES) implantation after percutaneous coronary intervention (PCI) is the management of choice in a patient with the acute coronary syndrome (ACS) and stable angina. In the months following DES implantation, both aspirin and an additional platelet receptor (P2Y12) inhibitor are required to reduce the risk of stent thrombosis [4]. Extended DAPT use lowers the risk of ischemic events but raises the risk of bleeding events. There is a critical trade-off between the dangers of ischemia and bleeding that must be carefully considered when determining the duration of DAPT [5]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
