Shorter- versus Longer-duration Dual Antiplatelet Therapy in Patients with Diabetes Mellitus Undergoing Drug-eluting Stents Implantation: A Meta-analysis of Randomized Controlled Trials

BACKGROUND: Patients with diabetes mellitus (DM) have a higher risk of thromboembolic events; however, the optimal duration of dual antiplatelet therapy (DAPT) remains unclear. The goal of this study was to assess the efficacy and safety of various DAPT durations in patients with DM undergoing drug-...

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Autores principales: Huang, He, Li, Ya, Chen, Yu, Fu, Guo-Sheng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5146796/
https://www.ncbi.nlm.nih.gov/pubmed/27901002
http://dx.doi.org/10.4103/0366-6999.194663
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author Huang, He
Li, Ya
Chen, Yu
Fu, Guo-Sheng
author_facet Huang, He
Li, Ya
Chen, Yu
Fu, Guo-Sheng
author_sort Huang, He
collection PubMed
description BACKGROUND: Patients with diabetes mellitus (DM) have a higher risk of thromboembolic events; however, the optimal duration of dual antiplatelet therapy (DAPT) remains unclear. The goal of this study was to assess the efficacy and safety of various DAPT durations in patients with DM undergoing drug-eluting stent implantation. METHODS: We conducted a literature search for randomized controlled trials (RCTs). We searched databases including EMBASE, PubMed, Cochrane Library, and Scopus up to June 2016. Investigators extracted data independently, including outcomes, characteristics, and study quality. A random-effect model was used to pool odds ratios (ORs) with 95% confidence intervals (CIs) of the clinical outcomes. RESULTS: Six RCTs totaling 6040 patients with DM were included in the study. Shorter-duration DAPT resulted in an increased rate of stent thrombosis (ST) (OR, 1.83, 95% CI: 1.03–3.26, P = 0.04), but did not increase the risk of myocardial infarction (OR, 1.33, 95% CI: 0.71–2.47, P = 0.37), stroke (OR, 0.96, 95% CI: 0.52–1.77, P = 0.90), target vessel revascularization (OR, 1.19, 95% CI: 0.46–3.07, P = 0.71), all-cause death (OR: 0.72, 95% CI: 0.48–1.09, P = 0.12), or cardiac death (OR, 0.82, 95% CI: 0.49–1.36, P = 0.44) significantly. Shorter-duration DAPT was associated with a decreased risk of major bleeding (OR, 0.60, 95% CI: 0.38–0.94, P = 0.02). CONCLUSION: In patients with DM, longer-duration DAPT had a lower risk of ST, but was associated with an increased bleeding risk.
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spelling pubmed-51467962016-12-19 Shorter- versus Longer-duration Dual Antiplatelet Therapy in Patients with Diabetes Mellitus Undergoing Drug-eluting Stents Implantation: A Meta-analysis of Randomized Controlled Trials Huang, He Li, Ya Chen, Yu Fu, Guo-Sheng Chin Med J (Engl) Meta Analysis BACKGROUND: Patients with diabetes mellitus (DM) have a higher risk of thromboembolic events; however, the optimal duration of dual antiplatelet therapy (DAPT) remains unclear. The goal of this study was to assess the efficacy and safety of various DAPT durations in patients with DM undergoing drug-eluting stent implantation. METHODS: We conducted a literature search for randomized controlled trials (RCTs). We searched databases including EMBASE, PubMed, Cochrane Library, and Scopus up to June 2016. Investigators extracted data independently, including outcomes, characteristics, and study quality. A random-effect model was used to pool odds ratios (ORs) with 95% confidence intervals (CIs) of the clinical outcomes. RESULTS: Six RCTs totaling 6040 patients with DM were included in the study. Shorter-duration DAPT resulted in an increased rate of stent thrombosis (ST) (OR, 1.83, 95% CI: 1.03–3.26, P = 0.04), but did not increase the risk of myocardial infarction (OR, 1.33, 95% CI: 0.71–2.47, P = 0.37), stroke (OR, 0.96, 95% CI: 0.52–1.77, P = 0.90), target vessel revascularization (OR, 1.19, 95% CI: 0.46–3.07, P = 0.71), all-cause death (OR: 0.72, 95% CI: 0.48–1.09, P = 0.12), or cardiac death (OR, 0.82, 95% CI: 0.49–1.36, P = 0.44) significantly. Shorter-duration DAPT was associated with a decreased risk of major bleeding (OR, 0.60, 95% CI: 0.38–0.94, P = 0.02). CONCLUSION: In patients with DM, longer-duration DAPT had a lower risk of ST, but was associated with an increased bleeding risk. Medknow Publications & Media Pvt Ltd 2016-12-05 /pmc/articles/PMC5146796/ /pubmed/27901002 http://dx.doi.org/10.4103/0366-6999.194663 Text en Copyright: © 2016 Chinese Medical Journal http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Meta Analysis
Huang, He
Li, Ya
Chen, Yu
Fu, Guo-Sheng
Shorter- versus Longer-duration Dual Antiplatelet Therapy in Patients with Diabetes Mellitus Undergoing Drug-eluting Stents Implantation: A Meta-analysis of Randomized Controlled Trials
title Shorter- versus Longer-duration Dual Antiplatelet Therapy in Patients with Diabetes Mellitus Undergoing Drug-eluting Stents Implantation: A Meta-analysis of Randomized Controlled Trials
title_full Shorter- versus Longer-duration Dual Antiplatelet Therapy in Patients with Diabetes Mellitus Undergoing Drug-eluting Stents Implantation: A Meta-analysis of Randomized Controlled Trials
title_fullStr Shorter- versus Longer-duration Dual Antiplatelet Therapy in Patients with Diabetes Mellitus Undergoing Drug-eluting Stents Implantation: A Meta-analysis of Randomized Controlled Trials
title_full_unstemmed Shorter- versus Longer-duration Dual Antiplatelet Therapy in Patients with Diabetes Mellitus Undergoing Drug-eluting Stents Implantation: A Meta-analysis of Randomized Controlled Trials
title_short Shorter- versus Longer-duration Dual Antiplatelet Therapy in Patients with Diabetes Mellitus Undergoing Drug-eluting Stents Implantation: A Meta-analysis of Randomized Controlled Trials
title_sort shorter- versus longer-duration dual antiplatelet therapy in patients with diabetes mellitus undergoing drug-eluting stents implantation: a meta-analysis of randomized controlled trials
topic Meta Analysis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5146796/
https://www.ncbi.nlm.nih.gov/pubmed/27901002
http://dx.doi.org/10.4103/0366-6999.194663
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