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-...
Autores principales: | , , , |
---|---|
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 |
_version_ | 1782473552483581952 |
---|---|
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. |
format | Online Article Text |
id | pubmed-5146796 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT huanghe shorterversuslongerdurationdualantiplatelettherapyinpatientswithdiabetesmellitusundergoingdrugelutingstentsimplantationametaanalysisofrandomizedcontrolledtrials AT liya shorterversuslongerdurationdualantiplatelettherapyinpatientswithdiabetesmellitusundergoingdrugelutingstentsimplantationametaanalysisofrandomizedcontrolledtrials AT chenyu shorterversuslongerdurationdualantiplatelettherapyinpatientswithdiabetesmellitusundergoingdrugelutingstentsimplantationametaanalysisofrandomizedcontrolledtrials AT fuguosheng shorterversuslongerdurationdualantiplatelettherapyinpatientswithdiabetesmellitusundergoingdrugelutingstentsimplantationametaanalysisofrandomizedcontrolledtrials |