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Effects of single versus dual antiplatelet therapy on the adverse events after transcatheter aortic valve implantation: A meta‐analysis

Dual antiplatelet therapy (DAPT) was currently recommended for transcatheter aortic valve implantation (TAVI) postoperative management in clinical application. However, POPular‐TAVI trial showed DAPT increased the incidence of adverse events compared to single antiplatelet therapy (SAPT). Herein, we...

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Autores principales: Yu, Shengqin, Zhang, Shuying, Yao, Changli, Liu, Jihong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wiley Periodicals, Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8715399/
https://www.ncbi.nlm.nih.gov/pubmed/34664716
http://dx.doi.org/10.1002/clc.23731
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author Yu, Shengqin
Zhang, Shuying
Yao, Changli
Liu, Jihong
author_facet Yu, Shengqin
Zhang, Shuying
Yao, Changli
Liu, Jihong
author_sort Yu, Shengqin
collection PubMed
description Dual antiplatelet therapy (DAPT) was currently recommended for transcatheter aortic valve implantation (TAVI) postoperative management in clinical application. However, POPular‐TAVI trial showed DAPT increased the incidence of adverse events compared to single antiplatelet therapy (SAPT). Herein, we performed a meta‐analysis to investigate the effect of SAPT versus DAPT on the adverse events after TAVI. Eleven studies were available from PubMed, Embase, Cochrane Library, and Web of Science from inception to April 1, 2021. The pooled effect size was presented as relative risk (RR) with 95% confidence intervals (CIs). The sensitivity analysis was used to assess the stability of analysis results, and Begg's test was applied to evaluate the publication bias. The Cochran Q test and the I (2) statistic were used to evaluate the heterogeneity, and the source of heterogeneity was explored by meta‐regression. A total of 4804 patients were obtained, with 2257 in SAPT group and 2547 in DAPT group. Compared to the DAPT, SAPT was associated with the decreased risk of all‐cause bleeding (RR: 0.51, 95% CI: 0.44–0.61), major bleeding (RR: 0.53, 95% CI: 0.32–0.86), and minor bleeding (RR: 0.58, 95% CI: 0.34–0.98). There were no significant differences in mortality and myocardial infarction events, stroke events, and acute kidney injury between the two groups. SAPT was superior to DAPT in decreasing all‐cause bleeding, major bleeding, and minor bleeding, suggesting that SAPT could be preferentially recommended for TAVI postoperative management in most patients without another indication for DAPT and oral anticoagulation.
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spelling pubmed-87153992022-01-06 Effects of single versus dual antiplatelet therapy on the adverse events after transcatheter aortic valve implantation: A meta‐analysis Yu, Shengqin Zhang, Shuying Yao, Changli Liu, Jihong Clin Cardiol Reviews Dual antiplatelet therapy (DAPT) was currently recommended for transcatheter aortic valve implantation (TAVI) postoperative management in clinical application. However, POPular‐TAVI trial showed DAPT increased the incidence of adverse events compared to single antiplatelet therapy (SAPT). Herein, we performed a meta‐analysis to investigate the effect of SAPT versus DAPT on the adverse events after TAVI. Eleven studies were available from PubMed, Embase, Cochrane Library, and Web of Science from inception to April 1, 2021. The pooled effect size was presented as relative risk (RR) with 95% confidence intervals (CIs). The sensitivity analysis was used to assess the stability of analysis results, and Begg's test was applied to evaluate the publication bias. The Cochran Q test and the I (2) statistic were used to evaluate the heterogeneity, and the source of heterogeneity was explored by meta‐regression. A total of 4804 patients were obtained, with 2257 in SAPT group and 2547 in DAPT group. Compared to the DAPT, SAPT was associated with the decreased risk of all‐cause bleeding (RR: 0.51, 95% CI: 0.44–0.61), major bleeding (RR: 0.53, 95% CI: 0.32–0.86), and minor bleeding (RR: 0.58, 95% CI: 0.34–0.98). There were no significant differences in mortality and myocardial infarction events, stroke events, and acute kidney injury between the two groups. SAPT was superior to DAPT in decreasing all‐cause bleeding, major bleeding, and minor bleeding, suggesting that SAPT could be preferentially recommended for TAVI postoperative management in most patients without another indication for DAPT and oral anticoagulation. Wiley Periodicals, Inc. 2021-10-19 /pmc/articles/PMC8715399/ /pubmed/34664716 http://dx.doi.org/10.1002/clc.23731 Text en © 2021 The Authors. Clinical Cardiology published by Wiley Periodicals LLC. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Reviews
Yu, Shengqin
Zhang, Shuying
Yao, Changli
Liu, Jihong
Effects of single versus dual antiplatelet therapy on the adverse events after transcatheter aortic valve implantation: A meta‐analysis
title Effects of single versus dual antiplatelet therapy on the adverse events after transcatheter aortic valve implantation: A meta‐analysis
title_full Effects of single versus dual antiplatelet therapy on the adverse events after transcatheter aortic valve implantation: A meta‐analysis
title_fullStr Effects of single versus dual antiplatelet therapy on the adverse events after transcatheter aortic valve implantation: A meta‐analysis
title_full_unstemmed Effects of single versus dual antiplatelet therapy on the adverse events after transcatheter aortic valve implantation: A meta‐analysis
title_short Effects of single versus dual antiplatelet therapy on the adverse events after transcatheter aortic valve implantation: A meta‐analysis
title_sort effects of single versus dual antiplatelet therapy on the adverse events after transcatheter aortic valve implantation: a meta‐analysis
topic Reviews
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8715399/
https://www.ncbi.nlm.nih.gov/pubmed/34664716
http://dx.doi.org/10.1002/clc.23731
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