Short- versus long-term dual antiplatelet therapy after second-generation drug-eluting stent implantation in patients with diabetes mellitus: A meta-analysis of randomized controlled trials.

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  • Author(s): Zhang H;Zhang H; Ke J; Ke J; Huang J; Huang J; Xu K; Xu K; Chen Y; Chen Y
  • Source:
    PloS one [PLoS One] 2020 Dec 16; Vol. 15 (12), pp. e0242845. Date of Electronic Publication: 2020 Dec 16 (Print Publication: 2020).
  • Publication Type:
    Comparative Study; Journal Article; Meta-Analysis
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE
    • Publication Information:
      Original Publication: San Francisco, CA : Public Library of Science
    • Subject Terms:
      Drug-Eluting Stents* ; Randomized Controlled Trials as Topic*; Diabetes Mellitus/*drug therapy ; Platelet Aggregation Inhibitors/*therapeutic use; Humans ; Time Factors ; Treatment Outcome
    • Abstract:
      Background: Diabetes is considered to be a high-risk factor for thromboembolic events. However, available data about the optimal dual antiplatelet therapy (DAPT) in patients with diabetes mellitus (DM) after second-generation drug-eluting stent (DES) implantation are scant.
      Objective: The purpose of this study was to compare the impact of various DAPT durations on clinical outcomes in patients with DM after second-generation DES implantation.
      Methods: We searched PubMed, Embase, and the Cochrane Library for studies that compared short-term (≤ 6 months) and long-term (≥ 12 months) DAPT in patients with DM. The primary endpoints were late (31-365 days) and very late (> 365 days) stent thrombosis (ST). The secondary endpoints included myocardial infarction (MI), target vessel recanalization (TVR), all-cause death, and major bleeding.
      Results: Six randomized controlled trials, with a total of 3,657 patients with DM, were included in the study. In terms of the primary endpoint, there was no significant difference between the two groups in late (OR 1.15, 95% CI: 0.42-3.19, P = 0.79) or very late (OR 2.18, 95% CI: 0.20-24.18; P = 0.53) ST. Moreover, there was no significant difference in the secondary endpoints, including MI (OR 1.11, 95% CI: 0.72-1.71, P = 0.63), TVR (OR 1.31, 95% CI: 0.82-2.07, P = 0.26), all-cause death (OR 1.03, 95% CI: 0.61-1.75, P = 0.90) and major bleeding (OR 1.07, 95% CI: 0.34-3.40, P = 0.90) between the two groups.
      Conclusion: Our study demonstrated that compared with long-term DAPT, short-term DAPT had no significant difference in the clinical outcomes of patients with DM implanted with second-generation DES.
      Competing Interests: The authors have declared that no competing interests exist.
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    • Accession Number:
      0 (Platelet Aggregation Inhibitors)
    • Publication Date:
      Date Created: 20201216 Date Completed: 20210118 Latest Revision: 20210118
    • Publication Date:
      20240105
    • Accession Number:
      PMC7743959
    • Accession Number:
      10.1371/journal.pone.0242845
    • Accession Number:
      33326442