Dual Antiplatelet Therapy Duration in Patients at High Bleeding Risk

Among patients at high bleeding risk (HBR) undergoing percutaneous coronary intervention (PCI), is an abbreviated dual antiplatelet therapy (DAPT) regimen safer and as effective as standard DAPT duration?In this systematic review and meta-analysis of 14 randomized clinical trials, including 11 398 patients at HBR, abbreviated DAPT (1-month to 3-month) was associated with significantly lower bleeding risk compared with standard DAPT (6-month to 12-month). In comparisons with standard DAPT, abbreviated regimens were not associated with an increase in major adverse cardiovascular events, and an increased risk of major adverse cardiovascular events was observed with 1 vs 3 months of DAPT in the single trial comparing these 2 regimens, but the network estimate was nonsignificant.In this meta-analysis, abbreviated DAPT was associated with less bleeding and, at least for 3-month regimens, was not associated with an increase in ischemic risk in patients at HBR undergoing PCI.

Corresponding Author: Marco Valgimigli, MD, PhD, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Via Tesserete, 48, CH-6900 Lugano, Switzerland (marco.valgimigli@eoc.ch).

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