Coronary disease & ACSMeta-analysis
Dual Antiplatelet Therapy Duration in Patients at High Bleeding Risk
- Systematic review and meta-analysis of randomised trials
- pairwise meta-analysis
- frequentist network meta-analysis
Authors' conclusion
In this systematic review and meta-analysis, for patients at HBR undergoing PCI, abbreviated DAPT was associated with a lower risk of bleeding and, at least for 3-month regimens, was not associated with an increase in fatal or nonfatal ischemic cardiovascular or cerebrovascular events compared with standard 6- to 12-month DAPT.
Study context
- Population
- Patients at high bleeding risk undergoing percutaneous coronary intervention (PCI) without an indication for oral anticoagulation
- Participants
- 11,398 patients · 14 randomized clinical trials (RCTs)
- Comparison
- Abbreviated vs standard DAPT
- Outcome
- Coprimary: major or clinically relevant nonmajor bleeding (MCRB, safety) and MACE (CV death, MI or stroke, efficacy)
Pooled result
Coprimary: MCRB (safety) and MACE (efficacy)
Relative risk
0.71
95% CI 0.55–0.92
P = 0.009
Abbreviated DAPT vs Standard DAPT
RR 0.71 (95% CI 0.55–0.92); P = 0.009
As reported in the abstract
Further pooled results
| Outcome | RR (95% CI) | |
|---|---|---|
| MACE, 1-month vs 3-month DAPT (network meta-analysis) | 1.28 (0.96–1.72) | |
| 0.512Relative risk (log scale) |
- Major adverse cardiovascular events (MACE), 1-month vs 3-month DAPT (network meta-analysis): network estimate nonsignificant; increased risk in the single direct trial
MACE components
- Individual components of MACE did not differ between abbreviated and standard regimens
Safety
| Outcome | RR (95% CI) | P value | |
|---|---|---|---|
| Major bleeding | 0.76 (0.59–0.99) | P = 0.04 | |
| 0.512Relative risk (log scale) |
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Dual Antiplatelet Therapy Duration in Patients at High Bleeding Risk. JAMA Cardiol. Published 1 August 2026. doi:10.1001/jamacardio.2026.1922
Summarised from the published abstract; every number is checked against it