Coronary disease & ACS

Dual Antiplatelet Therapy Duration in Patients at High Bleeding Risk: A Systematic Review and Meta-Analysis

JAMA CardiolPublished Systematic review and meta-analysis of randomised trials

Pooled result · Coprimary: MCRB (safety) and MACE (efficacy)Result — go to the resultRelative risk 0.71 95% CI 0.55–0.92

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)
Methodological detailspairwise meta-analysis, frequentist network meta-analysis
  • Pairwise meta-analysis
  • Frequentist network meta-analysis

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

OutcomeRR (95% CI)
MACE, 1-month vs 3-month DAPT (network meta-analysis)1.28 (0.96–1.72)
  • 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

OutcomeRR (95% CI)P value
Major bleeding0.76 (0.59–0.99)P = 0.04

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: A Systematic Review and Meta-Analysis. JAMA Cardiol. Published 1 August 2026. doi:10.1001/jamacardio.2026.1922

Summarised from the published abstract; every number is checked against it

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