Optimal antiplatelet strategy following coronary artery bypass grafting: a meta-analysis
Authors' conclusion
In patients with CABG, DAPT compared with SAPT and DAPT-T/P compared with DAPT-C were associated with reduction in all-cause and cardiovascular mortality, especially in patients with acute coronary syndrome. Additionally, DAPT was associated with reduction in MACCE, but higher rates of major and minor bleeding.
Study context
- Population
- Patients after coronary artery bypass grafting (CABG)
- Participants
- 77,447 patients · 38 studies
- Comparison
- DAPT vs SAPT, and DAPT-T/P vs DAPT-C, after CABG
- Outcome
- All-cause mortality, CV mortality, major adverse cardiac and cerebrovascular events (MACCE)
Methodological detailsrandom-effects models, PRISMA
- Random-effects models
- PRISMA
Pooled result
As reported in the abstract
Odds ratio (95% CI)P value
DAPT vs SAPTall-cause mortality
0.65(0.50–0.86)
P = 0.002DAPT vs SAPTCV mortality
0.53(0.33–0.84)
P = 0.008DAPT vs SAPTMACCE
0.68(0.51–0.91)
P = 0.01DAPT-T/P vs DAPT-Call-cause mortality
0.43(0.29–0.65)
P ≤ 0.0001DAPT-T/P vs DAPT-CCV mortality
0.44(0.24–0.80)
P = 0.008Safety
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| BleedingDAPT vs SAPT · major bleeding | 1.30 (1.08–1.56) | P = 0.007 | |
| BleedingDAPT vs SAPT · minor bleeding | 1.87 (1.28–2.74) | P = 0.001 | |
| 0.20.5125Odds ratio (log scale) |
Bleeding
- DAPT-T/P vs DAPT-C: no differences on bleeding outcomes
Original publication
Optimal antiplatelet strategy following coronary artery bypass grafting: a meta-analysis. Heart. Published 30 August 2023. doi:10.
Summarised from the published abstract; every number is checked against it