P2Y12 inhibitor monotherapy after short dual antiplatelet therapy (DAPT) in acute coronary syndrome: a systematic review and meta-analysis
Pooled result · MACEResult — go to the resultOdds ratio 0.92 95% CI 0.76–1.12Authors' conclusion
In patients with ACS, P2Y12 inhibitor monotherapy after short DAPT halves bleeding without increasing ischaemic events compared with standard DAPT.
Study context
- Population
- Patients with acute coronary syndrome (ACS)
- Participants
- 27,284 patients7 RCTs
- Comparison
- P2Y12 inhibitor monotherapy after short DAPT vs 12-month DAPT
- Outcome
- Major adverse cardiovascular events (MACE)
Methodological detailstrial sequential analysis
- Trial sequential analysis
Pooled result
As reported in the abstract
Odds ratio
0.92
95% CI 0.76–1.12
P2Y12 inhibitor monotherapyvs 12-month DAPT
OR 0.92 (95% CI 0.76–1.12)
Further pooled results
| Outcome | OR (95% CI) | |
|---|---|---|
| Net adverse clinical events (NACE) | 0.75 (0.60–0.94) | |
| 0.512Odds ratio (log scale) |
- Net adverse clinical events (NACE): ticagrelor vs clopidogrel interaction Pint = 0.018
Net adverse clinical events (NACE)
- Trial sequential analysis: conclusive evidence of improved NACE with ticagrelor, but not clopidogrel monotherapy, vs standard DAPT
Ticagrelor vs clopidogrel monotherapy subgroup difference: all-cause death, MI
- All-cause death interaction
- Pint = 0.042
- MI interaction
- Pint = 0.028
Safety
| Outcome | OR (95% CI) | |
|---|---|---|
| Any bleeding | 0.54 (0.43–0.66) | |
| Major bleeding | 0.47 (0.37–0.60) | |
| 0.20.5125Odds ratio (log scale) |
Original publication
P2Y12 inhibitor monotherapy after short DAPT in acute coronary syndrome: a systematic review and meta-analysis. Eur Heart J Cardiovasc Pharmacother. Published 25 July 2024. doi:10.
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