De-escalation of antiplatelet therapy after percutaneous coronary intervention among East Asians and non-East Asians: a meta-analysis of randomized controlled trials

Background To study the impact of de-escalation antiplatelet therapy retaining P2Y12 inhibition on major bleeding and ischemic outcomes after percutaneous coronary intervention (PCI) among East Asians and non-East Asians was unclear. Methods We systematically searched PubMed, Embase, and the Cochran...
Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Wang, Ge [verfasserIn] Wang, Xiao Zhao, Guanqi Huang, Xin Guo, Ruifeng Nie, Shaoping

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2022

Schlagwörter:	Antiplatelet therapy De-escalation Meta-analysis Percutaneous coronary intervention Randomized controlled trials

Anmerkung:	© The Author(s) 2022

Übergeordnetes Werk:	Enthalten in: BMC cardiovascular disorders - London : BioMed Central, 2001, 22(2022), 1 vom: 04. Feb.
Übergeordnetes Werk:	volume:22 ; year:2022 ; number:1 ; day:04 ; month:02

Links:	Volltext

DOI / URN:	10.1186/s12872-022-02476-1

Katalog-ID:	SPR05046390X

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520			\|a Background To study the impact of de-escalation antiplatelet therapy retaining P2Y12 inhibition on major bleeding and ischemic outcomes after percutaneous coronary intervention (PCI) among East Asians and non-East Asians was unclear. Methods We systematically searched PubMed, Embase, and the Cochrane Library for randomized controlled trials through September 2020. Eight trials were included, which studied de-escalation of DAPT (D-DAPT, switching to P2Y12 inhibitor monotherapy, or switching to clopidogrel or dose reduction of the P2Y12 inhibitor after 1 to 3 months) versus 12 months standard DAPT (S-DAPT). The primary outcomes data was conducted using random effects models. Results Among the 8 included trials consisting of 37,775 patients, 62.6% presented with acute coronary syndrome. The median follow-up duration ranged from 12 to 24 months. Compared with S-DAPT, D-DAPT was associated with a lower risk of major bleeding (RR = 0.67, 95% CI 0.48–0.93, p = 0.02); however, this was only observed among East-Asians (RR = 0.61, 95% CI 0.37–0.99, p = 0.048). Among non-East Asians, the rate of major bleeding was similar between the two groups (RR = 0.73, 95% CI 0.46–1.14, p = 0.17, p for interaction = 0.59). There were no significant differences in the major adverse cardiovascular events (MACE) between D-DAPT and S-DAPT treatment among both East Asians (RR = 0.84, 95% CI 0.66–1.08, p = 0.18) and non-East Asians (RR = 0.89, 95% CI 0.79–1.00, p = 0.059, p for interaction = 0.71). Conclusions The De-escalation strategy that retains P2Y12 inhibition after a PCI was associated with reduced risk of bleeding events, which was only demonstrated in East Asians patients, and not in non-East Asian patients.
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allfields	10.1186/s12872-022-02476-1 doi (DE-627)SPR05046390X (SPR)s12872-022-02476-1-e DE-627 ger DE-627 rakwb eng Wang, Ge verfasserin aut De-escalation of antiplatelet therapy after percutaneous coronary intervention among East Asians and non-East Asians: a meta-analysis of randomized controlled trials 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2022 Background To study the impact of de-escalation antiplatelet therapy retaining P2Y12 inhibition on major bleeding and ischemic outcomes after percutaneous coronary intervention (PCI) among East Asians and non-East Asians was unclear. Methods We systematically searched PubMed, Embase, and the Cochrane Library for randomized controlled trials through September 2020. Eight trials were included, which studied de-escalation of DAPT (D-DAPT, switching to P2Y12 inhibitor monotherapy, or switching to clopidogrel or dose reduction of the P2Y12 inhibitor after 1 to 3 months) versus 12 months standard DAPT (S-DAPT). The primary outcomes data was conducted using random effects models. Results Among the 8 included trials consisting of 37,775 patients, 62.6% presented with acute coronary syndrome. The median follow-up duration ranged from 12 to 24 months. Compared with S-DAPT, D-DAPT was associated with a lower risk of major bleeding (RR = 0.67, 95% CI 0.48–0.93, p = 0.02); however, this was only observed among East-Asians (RR = 0.61, 95% CI 0.37–0.99, p = 0.048). Among non-East Asians, the rate of major bleeding was similar between the two groups (RR = 0.73, 95% CI 0.46–1.14, p = 0.17, p for interaction = 0.59). There were no significant differences in the major adverse cardiovascular events (MACE) between D-DAPT and S-DAPT treatment among both East Asians (RR = 0.84, 95% CI 0.66–1.08, p = 0.18) and non-East Asians (RR = 0.89, 95% CI 0.79–1.00, p = 0.059, p for interaction = 0.71). Conclusions The De-escalation strategy that retains P2Y12 inhibition after a PCI was associated with reduced risk of bleeding events, which was only demonstrated in East Asians patients, and not in non-East Asian patients. Antiplatelet therapy (dpeaa)DE-He213 De-escalation (dpeaa)DE-He213 Meta-analysis (dpeaa)DE-He213 Percutaneous coronary intervention (dpeaa)DE-He213 Randomized controlled trials (dpeaa)DE-He213 Wang, Xiao aut Zhao, Guanqi aut Huang, Xin aut Guo, Ruifeng aut Nie, Shaoping aut Enthalten in BMC cardiovascular disorders London : BioMed Central, 2001 22(2022), 1 vom: 04. Feb. (DE-627)335488870 (DE-600)2059859-2 1471-2261 nnns volume:22 year:2022 number:1 day:04 month:02 https://dx.doi.org/10.1186/s12872-022-02476-1 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 22 2022 1 04 02
spelling	10.1186/s12872-022-02476-1 doi (DE-627)SPR05046390X (SPR)s12872-022-02476-1-e DE-627 ger DE-627 rakwb eng Wang, Ge verfasserin aut De-escalation of antiplatelet therapy after percutaneous coronary intervention among East Asians and non-East Asians: a meta-analysis of randomized controlled trials 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2022 Background To study the impact of de-escalation antiplatelet therapy retaining P2Y12 inhibition on major bleeding and ischemic outcomes after percutaneous coronary intervention (PCI) among East Asians and non-East Asians was unclear. Methods We systematically searched PubMed, Embase, and the Cochrane Library for randomized controlled trials through September 2020. Eight trials were included, which studied de-escalation of DAPT (D-DAPT, switching to P2Y12 inhibitor monotherapy, or switching to clopidogrel or dose reduction of the P2Y12 inhibitor after 1 to 3 months) versus 12 months standard DAPT (S-DAPT). The primary outcomes data was conducted using random effects models. Results Among the 8 included trials consisting of 37,775 patients, 62.6% presented with acute coronary syndrome. The median follow-up duration ranged from 12 to 24 months. Compared with S-DAPT, D-DAPT was associated with a lower risk of major bleeding (RR = 0.67, 95% CI 0.48–0.93, p = 0.02); however, this was only observed among East-Asians (RR = 0.61, 95% CI 0.37–0.99, p = 0.048). Among non-East Asians, the rate of major bleeding was similar between the two groups (RR = 0.73, 95% CI 0.46–1.14, p = 0.17, p for interaction = 0.59). There were no significant differences in the major adverse cardiovascular events (MACE) between D-DAPT and S-DAPT treatment among both East Asians (RR = 0.84, 95% CI 0.66–1.08, p = 0.18) and non-East Asians (RR = 0.89, 95% CI 0.79–1.00, p = 0.059, p for interaction = 0.71). Conclusions The De-escalation strategy that retains P2Y12 inhibition after a PCI was associated with reduced risk of bleeding events, which was only demonstrated in East Asians patients, and not in non-East Asian patients. Antiplatelet therapy (dpeaa)DE-He213 De-escalation (dpeaa)DE-He213 Meta-analysis (dpeaa)DE-He213 Percutaneous coronary intervention (dpeaa)DE-He213 Randomized controlled trials (dpeaa)DE-He213 Wang, Xiao aut Zhao, Guanqi aut Huang, Xin aut Guo, Ruifeng aut Nie, Shaoping aut Enthalten in BMC cardiovascular disorders London : BioMed Central, 2001 22(2022), 1 vom: 04. Feb. (DE-627)335488870 (DE-600)2059859-2 1471-2261 nnns volume:22 year:2022 number:1 day:04 month:02 https://dx.doi.org/10.1186/s12872-022-02476-1 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 22 2022 1 04 02
allfields_unstemmed	10.1186/s12872-022-02476-1 doi (DE-627)SPR05046390X (SPR)s12872-022-02476-1-e DE-627 ger DE-627 rakwb eng Wang, Ge verfasserin aut De-escalation of antiplatelet therapy after percutaneous coronary intervention among East Asians and non-East Asians: a meta-analysis of randomized controlled trials 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2022 Background To study the impact of de-escalation antiplatelet therapy retaining P2Y12 inhibition on major bleeding and ischemic outcomes after percutaneous coronary intervention (PCI) among East Asians and non-East Asians was unclear. Methods We systematically searched PubMed, Embase, and the Cochrane Library for randomized controlled trials through September 2020. Eight trials were included, which studied de-escalation of DAPT (D-DAPT, switching to P2Y12 inhibitor monotherapy, or switching to clopidogrel or dose reduction of the P2Y12 inhibitor after 1 to 3 months) versus 12 months standard DAPT (S-DAPT). The primary outcomes data was conducted using random effects models. Results Among the 8 included trials consisting of 37,775 patients, 62.6% presented with acute coronary syndrome. The median follow-up duration ranged from 12 to 24 months. Compared with S-DAPT, D-DAPT was associated with a lower risk of major bleeding (RR = 0.67, 95% CI 0.48–0.93, p = 0.02); however, this was only observed among East-Asians (RR = 0.61, 95% CI 0.37–0.99, p = 0.048). Among non-East Asians, the rate of major bleeding was similar between the two groups (RR = 0.73, 95% CI 0.46–1.14, p = 0.17, p for interaction = 0.59). There were no significant differences in the major adverse cardiovascular events (MACE) between D-DAPT and S-DAPT treatment among both East Asians (RR = 0.84, 95% CI 0.66–1.08, p = 0.18) and non-East Asians (RR = 0.89, 95% CI 0.79–1.00, p = 0.059, p for interaction = 0.71). Conclusions The De-escalation strategy that retains P2Y12 inhibition after a PCI was associated with reduced risk of bleeding events, which was only demonstrated in East Asians patients, and not in non-East Asian patients. Antiplatelet therapy (dpeaa)DE-He213 De-escalation (dpeaa)DE-He213 Meta-analysis (dpeaa)DE-He213 Percutaneous coronary intervention (dpeaa)DE-He213 Randomized controlled trials (dpeaa)DE-He213 Wang, Xiao aut Zhao, Guanqi aut Huang, Xin aut Guo, Ruifeng aut Nie, Shaoping aut Enthalten in BMC cardiovascular disorders London : BioMed Central, 2001 22(2022), 1 vom: 04. Feb. (DE-627)335488870 (DE-600)2059859-2 1471-2261 nnns volume:22 year:2022 number:1 day:04 month:02 https://dx.doi.org/10.1186/s12872-022-02476-1 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 22 2022 1 04 02
allfieldsGer	10.1186/s12872-022-02476-1 doi (DE-627)SPR05046390X (SPR)s12872-022-02476-1-e DE-627 ger DE-627 rakwb eng Wang, Ge verfasserin aut De-escalation of antiplatelet therapy after percutaneous coronary intervention among East Asians and non-East Asians: a meta-analysis of randomized controlled trials 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2022 Background To study the impact of de-escalation antiplatelet therapy retaining P2Y12 inhibition on major bleeding and ischemic outcomes after percutaneous coronary intervention (PCI) among East Asians and non-East Asians was unclear. Methods We systematically searched PubMed, Embase, and the Cochrane Library for randomized controlled trials through September 2020. Eight trials were included, which studied de-escalation of DAPT (D-DAPT, switching to P2Y12 inhibitor monotherapy, or switching to clopidogrel or dose reduction of the P2Y12 inhibitor after 1 to 3 months) versus 12 months standard DAPT (S-DAPT). The primary outcomes data was conducted using random effects models. Results Among the 8 included trials consisting of 37,775 patients, 62.6% presented with acute coronary syndrome. The median follow-up duration ranged from 12 to 24 months. Compared with S-DAPT, D-DAPT was associated with a lower risk of major bleeding (RR = 0.67, 95% CI 0.48–0.93, p = 0.02); however, this was only observed among East-Asians (RR = 0.61, 95% CI 0.37–0.99, p = 0.048). Among non-East Asians, the rate of major bleeding was similar between the two groups (RR = 0.73, 95% CI 0.46–1.14, p = 0.17, p for interaction = 0.59). There were no significant differences in the major adverse cardiovascular events (MACE) between D-DAPT and S-DAPT treatment among both East Asians (RR = 0.84, 95% CI 0.66–1.08, p = 0.18) and non-East Asians (RR = 0.89, 95% CI 0.79–1.00, p = 0.059, p for interaction = 0.71). Conclusions The De-escalation strategy that retains P2Y12 inhibition after a PCI was associated with reduced risk of bleeding events, which was only demonstrated in East Asians patients, and not in non-East Asian patients. Antiplatelet therapy (dpeaa)DE-He213 De-escalation (dpeaa)DE-He213 Meta-analysis (dpeaa)DE-He213 Percutaneous coronary intervention (dpeaa)DE-He213 Randomized controlled trials (dpeaa)DE-He213 Wang, Xiao aut Zhao, Guanqi aut Huang, Xin aut Guo, Ruifeng aut Nie, Shaoping aut Enthalten in BMC cardiovascular disorders London : BioMed Central, 2001 22(2022), 1 vom: 04. Feb. (DE-627)335488870 (DE-600)2059859-2 1471-2261 nnns volume:22 year:2022 number:1 day:04 month:02 https://dx.doi.org/10.1186/s12872-022-02476-1 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 22 2022 1 04 02
allfieldsSound	10.1186/s12872-022-02476-1 doi (DE-627)SPR05046390X (SPR)s12872-022-02476-1-e DE-627 ger DE-627 rakwb eng Wang, Ge verfasserin aut De-escalation of antiplatelet therapy after percutaneous coronary intervention among East Asians and non-East Asians: a meta-analysis of randomized controlled trials 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2022 Background To study the impact of de-escalation antiplatelet therapy retaining P2Y12 inhibition on major bleeding and ischemic outcomes after percutaneous coronary intervention (PCI) among East Asians and non-East Asians was unclear. Methods We systematically searched PubMed, Embase, and the Cochrane Library for randomized controlled trials through September 2020. Eight trials were included, which studied de-escalation of DAPT (D-DAPT, switching to P2Y12 inhibitor monotherapy, or switching to clopidogrel or dose reduction of the P2Y12 inhibitor after 1 to 3 months) versus 12 months standard DAPT (S-DAPT). The primary outcomes data was conducted using random effects models. Results Among the 8 included trials consisting of 37,775 patients, 62.6% presented with acute coronary syndrome. The median follow-up duration ranged from 12 to 24 months. Compared with S-DAPT, D-DAPT was associated with a lower risk of major bleeding (RR = 0.67, 95% CI 0.48–0.93, p = 0.02); however, this was only observed among East-Asians (RR = 0.61, 95% CI 0.37–0.99, p = 0.048). Among non-East Asians, the rate of major bleeding was similar between the two groups (RR = 0.73, 95% CI 0.46–1.14, p = 0.17, p for interaction = 0.59). There were no significant differences in the major adverse cardiovascular events (MACE) between D-DAPT and S-DAPT treatment among both East Asians (RR = 0.84, 95% CI 0.66–1.08, p = 0.18) and non-East Asians (RR = 0.89, 95% CI 0.79–1.00, p = 0.059, p for interaction = 0.71). Conclusions The De-escalation strategy that retains P2Y12 inhibition after a PCI was associated with reduced risk of bleeding events, which was only demonstrated in East Asians patients, and not in non-East Asian patients. Antiplatelet therapy (dpeaa)DE-He213 De-escalation (dpeaa)DE-He213 Meta-analysis (dpeaa)DE-He213 Percutaneous coronary intervention (dpeaa)DE-He213 Randomized controlled trials (dpeaa)DE-He213 Wang, Xiao aut Zhao, Guanqi aut Huang, Xin aut Guo, Ruifeng aut Nie, Shaoping aut Enthalten in BMC cardiovascular disorders London : BioMed Central, 2001 22(2022), 1 vom: 04. Feb. (DE-627)335488870 (DE-600)2059859-2 1471-2261 nnns volume:22 year:2022 number:1 day:04 month:02 https://dx.doi.org/10.1186/s12872-022-02476-1 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 22 2022 1 04 02
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authorswithroles_txt_mv	Wang, Ge @@aut@@ Wang, Xiao @@aut@@ Zhao, Guanqi @@aut@@ Huang, Xin @@aut@@ Guo, Ruifeng @@aut@@ Nie, Shaoping @@aut@@
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Methods We systematically searched PubMed, Embase, and the Cochrane Library for randomized controlled trials through September 2020. Eight trials were included, which studied de-escalation of DAPT (D-DAPT, switching to P2Y12 inhibitor monotherapy, or switching to clopidogrel or dose reduction of the P2Y12 inhibitor after 1 to 3 months) versus 12 months standard DAPT (S-DAPT). The primary outcomes data was conducted using random effects models. Results Among the 8 included trials consisting of 37,775 patients, 62.6% presented with acute coronary syndrome. The median follow-up duration ranged from 12 to 24 months. Compared with S-DAPT, D-DAPT was associated with a lower risk of major bleeding (RR = 0.67, 95% CI 0.48–0.93, p = 0.02); however, this was only observed among East-Asians (RR = 0.61, 95% CI 0.37–0.99, p = 0.048). Among non-East Asians, the rate of major bleeding was similar between the two groups (RR = 0.73, 95% CI 0.46–1.14, p = 0.17, p for interaction = 0.59). There were no significant differences in the major adverse cardiovascular events (MACE) between D-DAPT and S-DAPT treatment among both East Asians (RR = 0.84, 95% CI 0.66–1.08, p = 0.18) and non-East Asians (RR = 0.89, 95% CI 0.79–1.00, p = 0.059, p for interaction = 0.71). 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author	Wang, Ge
spellingShingle	Wang, Ge misc Antiplatelet therapy misc De-escalation misc Meta-analysis misc Percutaneous coronary intervention misc Randomized controlled trials De-escalation of antiplatelet therapy after percutaneous coronary intervention among East Asians and non-East Asians: a meta-analysis of randomized controlled trials
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topic_title	De-escalation of antiplatelet therapy after percutaneous coronary intervention among East Asians and non-East Asians: a meta-analysis of randomized controlled trials Antiplatelet therapy (dpeaa)DE-He213 De-escalation (dpeaa)DE-He213 Meta-analysis (dpeaa)DE-He213 Percutaneous coronary intervention (dpeaa)DE-He213 Randomized controlled trials (dpeaa)DE-He213
topic	misc Antiplatelet therapy misc De-escalation misc Meta-analysis misc Percutaneous coronary intervention misc Randomized controlled trials
topic_unstemmed	misc Antiplatelet therapy misc De-escalation misc Meta-analysis misc Percutaneous coronary intervention misc Randomized controlled trials
topic_browse	misc Antiplatelet therapy misc De-escalation misc Meta-analysis misc Percutaneous coronary intervention misc Randomized controlled trials
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title	De-escalation of antiplatelet therapy after percutaneous coronary intervention among East Asians and non-East Asians: a meta-analysis of randomized controlled trials
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title_full	De-escalation of antiplatelet therapy after percutaneous coronary intervention among East Asians and non-East Asians: a meta-analysis of randomized controlled trials
author_sort	Wang, Ge
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author_browse	Wang, Ge Wang, Xiao Zhao, Guanqi Huang, Xin Guo, Ruifeng Nie, Shaoping
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title_sort	de-escalation of antiplatelet therapy after percutaneous coronary intervention among east asians and non-east asians: a meta-analysis of randomized controlled trials
title_auth	De-escalation of antiplatelet therapy after percutaneous coronary intervention among East Asians and non-East Asians: a meta-analysis of randomized controlled trials
abstract	Background To study the impact of de-escalation antiplatelet therapy retaining P2Y12 inhibition on major bleeding and ischemic outcomes after percutaneous coronary intervention (PCI) among East Asians and non-East Asians was unclear. Methods We systematically searched PubMed, Embase, and the Cochrane Library for randomized controlled trials through September 2020. Eight trials were included, which studied de-escalation of DAPT (D-DAPT, switching to P2Y12 inhibitor monotherapy, or switching to clopidogrel or dose reduction of the P2Y12 inhibitor after 1 to 3 months) versus 12 months standard DAPT (S-DAPT). The primary outcomes data was conducted using random effects models. Results Among the 8 included trials consisting of 37,775 patients, 62.6% presented with acute coronary syndrome. The median follow-up duration ranged from 12 to 24 months. Compared with S-DAPT, D-DAPT was associated with a lower risk of major bleeding (RR = 0.67, 95% CI 0.48–0.93, p = 0.02); however, this was only observed among East-Asians (RR = 0.61, 95% CI 0.37–0.99, p = 0.048). Among non-East Asians, the rate of major bleeding was similar between the two groups (RR = 0.73, 95% CI 0.46–1.14, p = 0.17, p for interaction = 0.59). There were no significant differences in the major adverse cardiovascular events (MACE) between D-DAPT and S-DAPT treatment among both East Asians (RR = 0.84, 95% CI 0.66–1.08, p = 0.18) and non-East Asians (RR = 0.89, 95% CI 0.79–1.00, p = 0.059, p for interaction = 0.71). Conclusions The De-escalation strategy that retains P2Y12 inhibition after a PCI was associated with reduced risk of bleeding events, which was only demonstrated in East Asians patients, and not in non-East Asian patients. © The Author(s) 2022
abstractGer	Background To study the impact of de-escalation antiplatelet therapy retaining P2Y12 inhibition on major bleeding and ischemic outcomes after percutaneous coronary intervention (PCI) among East Asians and non-East Asians was unclear. Methods We systematically searched PubMed, Embase, and the Cochrane Library for randomized controlled trials through September 2020. Eight trials were included, which studied de-escalation of DAPT (D-DAPT, switching to P2Y12 inhibitor monotherapy, or switching to clopidogrel or dose reduction of the P2Y12 inhibitor after 1 to 3 months) versus 12 months standard DAPT (S-DAPT). The primary outcomes data was conducted using random effects models. Results Among the 8 included trials consisting of 37,775 patients, 62.6% presented with acute coronary syndrome. The median follow-up duration ranged from 12 to 24 months. Compared with S-DAPT, D-DAPT was associated with a lower risk of major bleeding (RR = 0.67, 95% CI 0.48–0.93, p = 0.02); however, this was only observed among East-Asians (RR = 0.61, 95% CI 0.37–0.99, p = 0.048). Among non-East Asians, the rate of major bleeding was similar between the two groups (RR = 0.73, 95% CI 0.46–1.14, p = 0.17, p for interaction = 0.59). There were no significant differences in the major adverse cardiovascular events (MACE) between D-DAPT and S-DAPT treatment among both East Asians (RR = 0.84, 95% CI 0.66–1.08, p = 0.18) and non-East Asians (RR = 0.89, 95% CI 0.79–1.00, p = 0.059, p for interaction = 0.71). Conclusions The De-escalation strategy that retains P2Y12 inhibition after a PCI was associated with reduced risk of bleeding events, which was only demonstrated in East Asians patients, and not in non-East Asian patients. © The Author(s) 2022
abstract_unstemmed	Background To study the impact of de-escalation antiplatelet therapy retaining P2Y12 inhibition on major bleeding and ischemic outcomes after percutaneous coronary intervention (PCI) among East Asians and non-East Asians was unclear. Methods We systematically searched PubMed, Embase, and the Cochrane Library for randomized controlled trials through September 2020. Eight trials were included, which studied de-escalation of DAPT (D-DAPT, switching to P2Y12 inhibitor monotherapy, or switching to clopidogrel or dose reduction of the P2Y12 inhibitor after 1 to 3 months) versus 12 months standard DAPT (S-DAPT). The primary outcomes data was conducted using random effects models. Results Among the 8 included trials consisting of 37,775 patients, 62.6% presented with acute coronary syndrome. The median follow-up duration ranged from 12 to 24 months. Compared with S-DAPT, D-DAPT was associated with a lower risk of major bleeding (RR = 0.67, 95% CI 0.48–0.93, p = 0.02); however, this was only observed among East-Asians (RR = 0.61, 95% CI 0.37–0.99, p = 0.048). Among non-East Asians, the rate of major bleeding was similar between the two groups (RR = 0.73, 95% CI 0.46–1.14, p = 0.17, p for interaction = 0.59). There were no significant differences in the major adverse cardiovascular events (MACE) between D-DAPT and S-DAPT treatment among both East Asians (RR = 0.84, 95% CI 0.66–1.08, p = 0.18) and non-East Asians (RR = 0.89, 95% CI 0.79–1.00, p = 0.059, p for interaction = 0.71). Conclusions The De-escalation strategy that retains P2Y12 inhibition after a PCI was associated with reduced risk of bleeding events, which was only demonstrated in East Asians patients, and not in non-East Asian patients. © The Author(s) 2022
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title_short	De-escalation of antiplatelet therapy after percutaneous coronary intervention among East Asians and non-East Asians: a meta-analysis of randomized controlled trials
url	https://dx.doi.org/10.1186/s12872-022-02476-1
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author2	Wang, Xiao Zhao, Guanqi Huang, Xin Guo, Ruifeng Nie, Shaoping
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up_date	2024-07-03T15:42:11.465Z
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Methods We systematically searched PubMed, Embase, and the Cochrane Library for randomized controlled trials through September 2020. Eight trials were included, which studied de-escalation of DAPT (D-DAPT, switching to P2Y12 inhibitor monotherapy, or switching to clopidogrel or dose reduction of the P2Y12 inhibitor after 1 to 3 months) versus 12 months standard DAPT (S-DAPT). The primary outcomes data was conducted using random effects models. Results Among the 8 included trials consisting of 37,775 patients, 62.6% presented with acute coronary syndrome. The median follow-up duration ranged from 12 to 24 months. Compared with S-DAPT, D-DAPT was associated with a lower risk of major bleeding (RR = 0.67, 95% CI 0.48–0.93, p = 0.02); however, this was only observed among East-Asians (RR = 0.61, 95% CI 0.37–0.99, p = 0.048). Among non-East Asians, the rate of major bleeding was similar between the two groups (RR = 0.73, 95% CI 0.46–1.14, p = 0.17, p for interaction = 0.59). There were no significant differences in the major adverse cardiovascular events (MACE) between D-DAPT and S-DAPT treatment among both East Asians (RR = 0.84, 95% CI 0.66–1.08, p = 0.18) and non-East Asians (RR = 0.89, 95% CI 0.79–1.00, p = 0.059, p for interaction = 0.71). Conclusions The De-escalation strategy that retains P2Y12 inhibition after a PCI was associated with reduced risk of bleeding events, which was only demonstrated in East Asians patients, and not in non-East Asian patients.</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Antiplatelet therapy</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">De-escalation</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Meta-analysis</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Percutaneous coronary intervention</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Randomized controlled trials</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Wang, Xiao</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Zhao, Guanqi</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Huang, Xin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Guo, Ruifeng</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Nie, Shaoping</subfield><subfield code="4">aut</subfield></datafield><datafield tag="773" ind1="0" ind2="8"><subfield code="i">Enthalten in</subfield><subfield code="t">BMC cardiovascular disorders</subfield><subfield code="d">London : BioMed Central, 2001</subfield><subfield code="g">22(2022), 1 vom: 04. 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De-escalation of antiplatelet therapy after percutaneous coronary intervention among East Asians and non-East Asians: a meta-analysis of randomized controlled trials

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