Archives of medical sciences. Atherosclerotic diseases · 2026
Comparison of P2Y12 inhibitors vs. aspirin monotherapy following dual antiplatelet therapy in patients after percutaneous coronary intervention: a systematic review and meta-analysis.
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Kazmi Muhammad Hazqeel, Dohadwala Taha Kassim, Haleem Syed Mohammad, Thirupathy Umabalan, Sajnani Piyush, Camila Pena Campos Indira, Ayyad Mennatalla, Ch'ng Brandon Xian, Arshad Muhammad Muneeb, Nasser Ibrahim Ali, Mesmar Ahmad, Khawaja Muhammad Nadeem, Al-Zou'bi Amer 'Mohammad Amin', Chatha Salman, Tariq Osama, Zulfiqar Eeshal, Ahmed Mushood, Ahmed Raheel
Аннотация
INTRODUCTION: P2Y12 inhibitor monotherapy has emerged as a potential alternative to aspirin following dual antiplatelet therapy (DAPT) in patients undergoing percutaneous coronary intervention (PCI), but the optimal choice remains uncertain.
METHODS: A systematic literature search compared P2Y12 inhibitors with aspirin post PCI. A random-effects model pooled odds ratios (ORs) with 95% confidence intervals (CIs) for outcomes.
RESULTS: Seven studies (29,756 patients) were included. P2Y12 inhibitors significantly reduced MACE compared to aspirin [OR = 0.73; 95% CI: 0.64-0.84]. No significant difference was observed in all-cause mortality [OR = 0.90; 95% CI: 0.77-1.05], cardiac death [OR = 0.86; 95% CI: 0.68-1.09], major bleeding [OR = 1.06; 95% CI: 0.67-1.68], MI [OR = 0.78; 95% CI: 0.56-1.08], or stent thrombosis [OR = 0.71; 95% CI: 0.41-1.22]. P2Y12 inhibitors significantly reduced repeat revascularisation [OR = 0.83; 95% CI: 0.73-0.94] and stroke [OR = 0.63; 95% CI: 0.48-0.81].
CONCLUSIONS: P2Y12 inhibitors may be a safer, more effective alternative to aspirin alone after PCI.
METHODS: A systematic literature search compared P2Y12 inhibitors with aspirin post PCI. A random-effects model pooled odds ratios (ORs) with 95% confidence intervals (CIs) for outcomes.
RESULTS: Seven studies (29,756 patients) were included. P2Y12 inhibitors significantly reduced MACE compared to aspirin [OR = 0.73; 95% CI: 0.64-0.84]. No significant difference was observed in all-cause mortality [OR = 0.90; 95% CI: 0.77-1.05], cardiac death [OR = 0.86; 95% CI: 0.68-1.09], major bleeding [OR = 1.06; 95% CI: 0.67-1.68], MI [OR = 0.78; 95% CI: 0.56-1.08], or stent thrombosis [OR = 0.71; 95% CI: 0.41-1.22]. P2Y12 inhibitors significantly reduced repeat revascularisation [OR = 0.83; 95% CI: 0.73-0.94] and stroke [OR = 0.63; 95% CI: 0.48-0.81].
CONCLUSIONS: P2Y12 inhibitors may be a safer, more effective alternative to aspirin alone after PCI.