Indian heart journal · 2026
Upfront Aspirin-Free Antiplatelet Monotherapy After Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis of Safety and Efficacy.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Mahajan Kunal, Dutta Deep, Kamrul-Hasan A B M, Pradhan Akshyaya, Vohra Shekhar, Mahajan Nitin
Аннотация
BACKGROUND: Evidence comparing non-aspirin single antiplatelet therapy (SAPT) with aspirin-containing dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) is limited. We performed a systematic review and meta-analysis to evaluate the safety and efficacy of non-aspirin SAPT with a P2Y12 inhibitor started at or within one week of PCI.
METHODS: Electronic databases were searched for studies evaluating non-aspirin SAPT after PCI. Primary outcomes were bleeding defined by Bleeding Academic Research Consortium (BARC) criteria [BARC 1-5 (any bleeding) and BARC 3-5 (major bleeding)], all-cause mortality (ACM), and cardiovascular mortality. Secondary outcomes were stroke, myocardial infarction (MI), need for revascularization, and stent thrombosis (STS).
RESULTS: Seven studies (2 randomized controlled trials and 5 observational studies) including 5468 patients on non-aspirin SAPT were analysed. In the single-arm meta-analysis of non-aspirin SAPT, pooled prevalence was 5% (95% CI 3-11;I2=92%) for any BARC 1-5 bleeding, 3% (95% CI 1-7;I2=92.5%) for major BARC 3-5 bleeding, 2% (95% CI 1-3;I2=65.4%) for ACM, 2% (95% CI 2-3;I2=31%) for cardiovascular mortality, 1% (95% CI 1-1;I2=0%) for STS, 1% (95% CI 0-1;I2=40.1%) for stroke, 2% (95% CI 1-3;I2=66.6%) for MI, and 2% (95% CI 1-4;I2=75.9%) for revascularization. In pairwise analyses of the two trials, non-aspirin SAPT versus aspirin-based DAPT showed similar risks of all-cause mortality, cardiovascular mortality, bleeding, and stroke but higher risks of MI (odds ratio [OR]1.41;95% CI 1.01-1.97; P=0.05; I2=0%) and revascularization (OR1.73; 95% CI 1.18-2.52;P=0.005;I2=0%).
CONCLUSION: Upfront aspirin-free SAPT after PCI was associated with increased risks of MI and revascularization without a reduction in bleeding compared with aspirin-based DAPT.
METHODS: Electronic databases were searched for studies evaluating non-aspirin SAPT after PCI. Primary outcomes were bleeding defined by Bleeding Academic Research Consortium (BARC) criteria [BARC 1-5 (any bleeding) and BARC 3-5 (major bleeding)], all-cause mortality (ACM), and cardiovascular mortality. Secondary outcomes were stroke, myocardial infarction (MI), need for revascularization, and stent thrombosis (STS).
RESULTS: Seven studies (2 randomized controlled trials and 5 observational studies) including 5468 patients on non-aspirin SAPT were analysed. In the single-arm meta-analysis of non-aspirin SAPT, pooled prevalence was 5% (95% CI 3-11;I2=92%) for any BARC 1-5 bleeding, 3% (95% CI 1-7;I2=92.5%) for major BARC 3-5 bleeding, 2% (95% CI 1-3;I2=65.4%) for ACM, 2% (95% CI 2-3;I2=31%) for cardiovascular mortality, 1% (95% CI 1-1;I2=0%) for STS, 1% (95% CI 0-1;I2=40.1%) for stroke, 2% (95% CI 1-3;I2=66.6%) for MI, and 2% (95% CI 1-4;I2=75.9%) for revascularization. In pairwise analyses of the two trials, non-aspirin SAPT versus aspirin-based DAPT showed similar risks of all-cause mortality, cardiovascular mortality, bleeding, and stroke but higher risks of MI (odds ratio [OR]1.41;95% CI 1.01-1.97; P=0.05; I2=0%) and revascularization (OR1.73; 95% CI 1.18-2.52;P=0.005;I2=0%).
CONCLUSION: Upfront aspirin-free SAPT after PCI was associated with increased risks of MI and revascularization without a reduction in bleeding compared with aspirin-based DAPT.