Journal article
Abstract 11625: Anti-Thrombotic Therapy Strategies With Long-Term Anticoagulation After Percutaneous Coronary Intervention a Systematic Review and Meta-Analysis
Circulation (New York, N.Y.), Vol.138(Suppl_1 Suppl 1), pp.A11625-A11625
06 Nov 2018
Abstract
BackgroundLong-term oral anticoagulants (OAC) poses a challenge after percutaneous coronary intervention (PCI) for dual antiplatelet therapy (DAPT) with Aspirin and P2Y12 inhibitors due to increased bleeding risk. We hypothesize that dual anti-thrombotic therapy (DATT) reduces bleeding without increased cardiovascular events.MethodWe searched MEDLINE and PUBMED from inception to March 01, 2018 for randomized control trials (RCTs) comparing DATT vs. Triple anti-thrombotic therapy (TATT) after PCI.ResultsWe identified 251 citations, of which 4 RCTs and 5,317 patients, (3,039 on DATT vs 2,278 on TATT) were included. Significantly reduced total bleeding in DATT arm, 731 vs. 786, odds ratio [OR] = 0.51, Confidence Interval [CI] = 0.39 – 0.67, p < 0.00001, I = 71 %, (I = 0% without WOEST study), TIIMI major bleeding- 60 in DATT vs 80 in TATT group, OR = 0.56, CI = 0.4 – 0.79, p = 0.0009, I = 0%, and TIIMI minor bleeding- DATT vs TATT group 70 vs 126, OR = 0.43, CI = 0.32 – 0.59, p < 0.00001, I = 0% was observed. There was no difference in the incidence of strokes, myocardial infarction, stent thrombosis, and mortality. A trend towards decreased non-cardiac deaths with DATT was observed, 14 vs 26, OR = 0.55, CI = 0.27 – 1.10, p = 0.09, I = 6%.ConclusionsDATT significantly reduces bleeding vs. TATT with no difference in adverse cardiovascular outcomes. TATT is associated with more severe bleeding and a trend towards increased non-cardiac death.
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Details
- Title
- Abstract 11625: Anti-Thrombotic Therapy Strategies With Long-Term Anticoagulation After Percutaneous Coronary Intervention a Systematic Review and Meta-Analysis
- Creators
- Muhammad Rawala - College Station Medical CenterWaqas Siddiqui - Drexel UniversityChikezie Alvarez - Seton Hall UniversityMuhammad Khan - Dept of Medicine, Capital Health Regional Med Cntr, Trenton, NJMaryam Khan - Drexel UniversitySyed Hasni - Drexel UniversitySandeep Aggarwal - Drexel UniversityAndrew Kohut - University of PennsylvaniaHoward Eisen - Pennsylvania State University
- Publication Details
- Circulation (New York, N.Y.), Vol.138(Suppl_1 Suppl 1), pp.A11625-A11625
- Publisher
- by the American College of Cardiology Foundation and the American Heart Association, Inc
- Resource Type
- Journal article
- Language
- English
- Identifiers
- 991019318925704721