Safety and Efficacy of Dual versus Triple Antithrombotic Therapy in Patients Undergoing Percutaneous Coronary Intervention

Abstract Background Choosing an antithrombotic regimen post coronary intervention in patients with concomitant indication for anticoagulation is a challenge commonly encountered by clinicians. Methods We performed a meta-analysis of observational studies and randomized controlled trials comparing ou...

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Veröffentlicht in:	The American journal of medicine 2017-11, Vol.130 (11), p.1280-1289
Hauptverfasser:	Agarwal, Nayan, MD, Jain, Ankur, MD, Mahmoud, Ahmed N., MD, Bishnoi, Rohit, MD, Golwala, Harsh, MD, Karimi, Ashkan, MD, Mojadidi, Mohammad Khalid, MD, Garg, Jalaj, MD, Gupta, Tanush, MD, Patel, Nimesh Kirit, MD, Wayangankar, Siddharth, MD, Anderson, R. David, MD
Format:	Artikel
Sprache:	eng
Schlagworte:	Anticoagulants - pharmacology Anticoagulation Cardiovascular Diseases - therapy Drug Therapy, Combination - methods Dual therapy Hemorrhage - chemically induced Hemorrhage - prevention & control Humans Internal Medicine Mortality Observational Studies as Topic Percutaneous coronary intervention Percutaneous Coronary Intervention - adverse effects Platelet Aggregation Inhibitors - pharmacology Postoperative Complications - etiology Postoperative Complications - mortality Postoperative Complications - prevention & control Randomized Controlled Trials as Topic Triple therapy
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Zusammenfassung:	Abstract Background Choosing an antithrombotic regimen post coronary intervention in patients with concomitant indication for anticoagulation is a challenge commonly encountered by clinicians. Methods We performed a meta-analysis of observational studies and randomized controlled trials comparing outcomes of triple therapy (dual antiplatelet therapy and anticoagulant) with dual therapy (single antiplatelet therapy and anticoagulant) in patients on long-term anticoagulants after percutaneous coronary intervention. Major bleeding was the primary outcome. Random effects overall risk ratios were calculated using the DerSimonian and Laird model. Results Nine observational studies and 2 randomized controlled trials with a total of 7,276 patients met our selection criteria. At a mean follow up of 10.8 months major bleeding was higher in triple therapy cohort compared to dual therapy (6.6% versus 3.8%, RR 1.54, CI- 1.2-1.98, P
ISSN:	0002-9343 1555-7162
DOI:	10.1016/j.amjmed.2017.03.057