Clopidogrel Versus Aspirin as Monotherapy Following Dual Antiplatelet Therapy in Patients With Acute Coronary Syndrome Receiving a Drug‐Eluting Stent: A Systematic Literature Review and Meta‐Analysis
ABSTRACT Objective This study aimed to evaluate the comparative effectiveness and safety of clopidogrel versus aspirin as monotherapy following adequate dual antiplatelet therapy (DAPT) in patients with acute coronary syndrome (ACS). Methods MEDLINE, Embase, and CENTRAL were searched from database i...
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| Veröffentlicht in: | Clinical cardiology (Mahwah, N.J.) N.J.), 2024-09, Vol.47 (9), p.e24326-n/a |
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| container_title | Clinical cardiology (Mahwah, N.J.) |
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| creator | Sibbing, Dirk Nicolas, Johny Spirito, Alessandro Vogel, Birgit Cao, Davide Stipek, Wanda Kasireddy, Ellen Qian, Andi Khan, Irfan Mehran, Roxana |
| description | ABSTRACT
Objective
This study aimed to evaluate the comparative effectiveness and safety of clopidogrel versus aspirin as monotherapy following adequate dual antiplatelet therapy (DAPT) in patients with acute coronary syndrome (ACS).
Methods
MEDLINE, Embase, and CENTRAL were searched from database inception to September 1, 2023. Randomized controlled trials (RCTs) and observational studies evaluating the effectiveness or safety of clopidogrel versus aspirin as monotherapy following DAPT in patients with ACS who received a drug‐eluting stent were included. Random‐effects meta‐analyses were conducted to compare risks of major adverse cardiovascular events (MACE) and clinically relevant bleeding.
Results
Of 6242 s identified, three unique studies were included: one RCT and two retrospective cohort studies. Studies included a total of 7081 post‐percutaneous coronary intervention ACS patients, 4260 of whom received aspirin monotherapy and 2821 received clopidogrel monotherapy. Studies included variable proportions of patients with ST‐elevation myocardial infarction (STEMI), non‐STEMI, and unstable angina. From the meta‐analysis, clopidogrel was associated with a 28% reduction in the risk of MACE compared with aspirin (hazard ratio [HR]: 0.72; 95% confidence interval [CI]: 0.54, 0.98), with no significant difference in clinically relevant bleeding (HR: 0.92; 95% CI: 0.68, 1.24).
Conclusion
Despite the paucity of published evidence on the effectiveness and safety of clopidogrel versus aspirin in patients with ACS post‐drug‐eluting stent implantation, this meta‐analysis suggests that clopidogrel versus aspirin may result in a lower risk of MACE, with a similar risk of major bleeding. The present results are hypothesis‐generating and further large RCTs comparing antiplatelet monotherapy options in ACS patients are warranted.
Clopidogrel reduced the risk of major adverse cardiovascular events by 28% versus aspirin and there was a similar risk of major bleeding after adequate dual antiplatelet therapy in acute coronary syndrome patients post‐drug‐eluting stent implantation. |
| doi_str_mv | 10.1002/clc.24326 |
| format | Article |
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Objective
This study aimed to evaluate the comparative effectiveness and safety of clopidogrel versus aspirin as monotherapy following adequate dual antiplatelet therapy (DAPT) in patients with acute coronary syndrome (ACS).
Methods
MEDLINE, Embase, and CENTRAL were searched from database inception to September 1, 2023. Randomized controlled trials (RCTs) and observational studies evaluating the effectiveness or safety of clopidogrel versus aspirin as monotherapy following DAPT in patients with ACS who received a drug‐eluting stent were included. Random‐effects meta‐analyses were conducted to compare risks of major adverse cardiovascular events (MACE) and clinically relevant bleeding.
Results
Of 6242 s identified, three unique studies were included: one RCT and two retrospective cohort studies. Studies included a total of 7081 post‐percutaneous coronary intervention ACS patients, 4260 of whom received aspirin monotherapy and 2821 received clopidogrel monotherapy. Studies included variable proportions of patients with ST‐elevation myocardial infarction (STEMI), non‐STEMI, and unstable angina. From the meta‐analysis, clopidogrel was associated with a 28% reduction in the risk of MACE compared with aspirin (hazard ratio [HR]: 0.72; 95% confidence interval [CI]: 0.54, 0.98), with no significant difference in clinically relevant bleeding (HR: 0.92; 95% CI: 0.68, 1.24).
Conclusion
Despite the paucity of published evidence on the effectiveness and safety of clopidogrel versus aspirin in patients with ACS post‐drug‐eluting stent implantation, this meta‐analysis suggests that clopidogrel versus aspirin may result in a lower risk of MACE, with a similar risk of major bleeding. The present results are hypothesis‐generating and further large RCTs comparing antiplatelet monotherapy options in ACS patients are warranted.
Clopidogrel reduced the risk of major adverse cardiovascular events by 28% versus aspirin and there was a similar risk of major bleeding after adequate dual antiplatelet therapy in acute coronary syndrome patients post‐drug‐eluting stent implantation.</description><identifier>ISSN: 0160-9289</identifier><identifier>ISSN: 1932-8737</identifier><identifier>EISSN: 1932-8737</identifier><identifier>DOI: 10.1002/clc.24326</identifier><identifier>PMID: 39206792</identifier><language>eng</language><publisher>United States: John Wiley & Sons, Inc</publisher><subject>acute coronary syndrome ; Acute Coronary Syndrome - therapy ; Acute coronary syndromes ; Angina pectoris ; Aspirin ; Aspirin - administration & dosage ; Aspirin - adverse effects ; Aspirin - therapeutic use ; Cardiology ; Cardiovascular disease ; Clinical trials ; clopidogrel ; Clopidogrel - administration & dosage ; Clopidogrel - adverse effects ; Clopidogrel - therapeutic use ; Drug-Eluting Stents ; Dual Anti-Platelet Therapy - methods ; dual antiplatelet therapy ; Heart attacks ; Hemorrhage - chemically induced ; Humans ; Intervention ; Ischemia ; Literature reviews ; Meta-analysis ; Mortality ; Observational studies ; Patients ; Percutaneous Coronary Intervention - adverse effects ; Percutaneous Coronary Intervention - methods ; Platelet Aggregation Inhibitors - administration & dosage ; Platelet Aggregation Inhibitors - adverse effects ; Platelet Aggregation Inhibitors - therapeutic use ; Review ; single antiplatelet therapy ; Stents ; Stroke ; Systematic review ; Thrombosis ; Treatment Outcome</subject><ispartof>Clinical cardiology (Mahwah, N.J.), 2024-09, Vol.47 (9), p.e24326-n/a</ispartof><rights>2024 The Author(s). published by Wiley Periodicals, LLC.</rights><rights>2024 The Author(s). Clinical Cardiology published by Wiley Periodicals, LLC.</rights><rights>2024. This work is published under http://creativecommons.org/licenses/by/4.0/ (the "License"). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3346-d9110ab54b505d3c87d0f2fabc0aeba04cf2563ed9ee2216580556853b7dc4ad3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11358762/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11358762/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,1411,11541,27901,27902,45550,45551,46027,46451,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39206792$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sibbing, Dirk</creatorcontrib><creatorcontrib>Nicolas, Johny</creatorcontrib><creatorcontrib>Spirito, Alessandro</creatorcontrib><creatorcontrib>Vogel, Birgit</creatorcontrib><creatorcontrib>Cao, Davide</creatorcontrib><creatorcontrib>Stipek, Wanda</creatorcontrib><creatorcontrib>Kasireddy, Ellen</creatorcontrib><creatorcontrib>Qian, Andi</creatorcontrib><creatorcontrib>Khan, Irfan</creatorcontrib><creatorcontrib>Mehran, Roxana</creatorcontrib><title>Clopidogrel Versus Aspirin as Monotherapy Following Dual Antiplatelet Therapy in Patients With Acute Coronary Syndrome Receiving a Drug‐Eluting Stent: A Systematic Literature Review and Meta‐Analysis</title><title>Clinical cardiology (Mahwah, N.J.)</title><addtitle>Clin Cardiol</addtitle><description>ABSTRACT
Objective
This study aimed to evaluate the comparative effectiveness and safety of clopidogrel versus aspirin as monotherapy following adequate dual antiplatelet therapy (DAPT) in patients with acute coronary syndrome (ACS).
Methods
MEDLINE, Embase, and CENTRAL were searched from database inception to September 1, 2023. Randomized controlled trials (RCTs) and observational studies evaluating the effectiveness or safety of clopidogrel versus aspirin as monotherapy following DAPT in patients with ACS who received a drug‐eluting stent were included. Random‐effects meta‐analyses were conducted to compare risks of major adverse cardiovascular events (MACE) and clinically relevant bleeding.
Results
Of 6242 s identified, three unique studies were included: one RCT and two retrospective cohort studies. Studies included a total of 7081 post‐percutaneous coronary intervention ACS patients, 4260 of whom received aspirin monotherapy and 2821 received clopidogrel monotherapy. Studies included variable proportions of patients with ST‐elevation myocardial infarction (STEMI), non‐STEMI, and unstable angina. From the meta‐analysis, clopidogrel was associated with a 28% reduction in the risk of MACE compared with aspirin (hazard ratio [HR]: 0.72; 95% confidence interval [CI]: 0.54, 0.98), with no significant difference in clinically relevant bleeding (HR: 0.92; 95% CI: 0.68, 1.24).
Conclusion
Despite the paucity of published evidence on the effectiveness and safety of clopidogrel versus aspirin in patients with ACS post‐drug‐eluting stent implantation, this meta‐analysis suggests that clopidogrel versus aspirin may result in a lower risk of MACE, with a similar risk of major bleeding. The present results are hypothesis‐generating and further large RCTs comparing antiplatelet monotherapy options in ACS patients are warranted.
Clopidogrel reduced the risk of major adverse cardiovascular events by 28% versus aspirin and there was a similar risk of major bleeding after adequate dual antiplatelet therapy in acute coronary syndrome patients post‐drug‐eluting stent implantation.</description><subject>acute coronary syndrome</subject><subject>Acute Coronary Syndrome - therapy</subject><subject>Acute coronary syndromes</subject><subject>Angina pectoris</subject><subject>Aspirin</subject><subject>Aspirin - administration & dosage</subject><subject>Aspirin - adverse effects</subject><subject>Aspirin - therapeutic use</subject><subject>Cardiology</subject><subject>Cardiovascular disease</subject><subject>Clinical trials</subject><subject>clopidogrel</subject><subject>Clopidogrel - administration & dosage</subject><subject>Clopidogrel - adverse effects</subject><subject>Clopidogrel - therapeutic use</subject><subject>Drug-Eluting Stents</subject><subject>Dual Anti-Platelet Therapy - methods</subject><subject>dual antiplatelet therapy</subject><subject>Heart attacks</subject><subject>Hemorrhage - chemically induced</subject><subject>Humans</subject><subject>Intervention</subject><subject>Ischemia</subject><subject>Literature reviews</subject><subject>Meta-analysis</subject><subject>Mortality</subject><subject>Observational studies</subject><subject>Patients</subject><subject>Percutaneous Coronary Intervention - adverse effects</subject><subject>Percutaneous Coronary Intervention - methods</subject><subject>Platelet Aggregation Inhibitors - administration & dosage</subject><subject>Platelet Aggregation Inhibitors - adverse effects</subject><subject>Platelet Aggregation Inhibitors - therapeutic use</subject><subject>Review</subject><subject>single antiplatelet therapy</subject><subject>Stents</subject><subject>Stroke</subject><subject>Systematic review</subject><subject>Thrombosis</subject><subject>Treatment Outcome</subject><issn>0160-9289</issn><issn>1932-8737</issn><issn>1932-8737</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kstuEzEUhkcIRENhwQsgS2xgkdaXuXjYoNG0BaRUIFpgaXk8J4krxx5sT6LseATei7fgSXCaUAESK0v2938-R_qz7CnBJwRjeqqMOqE5o-W9bEJqRqe8YtX9bIJJiac15fVR9iiEm4RiTtnD7IjVFJdVTSfZj9a4Qfdu4cGgz-DDGFATBu21RTKgS2ddXIKXwxZdOGPcRtsFOhulQY2NejAygoGIrg9MSn2QUYONAX3RcYkaNUZArfPOSr9FV1vbe7cC9BEU6PVOJtGZHxc_v30_N2PcXVzFFH-FmgSHCKukU2imY_ogjn6XXGvYIGl7dAlRpmBjpdkGHR5nD-bSBHhyOI-zTxfn1-3b6ez9m3dtM5sqxvJy2teEYNkVeVfgomeKVz2e07nsFJbQSZyrOS1KBn0NQCkpC46LouQF66pe5bJnx9nrvXcYuxX0Ko3rpRGD16u0o3BSi79frF6KhVsLQljBq5Imw4uDwbuvI4QoVjooMEZacGMQDNd1VfP8Fn3-D3rjRp82ThTBnDOe4ypRL_eU8i4ED_O7aQgWu46I1BFx25HEPvtz_DvydykScLoHNtrA9v8m0c7avfIXiC3M9g</recordid><startdate>202409</startdate><enddate>202409</enddate><creator>Sibbing, Dirk</creator><creator>Nicolas, Johny</creator><creator>Spirito, Alessandro</creator><creator>Vogel, Birgit</creator><creator>Cao, Davide</creator><creator>Stipek, Wanda</creator><creator>Kasireddy, Ellen</creator><creator>Qian, Andi</creator><creator>Khan, Irfan</creator><creator>Mehran, Roxana</creator><general>John Wiley & Sons, Inc</general><general>John Wiley and Sons Inc</general><scope>24P</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>202409</creationdate><title>Clopidogrel Versus Aspirin as Monotherapy Following Dual Antiplatelet Therapy in Patients With Acute Coronary Syndrome Receiving a Drug‐Eluting Stent: A Systematic Literature Review and Meta‐Analysis</title><author>Sibbing, Dirk ; Nicolas, Johny ; Spirito, Alessandro ; Vogel, Birgit ; Cao, Davide ; Stipek, Wanda ; Kasireddy, Ellen ; Qian, Andi ; Khan, Irfan ; Mehran, Roxana</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3346-d9110ab54b505d3c87d0f2fabc0aeba04cf2563ed9ee2216580556853b7dc4ad3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>acute coronary syndrome</topic><topic>Acute Coronary Syndrome - therapy</topic><topic>Acute coronary syndromes</topic><topic>Angina pectoris</topic><topic>Aspirin</topic><topic>Aspirin - administration & dosage</topic><topic>Aspirin - adverse effects</topic><topic>Aspirin - therapeutic use</topic><topic>Cardiology</topic><topic>Cardiovascular disease</topic><topic>Clinical trials</topic><topic>clopidogrel</topic><topic>Clopidogrel - administration & dosage</topic><topic>Clopidogrel - adverse effects</topic><topic>Clopidogrel - therapeutic use</topic><topic>Drug-Eluting Stents</topic><topic>Dual Anti-Platelet Therapy - methods</topic><topic>dual antiplatelet therapy</topic><topic>Heart attacks</topic><topic>Hemorrhage - chemically induced</topic><topic>Humans</topic><topic>Intervention</topic><topic>Ischemia</topic><topic>Literature reviews</topic><topic>Meta-analysis</topic><topic>Mortality</topic><topic>Observational studies</topic><topic>Patients</topic><topic>Percutaneous Coronary Intervention - adverse effects</topic><topic>Percutaneous Coronary Intervention - methods</topic><topic>Platelet Aggregation Inhibitors - administration & dosage</topic><topic>Platelet Aggregation Inhibitors - adverse effects</topic><topic>Platelet Aggregation Inhibitors - therapeutic use</topic><topic>Review</topic><topic>single antiplatelet therapy</topic><topic>Stents</topic><topic>Stroke</topic><topic>Systematic review</topic><topic>Thrombosis</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sibbing, Dirk</creatorcontrib><creatorcontrib>Nicolas, Johny</creatorcontrib><creatorcontrib>Spirito, Alessandro</creatorcontrib><creatorcontrib>Vogel, Birgit</creatorcontrib><creatorcontrib>Cao, Davide</creatorcontrib><creatorcontrib>Stipek, Wanda</creatorcontrib><creatorcontrib>Kasireddy, Ellen</creatorcontrib><creatorcontrib>Qian, Andi</creatorcontrib><creatorcontrib>Khan, Irfan</creatorcontrib><creatorcontrib>Mehran, Roxana</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Clinical cardiology (Mahwah, N.J.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sibbing, Dirk</au><au>Nicolas, Johny</au><au>Spirito, Alessandro</au><au>Vogel, Birgit</au><au>Cao, Davide</au><au>Stipek, Wanda</au><au>Kasireddy, Ellen</au><au>Qian, Andi</au><au>Khan, Irfan</au><au>Mehran, Roxana</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clopidogrel Versus Aspirin as Monotherapy Following Dual Antiplatelet Therapy in Patients With Acute Coronary Syndrome Receiving a Drug‐Eluting Stent: A Systematic Literature Review and Meta‐Analysis</atitle><jtitle>Clinical cardiology (Mahwah, N.J.)</jtitle><addtitle>Clin Cardiol</addtitle><date>2024-09</date><risdate>2024</risdate><volume>47</volume><issue>9</issue><spage>e24326</spage><epage>n/a</epage><pages>e24326-n/a</pages><issn>0160-9289</issn><issn>1932-8737</issn><eissn>1932-8737</eissn><abstract>ABSTRACT
Objective
This study aimed to evaluate the comparative effectiveness and safety of clopidogrel versus aspirin as monotherapy following adequate dual antiplatelet therapy (DAPT) in patients with acute coronary syndrome (ACS).
Methods
MEDLINE, Embase, and CENTRAL were searched from database inception to September 1, 2023. Randomized controlled trials (RCTs) and observational studies evaluating the effectiveness or safety of clopidogrel versus aspirin as monotherapy following DAPT in patients with ACS who received a drug‐eluting stent were included. Random‐effects meta‐analyses were conducted to compare risks of major adverse cardiovascular events (MACE) and clinically relevant bleeding.
Results
Of 6242 s identified, three unique studies were included: one RCT and two retrospective cohort studies. Studies included a total of 7081 post‐percutaneous coronary intervention ACS patients, 4260 of whom received aspirin monotherapy and 2821 received clopidogrel monotherapy. Studies included variable proportions of patients with ST‐elevation myocardial infarction (STEMI), non‐STEMI, and unstable angina. From the meta‐analysis, clopidogrel was associated with a 28% reduction in the risk of MACE compared with aspirin (hazard ratio [HR]: 0.72; 95% confidence interval [CI]: 0.54, 0.98), with no significant difference in clinically relevant bleeding (HR: 0.92; 95% CI: 0.68, 1.24).
Conclusion
Despite the paucity of published evidence on the effectiveness and safety of clopidogrel versus aspirin in patients with ACS post‐drug‐eluting stent implantation, this meta‐analysis suggests that clopidogrel versus aspirin may result in a lower risk of MACE, with a similar risk of major bleeding. The present results are hypothesis‐generating and further large RCTs comparing antiplatelet monotherapy options in ACS patients are warranted.
Clopidogrel reduced the risk of major adverse cardiovascular events by 28% versus aspirin and there was a similar risk of major bleeding after adequate dual antiplatelet therapy in acute coronary syndrome patients post‐drug‐eluting stent implantation.</abstract><cop>United States</cop><pub>John Wiley & Sons, Inc</pub><pmid>39206792</pmid><doi>10.1002/clc.24326</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0160-9289 |
| ispartof | Clinical cardiology (Mahwah, N.J.), 2024-09, Vol.47 (9), p.e24326-n/a |
| issn | 0160-9289 1932-8737 1932-8737 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_11358762 |
| source | MEDLINE; Wiley Online Library Open Access; DOAJ Directory of Open Access Journals; Wiley Online Library Journals Frontfile Complete; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central |
| subjects | acute coronary syndrome Acute Coronary Syndrome - therapy Acute coronary syndromes Angina pectoris Aspirin Aspirin - administration & dosage Aspirin - adverse effects Aspirin - therapeutic use Cardiology Cardiovascular disease Clinical trials clopidogrel Clopidogrel - administration & dosage Clopidogrel - adverse effects Clopidogrel - therapeutic use Drug-Eluting Stents Dual Anti-Platelet Therapy - methods dual antiplatelet therapy Heart attacks Hemorrhage - chemically induced Humans Intervention Ischemia Literature reviews Meta-analysis Mortality Observational studies Patients Percutaneous Coronary Intervention - adverse effects Percutaneous Coronary Intervention - methods Platelet Aggregation Inhibitors - administration & dosage Platelet Aggregation Inhibitors - adverse effects Platelet Aggregation Inhibitors - therapeutic use Review single antiplatelet therapy Stents Stroke Systematic review Thrombosis Treatment Outcome |
| title | Clopidogrel Versus Aspirin as Monotherapy Following Dual Antiplatelet Therapy in Patients With Acute Coronary Syndrome Receiving a Drug‐Eluting Stent: A Systematic Literature Review and Meta‐Analysis |
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