IMR Press / RCM / Volume 23 / Issue 10 / DOI: 10.31083/j.rcm2310326
Open Access Systematic Review
Comparison of Short-Term DAPT and Long-Term DAPT on the Prognosis of PCI Patients: A Meta-Analysis of Randomized Controlled Trials
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1 Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, 100029 Beijing, China
2 Department of Cardiology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, 330006 Nanchang, Jiangxi, China
*Correspondence: (Hailong Ge); (Zhe Fang)
Academic Editors: Boyoung Joung and Giuseppe Boriani
Rev. Cardiovasc. Med. 2022, 23(10), 326;
Submitted: 8 June 2022 | Revised: 12 August 2022 | Accepted: 15 August 2022 | Published: 26 September 2022
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

Background: Dual antiplatelet therapy (DAPT) is the primary medication for patients after percutaneous coronary intervention (PCI). However, the best DAPT duration is still controversial. This systematic review and meta-analysis aims to assess the safety and effectiveness of short-term (3–6 months) DAPT compared to long-term (12 months) DAPT. Methods: We searched PubMed, Embase, Cochrane Library, and Web of Science systematically for all the randomized controlled trials (RCTs) which compared the different strategies for DAPT in patients undergoing PCI within ten years prior to January 2021. Major bleeding and any bleeding were identified as the safe endpoints. All causes of death, cardiac death, myocardial infarction, definite/probable stent thrombosis, target vessel revascularization, and stroke were identified as the efficacy endpoints. The hazard ratio (HR) and 95% confidence interval (CI) in each study were abstracted. Results: Overall, 11 trials and 24,242 patients were included in this meta-analysis with 15-month median follow-up time. Short-term DAPT was related to reduced risks of major bleeding (HR 0.65, 95% CI 0.48–0.89) and any bleeding (HR 0.64, 95% CI 0.53–0.79). No obvious differences in any of the other endpoints were observed. In acute coronary syndrome (ACS) patients with drug-eluting stents (DES), short-term compared with long-term DAPT was related to a decreased risk of major bleeding (HR 0.57, 95% CI 0.37–0.87) without significant increasing in the risks of any bleeding and ischemic endpoints. Furthermore, short-term DAPT followed by P2Y12 receptor inhibitor monotherapy appreciably lowered the risk of major bleeding (HR 0.64, 95% CI 0.42–0.96) and any bleeding (HR 0.58, 95% CI 0.36–0.93). There were no obvious differences concerning death between the different strategies for DAPT. Conclusions: After PCI with DES, short-term DAPT is safer than long-term DAPT, and is not inferior in effectiveness, even in ACS patients. P2Y12 receptor inhibitor monotherapy following short-term DAPT is also related to a decreased risk of bleeding and may be an alternative anti-platelet strategy.

dual antiplatelet therapy duration
P2Y12 receptor inhibitor
percutaneous coronary intervention (or PCI)
drug-eluting stents (or DES)
81973841/National Natural Science Foundation of China
2017YFC0908800/National Key Research and Development Program of China
SML20180601/Beijing Municipal Administration of Hospitals’ Mission plan
CFH2020-2-2063/Capital’s Funds for Health Improvement and Research
7202041/Beijing Municipal Natural Science Foundation
JING19-15/Beijing Municipal Health Commission
Fig. 1.
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