Safety and efficacy of dual vs. triple antithrombotic therapy in patients with atrial fibrillation following percutaneous coronary intervention: a systematic review and meta-analysis of randomized clinical trials
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Steg, Ph Gabriel
Doros, Gheorghe
Qamar, Arman
Ellis, Stephen G
Oldgren, Jonas
ten Berg, Jurrien M
Kimura, Takeshi
Hohnloser, Stefan H
Lip, Gregory Y H
Note: Order does not necessarily reflect citation order of authors.
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https://doi.org/10.1093/eurheartj/ehy162Metadata
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Golwala, H. B., C. P. Cannon, P. G. Steg, G. Doros, A. Qamar, S. G. Ellis, J. Oldgren, et al. 2018. “Safety and efficacy of dual vs. triple antithrombotic therapy in patients with atrial fibrillation following percutaneous coronary intervention: a systematic review and meta-analysis of randomized clinical trials.” European Heart Journal 39 (19): 1726-1735a. doi:10.1093/eurheartj/ehy162. http://dx.doi.org/10.1093/eurheartj/ehy162.Abstract
Abstract Aims Of patients with atrial fibrillation (AF), approximately 10% undergo percutaneous coronary intervention (PCI). We studied the safety and efficacy of dual vs. triple antithrombotic therapy (DAT vs. TAT) in this population. Methods and results A systematic review and meta-analysis was conducted using PubMed, Embase, EBSCO, Cochrane database of systematic reviews, Web of Science, and relevant meeting abstracts for Phase 3, randomized trials that compared DAT vs. TAT in patients with AF following PCI. Four trials including 5317 patients were included, of whom 3039 (57%) received DAT. Compared with the TAT arm, Thrombolysis in Myocardial Infarction (TIMI) major or minor bleeding showed a reduction by 47% in the DAT arm [4.3% vs. 9.0%; hazard ratio (HR) 0.53, 95% credible interval (CrI) 0.36–0.85, I2 = 42.9%]. In addition, there was no difference in the trial-defined major adverse cardiac events (MACE) (10.4% vs. 10.0%, HR 0.85, 95% CrI 0.48–1.29, I2 = 58.4%), or in individual outcomes of all-cause mortality, cardiac death, myocardial infarction, stent thrombosis, or stroke between the two arms. Conclusion: Compared with TAT, DAT shows a reduction in TIMI major or minor bleeding by 47% with comparable outcomes of MACE. Our findings support the concept that DAT may be a better option than TAT in many patients with AF following PCI.Other Sources
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5951099/pdf/Terms of Use
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