They compared cardiovascular outcomes in patients who discontinued ASA after short-term use versus its continuous use along with a P2Y12 inhibitor after PCI Short-term dual antiplatelet therapy, diabetes mellitus and percutaneous coronary intervention Ībbreviations such as PCI, ASA, DAPT and T2DM were also used. Short-term dual antiplatelet therapy and percutaneous coronary intervention Short-term aspirin, diabetes mellitus and percutaneous coronary intervention ĭiscontinuation of aspirin, diabetes mellitus and percutaneous coronary intervention Short-term aspirin and percutaneous coronary intervention ĭiscontinuation of aspirin and percutaneous coronary intervention This search was carried out using the following terms or phrases: In this analysis, we aimed to compare the efficacy and safety of discontinuing ASA after short-term use versus its continuous use with a P2Y12 inhibitor for the treatment of patients with T2DM following PCI.įrom May to June 2020, the databases of Cochrane Library, EMBASE database, MEDLINE database,, Web of Science, Scopus and Google Scholar were searched for publications showing ASA discontinuation after short-term use versus its continuous use with a P2Y12 inhibitor for the treatment of patients following PCI. Following revascularization of the coronary vessels, dual antiplatelet therapy (DAPT) with aspirin (ASA) and a P2Y12 inhibitor (clopidogrel, an irreversible P2Y12 inhibitor, or ticagrelor, a direct-acting reversible oral antagonist of P2Y12) is prescribed for a duration of 6–12 months to prevent stent thrombosis or re-infarction. In patients with ACS, revascularization by either percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) has been the treatment strategy. Vascular disorders of the cardiac system often lead to acute coronary syndrome (ACS). In fact, cardiovascular diseases have often been a major macro-vascular complication of T2DM. Type 2 diabetes mellitus (T2DM) and cardiovascular diseases are two major non-communicable diseases affecting a large population worldwide. Also, discontinuing ASA after short-term use and continuing the use of a P2Y12 inhibitor were somewhat safer in these patients with T2DM. Conclusionĭiscontinuing ASA after short-term use for the treatment of patients with T2DM following PCI was not associated with any increased cardiovascular outcomes. However, discontinuing ASA after short-term use in these patients with T2DM was associated with a lower risk of bleeding defined according to the Academic Research Consortium (BARC) type 2–5 (RR 0.55, 95% CI 0.41–0.73 P = 0.0001), and thrombolysis in myocardial infarction (TIMI) defined as major (RR 0.55, 95% CI 0.41–0.75 P = 0.0001) and minor bleeding (RR 0.58, 95% CI 0.43–0.78 P = 0.0004).
![revman 5 software uses what type of analysis revman 5 software uses what type of analysis](https://s2.studylib.net/store/data/005425576_1-02c4a05316362edf200af5e70c93192f.png)
Our result showed that compared to a longer duration (12 months) of DAPT (ASA + P2Y12 inhibitor) use in these patients with T2DM, discontinuing ASA after short-term use (1–3 months) thereafter using only a P2Y12 inhibitor (mono-therapy) was not associated with a significant increase in the risk of major adverse cardiovascular and cerebrovascular events (RR 0.92, 95% CI 0.76–1.12 P = 0.39), myocardial infarction (RR 0.98, 95% CI 0.75–1.26 P = 0.86), all-cause mortality (RR 0.78, 95% CI 0.60–1.02 P = 0.07), cardiac death (RR 0.76, 95% CI 0.43–1.35 P = 0.35), stroke (RR 1.06, 95% CI 0.67–1.67 P = 0.80) and stent thrombosis (RR 0.98, 95% CI 0.58–1.65 P = 0.93).
![revman 5 software uses what type of analysis revman 5 software uses what type of analysis](https://media.springernature.com/original/springer-static/image/art%3A10.1007%2Fs00198-015-3339-z/MediaObjects/198_2015_3339_Fig1_HTML.gif)
ResultsĪ total of 9774 participants with T2DM were included in this analysis, whereby 4941 patients were assigned to the ASA discontinuation group and 4833 patients to the dual antiplatelet (DAPT) group. Risk ratios (RR) and 95% confidence intervals (CI) were used to represent the results following data analysis.
![revman 5 software uses what type of analysis revman 5 software uses what type of analysis](https://i.ytimg.com/vi/_Gkka8tlw8g/maxresdefault.jpg)
The new RevMan software version 5.4 was used to analyze the data. The cardiovascular and bleeding outcomes representing efficacy and safety, respectively, were the endpoints of this study. Methodsįrom May to June 2020, electronic databases were searched for related publications. In this analysis, we aimed to compare the efficacy and safety of discontinuing aspirin (ASA) after short-term use versus its continuous use with a P2Y12 inhibitor for the treatment of patients with type 2 diabetes mellitus (T2DM) following percutaneous coronary intervention (PCI).