{"id":5948,"date":"2024-02-22T06:49:29","date_gmt":"2024-02-22T06:49:29","guid":{"rendered":"https:\/\/lucalombardo.net\/monotherapy-with-p2y12-inhibitors-after-dual-antiplatelet-therapy-filling-gaps-in-evidence\/"},"modified":"2024-02-22T06:49:29","modified_gmt":"2024-02-22T06:49:29","slug":"monotherapy-with-p2y12-inhibitors-after-dual-antiplatelet-therapy-filling-gaps-in-evidence","status":"publish","type":"post","link":"https:\/\/lucalombardo.net\/monotherapy-with-p2y12-inhibitors-after-dual-antiplatelet-therapy-filling-gaps-in-evidence\/","title":{"rendered":"Monotherapy with P2Y12-inhibitors after dual antiplatelet therapy: Filling gaps in evidence"},"content":{"rendered":"<div>\n<p>Int J Cardiol. 2024 Feb 19:131893. doi: 10.1016\/j.ijcard.2024.131893. Online ahead of print.<\/p>\n<p>ABSTRACT<\/p>\n<p>BACKGROUND: Whether P2Y12 inhibitor monotherapy (P2Y12-I) is superior to aspirin following DAPT discontinuation post-PCI remains to be established.<\/p>\n<p>METHODS: We updated our prior network meta-analysis where P2Y12-I and aspirin had been compared with DAPT or directly with each other. The focus is specifically on the available direct evidence, now consisting of the three head-to-head comparisons of P2Y12-I and aspirin in event-free PCI patients after DAPT. We include a Trial Sequential Analysis of the direct evidence based on meta-analytical literature.<\/p>\n<p>RESULTS: The main finding reveals a 39% significantly lower risk of myocardial infarction with P2Y12-I (RR 0.61, 95% CI 0.47-0.78, p = 0.0001, I2 = 0%) with no difference in bleeding. Trial Sequential Analysis demonstrates clinically meaningful evidence for a reduction in the incidence of myocardial infarction with P2Y12-I that is also supported by statistical significance.<\/p>\n<p>CONCLUSIONS: Accruing data highlight that P2Y12-I following DAPT discontinuation after PCI is associated with lower risk for MI and a similar risk for bleeding as compared with ASA. In light of potential limitations to the widespread adoption of life-long P2Y12-I treatment, clinicians should consider identifying selected patients who are expected to derive the highest benefit.<\/p>\n<p>PMID:<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/38382856\/?utm_source=WordPress&amp;utm_medium=rss&amp;utm_campaign=pubmed-2&amp;utm_content=1zkXoYKOt-8t58jSDojQzKlnaSOMPnVrnm7zst_owePoHuDE8i&amp;fc=20220210064823&amp;ff=20240222014925&amp;v=2.18.0.post9+e462414\">38382856<\/a> | DOI:<a href=\"https:\/\/doi.org\/10.1016\/j.ijcard.2024.131893\">10.1016\/j.ijcard.2024.131893<\/a><\/p>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>Int J Cardiol. 2024 Feb 19:131893. doi: 10.1016\/j.ijcard.2024.131893. Online ahead of print. ABSTRACT BACKGROUND: Whether P2Y12 inhibitor monotherapy (P2Y12-I) is superior to aspirin following DAPT discontinuation post-PCI remains to be established. METHODS: We updated our prior network meta-analysis where P2Y12-I and aspirin had been compared with DAPT or directly with each other. The focus is specifically on the available direct evidence, now consisting of the three head-to-head comparisons of P2Y12-I and aspirin in event-free PCI patients after DAPT. We include a Trial Sequential Analysis of the direct evidence based on meta-analytical literature. RESULTS: The main finding reveals a 39% significantly lower risk of myocardial infarction with P2Y12-I (RR 0.61, 95% CI 0.47-0.78, p = 0.0001, I2 = 0%) with no difference in bleeding. Trial Sequential Analysis demonstrates clinically meaningful evidence for a reduction in the incidence of myocardial infarction with P2Y12-I that is also supported by statistical significance. CONCLUSIONS: Accruing data highlight that P2Y12-I following DAPT discontinuation after PCI is associated with lower risk for MI and a similar risk for bleeding as compared with ASA. In light of potential limitations to the widespread adoption of life-long P2Y12-I treatment, clinicians should consider identifying selected patients who are expected to derive the highest benefit. PMID:38382856 | DOI:10.1016\/j.ijcard.2024.131893<\/p>\n","protected":false},"author":0,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[39],"tags":[],"_links":{"self":[{"href":"https:\/\/lucalombardo.net\/wp-json\/wp\/v2\/posts\/5948"}],"collection":[{"href":"https:\/\/lucalombardo.net\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/lucalombardo.net\/wp-json\/wp\/v2\/types\/post"}],"replies":[{"embeddable":true,"href":"https:\/\/lucalombardo.net\/wp-json\/wp\/v2\/comments?post=5948"}],"version-history":[{"count":0,"href":"https:\/\/lucalombardo.net\/wp-json\/wp\/v2\/posts\/5948\/revisions"}],"wp:attachment":[{"href":"https:\/\/lucalombardo.net\/wp-json\/wp\/v2\/media?parent=5948"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/lucalombardo.net\/wp-json\/wp\/v2\/categories?post=5948"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/lucalombardo.net\/wp-json\/wp\/v2\/tags?post=5948"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}