| Objective Dual antiplatelet therapy for 6-12 months or longer after percutaneous coronary intervention(PCI)is the cornerstone of the treatment for patients to improve prognosis,but the risk of bleeding cannot be ignored.Studies have shown that P2Y12 receptor inhibitors alone after short-duration dual antiplatelet therapy(DAPT)may better balance the risk of bleeding and ischemia and improve clinical benefits.The efficacy and safety of P2Y12 inhibitor monotherapy after short-duration dual antiplatelet therapy in patients after implantation of stents was assessed in this systematic analysis.Methods Pub Med,EMBASE(by Ovidsp),Web of Science and The Cochrane Library were searched from database inception to October 2,2019.The composite of cardiovascular outcomes,all-cause mortality,myocardial infarction(MI),stroke,stent thrombosis,and major bleeding were evaluated.Pooled outcomes were presented as relative risk(RR)and 95%confidence intervals(CIs).Results A total of four trials randomizing 29089 participants were included.Compared with the DAPT group(n= 14559),the P2Y12 inhibitor monotherapy group(n=14530)significantly decreased the incidence of bleeding events(2.0% vs.3.1%;RR: 0.60;95% CI: 0.43 to 0.84;p =0.005).There were no significant differences in all-cause mortality(1.3% vs 1.5%;RR:0.87;95% CI,0.71-1.06;P = 0.16),myocardial infarction(2.1% vs 1.9%;RR,1.06;95%CI,0.90-1.25;P = 0.46),stroke(0.6% vs 0.5%;RR,1.18;95% CI,0.67-2.07;P = 0.57),or stent thrombosis(0.5% vs 0.4%;RR,1.14;95% CI,0.81-1.61;P =0.44)between the 2 groups.Conclusion Compared with conventional 12-month aspirin plus P2Y12 inhibitor,P2Y12 inhibitor monotherapy after shortening the duration of dual antiplatelet therapy did not show significant differences in the adverse cardiovascular events,but markedly decreased the risk of bleeding in patients after PCI.P2Y12 inhibitor monotherapy may be a new alternative antiplatelet regimen.However,it still needs to be further confirmed due to limited data. |
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