| Title |
Should a prolonged duration of dual anti-platelet therapy be recommended to patients with diabetes mellitus following percutaneous coronary intervention? A systematic review and meta-analysis of 15 studies
|
|---|---|
| Published in |
BMC Cardiovascular Disorders, August 2016
|
| DOI | 10.1186/s12872-016-0343-y |
| Pubmed ID | |
| Authors |
Pravesh Kumar Bundhun, Chandra Mouli Yanamala, Feng Huang |
| Abstract |
This study aimed to compare the adverse clinical outcomes associated with a short and a prolonged duration of Dual Anti-Platelet Therapy (DAPT) in patients with Diabetes Mellitus (DM) after undergoing Percutaneous Coronary Intervention (PCI). Medline/PubMed, EMBASE and the Cochrane library were searched for studies comparing the short and prolonged DAPT use in patients with DM. Adverse outcomes were considered as the clinical endpoints in this analysis. Odds Ratios (OR) with 95 % Confidence Intervals (CI) were used to express the pooled effect on discontinuous variables and the pooled analyses were performed with RevMan 5.3. Fifteen studies with a total number of 25,742 patients with DM were included in this current analysis which showed no significant differences in primary endpoints, net clinical outcomes, myocardial infarction and stroke with OR: 1.03, 95 % CI: 0.65-1.64; P = 0.90, OR: 0.96, 95 % CI: 0.69-1.34; P = 0.81, OR: 0.85, 95 % CI: 0.70-1.04; P = 0.12 and OR: 0.94, 95 % CI: 0.65-1.36; P = 0.75 respectively. Revascularization was also similar between these 2 groups of patients with DM. However, even if mortality favored prolonged DAPT use, with OR: 0.87, 95 % CI: 0.76-1.00; P = 0.05, the result only approached significance. Also, stent thrombosis insignificantly favored a prolonged DAPT duration with OR: 0.56, 95 % CI: 0.27-1.17; P = 0.12. Thrombolysis In Myocardial Infarction (TIMI) defined major and minor bleeding were not significantly different in these diabetic patients with OR: 0.91, 95 % CI: 0.60-1.37; P = 0.65 and OR: 1.08, 95 % CI: 0.62-1.91; P = 0.78 respectively. However, bleeding defined by the Bleeding Academic Research Consortium (BARC) classification was significantly higher with a prolonged DAPT use in these diabetic patients with OR: 1.92, 95 % CI: 1.58-2.34; P < 0.00001. Following PCI, a prolonged DAPT use was associated with similar adverse clinical outcomes but with a significantly increased BARC defined bleeding compared to a short term DAPT use in these patients with DM. However, even if mortality and stent thrombosis favored a prolonged DAPT use, these outcomes only either reached statistical significance or were insignificant respectively, showing that a clear decision about recommending a prolonged duration of DAPT to patients with DM might not be possible at this moment, warranting further research in this particular subgroup. |
X Demographics
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Mauritius | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 43 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 43 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Bachelor | 5 | 12% |
| Student > Doctoral Student | 3 | 7% |
| Student > Master | 3 | 7% |
| Student > Postgraduate | 3 | 7% |
| Other | 2 | 5% |
| Other | 6 | 14% |
| Unknown | 21 | 49% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 12 | 28% |
| Nursing and Health Professions | 2 | 5% |
| Neuroscience | 2 | 5% |
| Agricultural and Biological Sciences | 1 | 2% |
| Computer Science | 1 | 2% |
| Other | 1 | 2% |
| Unknown | 24 | 56% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 31 August 2016.
All research outputs
#15,381,871
of 22,884,315 outputs
Outputs from BMC Cardiovascular Disorders
#840
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Outputs of similar age
#215,000
of 336,882 outputs
Outputs of similar age from BMC Cardiovascular Disorders
#13
of 23 outputs
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