TY  - JOUR
A1  - Golwala, Harsh B.
A1  - Cannon, Christopher P.
A1  - Steg, P. Gabriel
A1  - Doros, Gheorghe
A1  - Qamar, Arman
A1  - Ellis, Stephen G.
A1  - Oldgren, Jonas
A1  - Berg, Jurriën Maria ten
A1  - Kimura, Takeshi
A1  - Hohnloser, Stefan H.
A1  - Lip, Gregory Y. H.
A1  - Bhatt, Deepak L.
T1  - 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
T2  - European heart journal
N2  - 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.
KW  - Atrial fibrillation
KW  - Antithrombotic therapy
KW  - Percutaneous coronary intervention
KW  - Dual therapy
KW  - Triple therapy
Y1  - 2018
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/54467
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-544672
SN  - 1522-9645
SN  - 0195-668X
N1  - This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
VL  - 39
IS  - 19
SP  - 1726
EP  - 1735
PB  - Oxford University Press
CY  - Oxford
ER  -