{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T18:10:45Z","timestamp":1793556645667,"version":"4.5.0"},"reference-count":57,"publisher":"American Medical Association (AMA)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Cardiol"],"published-print":{"date-parts":[[2024,12,1]]},"abstract":"<jats:sec id=\"ab-hoi240057-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>The optimal duration of dual antiplatelet therapy (DAPT) in patients with acute coronary syndromes (ACS) undergoing percutaneous coronary intervention (PCI) remains under debate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-hoi240057-5\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To analyze the efficacy and safety of DAPT strategies in patients with ACS using a bayesian network meta-analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-hoi240057-6\">\n                    <jats:title>Data Sources<\/jats:title>\n                    <jats:p>MEDLINE, Embase, Cochrane, and LILACS databases were searched from inception to April 8, 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-hoi240057-7\">\n                    <jats:title>Study Selection<\/jats:title>\n                    <jats:p>Randomized clinical trials (RCTs) comparing DAPT duration strategies in patients with ACS undergoing PCI were selected. Short-term strategies (1 month of DAPT followed by P2Y12 inhibitors, 3 months of DAPT followed by P2Y12 inhibitors, 3 months of DAPT followed by aspirin, and 6 months of DAPT followed by aspirin) were compared with conventional 12 months of DAPT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-hoi240057-8\">\n                    <jats:title>Data Extraction and Synthesis<\/jats:title>\n                    <jats:p>This systematic review and network meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The risk ratio (RR) with a 95% credible interval (CrI) was calculated within a bayesian random-effects network meta-analysis. Treatments were ranked using surface under the cumulative ranking (SUCRA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-hoi240057-9\">\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>The primary efficacy end point was major adverse cardiac and cerebrovascular events (MACCE); the primary safety end point was major bleeding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-hoi240057-10\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 15 RCTs randomizing 35\u202f326 patients (mean [SD] age, 63.1 [11.1] years; 26\u202f954 male [76.3%]; 11\u202f339 STEMI [32.1%]) with ACS were included. A total of 24\u202f797 patients (70.2%) received potent P2Y12 inhibitors (ticagrelor or prasugrel). Compared with 12 months of DAPT, 1 month of DAPT followed by P2Y12 inhibitors reduced major bleeding (RR, 0.47; 95% CrI, 0.26-0.74) with no difference in MACCE (RR, 1.00; 95% CrI, 0.70-1.41). No significant differences were observed in MACCE incidence between strategies, although CrIs were wide. SUCRA ranked 1 month of DAPT followed by P2Y12 inhibitors as the best for reducing major bleeding and 3 months of DAPT followed by P2Y12 inhibitors as optimal for reducing MACCE (RR, 0.85; 95% CrI, 0.56-1.21).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-hoi240057-11\">\n                    <jats:title>Conclusion and Relevance<\/jats:title>\n                    <jats:p>Results of this systematic review and network meta-analysis reveal that, in patients with ACS undergoing PCI with DES, 1 month of DAPT followed by potent P2Y12 inhibitor monotherapy was associated with a reduction in major bleeding without increasing MACCE when compared with 12 months of DAPT. However, an increased risk of MACCE cannot be excluded, and 3 months of DAPT followed by potent P2Y12 inhibitor monotherapy was ranked as the best option to reduce MACCE. Because most patients receiving P2Y12 inhibitor monotherapy were taking ticagrelor, the safety of stopping aspirin in those taking clopidogrel remains unclear.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamacardio.2024.3216","type":"journal-article","created":{"date-parts":[[2024,10,9]],"date-time":"2024-10-09T11:24:28Z","timestamp":1728473068000},"page":"1094","source":"Crossref","is-referenced-by-count":54,"title":["Short-Term Dual Antiplatelet Therapy After Drug-Eluting Stenting in Patients With Acute Coronary Syndromes"],"prefix":"10.1001","volume":"9","author":[{"given":"Pedro E. 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P.","family":"Braga","sequence":"additional","affiliation":[{"name":"Department of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia O.","family":"Guimar\u00e3es","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roxana","family":"Mehran","sequence":"additional","affiliation":[{"name":"Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, New York, New York"},{"name":"Associate Editor, JAMA Cardiology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Windecker","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Bern University Hospital, Inselspital, University of Bern, Bern, 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