{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T15:42:53Z","timestamp":1792510973622,"version":"4.5.0"},"reference-count":33,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Appl Thromb Hemost"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The optimal duration of dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) in acute coronary syndrome (ACS) remains debated. While DAPT with aspirin and a P2Y12 inhibitor prevents ischemic events, it increases bleeding risk. This meta-analysis evaluates whether early aspirin discontinuation with P2Y12 inhibitor monotherapy offers comparable efficacy and improved safety versus standard long-term DAPT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This review, conducted according to PRISMA guidelines, searched PubMed, Cochrane Central and Clinicaltrials.gov up to September 2025 for RCTs comparing short-term DAPT (\u22643 months) followed by P2Y12 inhibitor monotherapy with standard-duration DAPT (\u22656-12 months). Outcomes included NACE, MACE, all-cause and cardiovascular mortality, myocardial infarction, stroke, stent thrombosis, and BARC 3 or 5 bleeding. Random-effects models were applied to estimate pooled risk ratios and 95% CIs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Ten RCTs involving 35,277 patients were included. Compared with standard DAPT, short-term DAPT followed by P2Y12 inhibitor monotherapy significantly reduced NACE (RR = 0.80, 95% CI 0.71-0.90; p = 0.0002; I\n                      <jats:sup>2<\/jats:sup>\n                      = 38%), and BARC type 3 or 5 bleeding (RR\u2009=\u20090.48, 95% CI 0.40-0.58; p\u2009&lt;\u20090.001; I\n                      <jats:sup>2<\/jats:sup>\n                      = 0%), without significant differences in MACE (RR: 1.01 [0.86, 1.19]; p\u2009=\u20090.87; I\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u2009 41%) or all-cause mortality (RR: 0.96 [0.80, 1.16]; p\u2009=\u20090.69; I\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20094%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Early transition to P2Y12 inhibitor monotherapy after 1\u20133\u2005months of DAPT in ACS patients undergoing PCI significantly reduces bleeding without increasing ischemic events. Ticagrelor- or prasugrel-based monotherapy represents a safe and effective alternative to conventional 12-month DAPT.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10760296261422490","type":"journal-article","created":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T17:54:31Z","timestamp":1770832471000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Potent P2Y12 Inhibitor Monotherapy Versus Dual Antiplatelet Therapy After Percutaneous Coronary Intervention for Acute Coronary Syndromes: A Systematic Review and Meta-Analysis"],"prefix":"10.1177","volume":"32","author":[{"given":"Muhammad","family":"Ibrahim","sequence":"first","affiliation":[{"name":"Ziauddin University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahtaj","family":"Tariq","sequence":"additional","affiliation":[{"name":"Dow University of Health Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Khalid","family":"Afridi","sequence":"additional","affiliation":[{"name":"Dow University of Health Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2050-6351","authenticated-orcid":false,"given":"Aroosa","family":"Zafar","sequence":"additional","affiliation":[{"name":"Wah Medical College"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fawaz Ahmed","family":"Khamisani","sequence":"additional","affiliation":[{"name":"Ziauddin University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1817-7800","authenticated-orcid":false,"given":"Hasibullah","family":"Aminpoor","sequence":"additional","affiliation":[{"name":"Kabul University of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. 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Washaqul","family":"Arfin","sequence":"additional","affiliation":[{"name":"Ziauddin University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregg C.","family":"Fonarow","sequence":"additional","affiliation":[{"name":"Ronald Reagan-UCLA Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen J.","family":"Greene","sequence":"additional","affiliation":[{"name":"Department of Medicine, Duke Clinical Research Institute"},{"name":"Division of Cardiology, Duke University School of Medicine, Durham, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muzammil H.","family":"Musani","sequence":"additional","affiliation":[{"name":"Adjunct Clinical Assistant Professor Indiana University School of Medicine"},{"name":"Director Advanced Cardiac Imaging, Lutheran Hospital, Fort Wayne, Indiana, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saad Ahmed","family":"Waqas","sequence":"additional","affiliation":[{"name":"Dow University of Health Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,2,11]]},"reference":[{"key":"e_1_3_4_2_2","volume-title":"StatPearls","author":"Singh A","year":"2023","unstructured":"Singh A, Museedi AS, Grossman SA. 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