{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T17:54:59Z","timestamp":1790704499794,"version":"4.1.0"},"reference-count":32,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2020,3,3]],"date-time":"2020-03-03T00:00:00Z","timestamp":1583193600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The respective ischemic and bleeding risks of early aspirin discontinuation following an acute coronary syndrome (ACS) or percutaneous coronary intervention (PCI) remain uncertain. We performed a prospero-registered review of randomized controlled trials (RCTs) comparing a P2Y12 inhibitor-based single antiplatelet strategy following early aspirin discontinuation to a strategy of sustained dual antiplatelet therapy (DAPT) in ACS or PCI patients requiring, or not, anticoagulation for another indication (CRD42019139576). We estimated risk ratios (RR) and 95% confidence intervals (CI) using random effect models. We included nine RCTs comprising 40,621 patients. Compared to prolonged DAPT, major bleeding (2.2% vs. 2.8%; RR 0.68; 95% CI: 0.54 to 0.87; p = 0.002; I2: 63%), non-major bleeding (5.0 % vs. 6.1 %; RR: 0.66; 95% CI: 0.47 to 0.94; p = 0.02; I2: 87%) and all bleeding (7.4% vs. 9.9%; RR: 0.65; 95% CI: 0.53 to 0.79; p &lt; 0.0001; I2: 88%) were significantly reduced with early aspirin discontinuation without significant difference for all-cause death (p = 0.60), major adverse cardiac and cerebrovascular events (MACE) (p = 0.60), myocardial infarction (MI) (p = 0.77), definite stent thrombosis (ST) (p = 0.63), and any stroke (p = 0.59). In patients on DAPT after an ACS or a PCI, early aspirin discontinuation prevents bleeding events with no significant adverse effect on the ischemic risk or mortality.<\/jats:p>","DOI":"10.3390\/jcm9030680","type":"journal-article","created":{"date-parts":[[2020,3,4]],"date-time":"2020-03-04T03:24:20Z","timestamp":1583292260000},"page":"680","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Early Aspirin Discontinuation Following Acute Coronary Syndrome or Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis of Randomized Controlled Trials"],"prefix":"10.3390","volume":"9","author":[{"given":"Paul","family":"Guedeney","sequence":"first","affiliation":[{"name":"Sorbonne University, ACTION Study Group, INSERM UMRS_1166, Cardiology Institute, Piti\u00e9 Salp\u00eatri\u00e8re Hospital (AP-HP) Paris, 75013 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jules","family":"Mesnier","sequence":"additional","affiliation":[{"name":"Sorbonne University, ACTION Study Group, INSERM UMRS_1166, Cardiology Institute, Piti\u00e9 Salp\u00eatri\u00e8re Hospital (AP-HP) Paris, 75013 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabato","family":"Sorrentino","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medical and Surgical Science, Magna Graecia University, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7865-9476","authenticated-orcid":false,"given":"Farouk","family":"Abcha","sequence":"additional","affiliation":[{"name":"Sorbonne University, ACTION Study Group, INSERM UMRS_1166, Cardiology Institute, Piti\u00e9 Salp\u00eatri\u00e8re Hospital (AP-HP) Paris, 75013 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"Zeitouni","sequence":"additional","affiliation":[{"name":"Sorbonne University, ACTION Study Group, INSERM UMRS_1166, Cardiology Institute, Piti\u00e9 Salp\u00eatri\u00e8re Hospital (AP-HP) Paris, 75013 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benoit","family":"Lattuca","sequence":"additional","affiliation":[{"name":"Sorbonne University, ACTION Study Group, INSERM UMRS_1166, Cardiology Institute, Piti\u00e9 Salp\u00eatri\u00e8re Hospital (AP-HP) Paris, 75013 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanne","family":"Silvain","sequence":"additional","affiliation":[{"name":"Sorbonne University, ACTION Study Group, INSERM UMRS_1166, Cardiology Institute, Piti\u00e9 Salp\u00eatri\u00e8re Hospital (AP-HP) Paris, 75013 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5388-942X","authenticated-orcid":false,"given":"Salvatore","family":"De Rosa","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medical and Surgical Science, Magna Graecia University, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1241-6487","authenticated-orcid":false,"given":"Ciro","family":"Indolfi","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medical and Surgical Science, Magna Graecia University, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Philippe","family":"Collet","sequence":"additional","affiliation":[{"name":"Sorbonne University, ACTION Study Group, INSERM UMRS_1166, Cardiology Institute, Piti\u00e9 Salp\u00eatri\u00e8re Hospital (AP-HP) Paris, 75013 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathieu","family":"Kerneis","sequence":"additional","affiliation":[{"name":"Sorbonne University, ACTION Study Group, INSERM UMRS_1166, Cardiology Institute, Piti\u00e9 Salp\u00eatri\u00e8re Hospital (AP-HP) Paris, 75013 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilles","family":"Montalescot","sequence":"additional","affiliation":[{"name":"Sorbonne University, ACTION Study Group, INSERM UMRS_1166, Cardiology Institute, Piti\u00e9 Salp\u00eatri\u00e8re Hospital (AP-HP) Paris, 75013 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,3,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1056\/NEJMoa010746","article-title":"Clopidogrel in Unstable Angina to Prevent Recurrent Events Trial Investigators Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation","volume":"345","author":"Yusuf","year":"2001","journal-title":"N. 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