PMID- 26450578
OWN - NLM
STAT- MEDLINE
DCOM- 20160609
LR  - 20181202
IS  - 1471-2261 (Electronic)
IS  - 1471-2261 (Linking)
VI  - 15
DP  - 2015 Oct 9
TI  - Comparing the effectiveness and safety between triple antiplatelet therapy and 
      dual antiplatelet therapy in type 2 diabetes mellitus patients after coronary 
      stents implantation: a systematic review and meta-analysis of randomized 
      controlled trials.
PG  - 118
LID - 10.1186/s12872-015-0114-1 [doi]
LID - 118
AB  - BACKGROUND: Since antiplatelet therapy in type 2 diabetes mellitus (T2DM) 
      patients is very important after intracoronary stenting, and because the most 
      commonly used therapies have been the dual antiplatelet therapy (DAPT) consisting 
      of aspirin and clopidogrel and the triple antiplatelet therapy (TAPT) consisting 
      of aspirin, clopidogrel and cilostazol, we aim to compare the effectiveness and 
      safety between triple antiplatelet therapy and dual antiplatelet therapy in T2DM 
      patients. METHODS: Systematic literature search was done from the databases of 
      PubMed, Cochrane, Embase, China National Knowledge Infrastructure (CNKI) and 
      WanFang. Randomized controlled trials (RCTs) comparing the effectiveness and 
      safety between triple therapy and dual therapy in T2DM patients after coronary 
      stents placement were included. Endpoints included major adverse cardiac effects 
      (MACEs), target lesion revascularization (TLR), target vessel revascularization 
      (TVR), death, stent thrombosis, bleeding and adverse drug reactions during a 9-12 
      months period, as well as platelet activities. RESULTS: Four studies including 
      1005 patients reporting the adverse clinical outcomes and six studies including 
      519 patients reporting the platelet activities, with a total of 1524 patients 
      have been analyzed in this meta-analysis. The pooling analysis shows that TAPT 
      has significantly decreased the occurrence of MACEs (RR: 0.55; 95 % CI: 
      0.36-0.86, P = 0.009), TLR (RR 0.41; 95 % CI: 0.21-0.80, P = 0.008), TVR (RR 
      0.55; 95 % CI: 0.34-0.88, P = 0.01) and the overall incidence of Death/ 
      Myocardial Infarction (MI)/TVR (RR 0.54; 95 % CI: 0.31-0.94, P = 0.03) during 
      this 9 to 12 months follow up period after stents implantation. Stent thrombosis 
      was almost similar in both groups. Bleeding seemed to favor DAPT but the result 
      was not statistically significant. Platelet aggregation, platelet reactivity 
      index (PRI) and platelet reactivity unit (PRU) were also reduced with Weight Mean 
      Difference (WMD) of (-13.80; 95 % CI: -17.03 to -10.56, P < 0.00001), (-22.87; 
      95 % CI: -23.66 to -22.07, P < 0.00001) and (-44.17; 95 % CI: -58.56 to -29.77, 
      P < 0.00001) respectively. CONCLUSION: Since MACEs have been significantly 
      decreased in the triple group, TAPT appears to be more effective than DAPT in 
      T2DM patients after intracoronary stenting. No significant difference in stent 
      thrombosis and bleeding risks between these 2 groups shows TAPT to be almost as 
      safe as DAPT in these diabetic patients.
FAU - Bundhun, Pravesh Kumar
AU  - Bundhun PK
AD  - Institute of Cardiovascular Diseases, the First Affiliated Hospital of Guangxi 
      Medical University, Nanning, Guangxi, 530027, P. R. China. pravesh021@gmail.com.
FAU - Qin, Tao
AU  - Qin T
AD  - Institute of Cardiovascular Diseases, the First Affiliated Hospital of Guangxi 
      Medical University, Nanning, Guangxi, 530027, P. R. China. qintao_gxmu@sina.com.
FAU - Chen, Meng-Hua
AU  - Chen MH
AD  - Institute of Cardiovascular Diseases, the First Affiliated Hospital of Guangxi 
      Medical University, Nanning, Guangxi, 530027, P. R. China. cmhnn@sina.com.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20151009
PL  - England
TA  - BMC Cardiovasc Disord
JT  - BMC cardiovascular disorders
JID - 100968539
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - 0 (Tetrazoles)
RN  - A74586SNO7 (Clopidogrel)
RN  - N7Z035406B (Cilostazol)
RN  - OM90ZUW7M1 (Ticlopidine)
RN  - R16CO5Y76E (Aspirin)
SB  - IM
MH  - Acute Coronary Syndrome/*surgery
MH  - Aspirin/adverse effects/therapeutic use
MH  - Cilostazol
MH  - Clopidogrel
MH  - Coronary Artery Disease/*surgery
MH  - Diabetes Mellitus, Type 2/*complications
MH  - Drug Therapy, Combination
MH  - Hemorrhage/chemically induced
MH  - Humans
MH  - Platelet Aggregation Inhibitors/*adverse effects/*therapeutic use
MH  - *Stents/adverse effects
MH  - Tetrazoles/adverse effects/therapeutic use
MH  - Thrombosis/etiology
MH  - Ticlopidine/adverse effects/analogs & derivatives/therapeutic use
PMC - PMC4599328
EDAT- 2015/10/10 06:00
MHDA- 2016/06/10 06:00
PMCR- 2015/10/09
CRDT- 2015/10/10 06:00
PHST- 2015/06/26 00:00 [received]
PHST- 2015/09/25 00:00 [accepted]
PHST- 2015/10/10 06:00 [entrez]
PHST- 2015/10/10 06:00 [pubmed]
PHST- 2016/06/10 06:00 [medline]
PHST- 2015/10/09 00:00 [pmc-release]
AID - 10.1186/s12872-015-0114-1 [pii]
AID - 114 [pii]
AID - 10.1186/s12872-015-0114-1 [doi]
PST - epublish
SO  - BMC Cardiovasc Disord. 2015 Oct 9;15:118. doi: 10.1186/s12872-015-0114-1.