PMID- 32844374
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210118
IS  - 1869-6953 (Print)
IS  - 1869-6961 (Electronic)
IS  - 1869-6961 (Linking)
VI  - 11
IP  - 10
DP  - 2020 Oct
TI  - Discontinuing Aspirin After Short Term Use Versus Continuous Use with a P2Y12 
      Inhibitor for the Treatment of Patients with Type 2 Diabetes Mellitus Following 
      Percutaneous Coronary Intervention: A Meta-analysis.
PG  - 2299-2311
LID - 10.1007/s13300-020-00909-8 [doi]
AB  - INTRODUCTION: In this analysis, we aimed to compare the efficacy and safety of 
      discontinuing aspirin (ASA) after short-term use versus its continuous use with a 
      P2Y12 inhibitor for the treatment of patients with type 2 diabetes mellitus 
      (T2DM) following percutaneous coronary intervention (PCI). METHODS: From May to 
      June 2020, electronic databases were searched for related publications. The 
      cardiovascular and bleeding outcomes representing efficacy and safety, 
      respectively, were the endpoints of this study. The new RevMan software version 
      5.4 was used to analyze the data. Risk ratios (RR) and 95% confidence intervals 
      (CI) were used to represent the results following data analysis. RESULTS: A total 
      of 9774 participants with T2DM were included in this analysis, whereby 4941 
      patients were assigned to the ASA discontinuation group and 4833 patients to the 
      dual antiplatelet (DAPT) group. Our result showed that compared to a longer 
      duration (12 months) of DAPT (ASA + P2Y12 inhibitor) use in these patients with 
      T2DM, discontinuing ASA after short-term use (1-3 months) thereafter using only a 
      P2Y12 inhibitor (mono-therapy) was not associated with a significant increase in 
      the risk of major adverse cardiovascular and cerebrovascular events (RR 0.92, 95% 
      CI 0.76-1.12; P = 0.39), myocardial infarction (RR 0.98, 95% CI 0.75-1.26; 
      P = 0.86), all-cause mortality (RR 0.78, 95% CI 0.60-1.02; P = 0.07), cardiac 
      death (RR 0.76, 95% CI 0.43-1.35; P = 0.35), stroke (RR 1.06, 95% CI 0.67-1.67; 
      P = 0.80) and stent thrombosis (RR 0.98, 95% CI 0.58-1.65; P = 0.93). However, 
      discontinuing ASA after short-term use in these patients with T2DM was associated 
      with a lower risk of bleeding defined according to the Academic Research 
      Consortium (BARC) type 2-5 (RR 0.55, 95% CI 0.41-0.73; P = 0.0001), and 
      thrombolysis in myocardial infarction (TIMI) defined as major (RR 0.55, 95% CI 
      0.41-0.75; P = 0.0001) and minor bleeding (RR 0.58, 95% CI 0.43-0.78; 
      P = 0.0004). CONCLUSION: Discontinuing ASA after short-term use for the treatment 
      of patients with T2DM following PCI was not associated with any increased 
      cardiovascular outcomes. Also, discontinuing ASA after short-term use and 
      continuing the use of a P2Y12 inhibitor were somewhat safer in these patients 
      with T2DM. Further research should follow.
FAU - Wang, Qiang
AU  - Wang Q
AD  - Institute of Cardiovascular Diseases, Jingzhou Central Hospital, Jingzhou 
      Clinical Medical College, Yangtze University, Jingzhou, Hubei, People's Republic 
      of China.
FAU - Yang, Keping
AU  - Yang K
AD  - Institute of Cardiovascular Diseases, Jingzhou Central Hospital, Jingzhou 
      Clinical Medical College, Yangtze University, Jingzhou, Hubei, People's Republic 
      of China. yangkeping2003@163.com.
FAU - Bundhun, Pravesh Kumar
AU  - Bundhun PK
AD  - Department of Internal Medicine, Flacq Hospital, Central Flacq, Mauritius.
LA  - eng
PT  - Journal Article
DEP - 20200825
PL  - United States
TA  - Diabetes Ther
JT  - Diabetes therapy : research, treatment and education of diabetes and related 
      disorders
JID - 101539025
PMC - PMC7509031
OTO - NOTNLM
OT  - Aspirin
OT  - Bleeding
OT  - Dual anti-platelet agents
OT  - Major adverse cardiovascular and cerebrovascular events
OT  - P2Y12 inhibitors
OT  - Percutaneous coronary intervention
OT  - Type 2 diabetes mellitus
EDAT- 2020/08/28 06:00
MHDA- 2020/08/28 06:01
PMCR- 2020/08/25
CRDT- 2020/08/27 06:00
PHST- 2020/07/23 00:00 [received]
PHST- 2020/08/28 06:00 [pubmed]
PHST- 2020/08/28 06:01 [medline]
PHST- 2020/08/27 06:00 [entrez]
PHST- 2020/08/25 00:00 [pmc-release]
AID - 10.1007/s13300-020-00909-8 [pii]
AID - 909 [pii]
AID - 10.1007/s13300-020-00909-8 [doi]
PST - ppublish
SO  - Diabetes Ther. 2020 Oct;11(10):2299-2311. doi: 10.1007/s13300-020-00909-8. Epub 
      2020 Aug 25.