{"doi":"10.1093/ehjcvp/pvaa025","title":"De-escalation of antiplatelets after percutaneous coronary intervention: a Bayesian network meta-analysis of various de-escalation strategies","abstract":"AIMS: To compare early de-escalation of dual antiplatelet therapy (DAPT) (1-3 months) to monotherapy with either P2Y12 inhibitor or aspirin vs. 12 months DAPT after percutaneous coronary intervention (PCI) with drug-eluting stent (DES). METHODS AND RESULTS: Electronic databases of Medline, Embase, and Cochrane library were searched through February 2020 to identify randomized controlled trials. A Bayesian network meta-analysis was conducted with random effects model. The main endpoints of interest were cardiovascular mortality and total bleeding events. Among seven trials (35 821 patients), 52.6% patients were presented with acute coronary syndrome. A total of 3359 patients and 14 530 patients were de-escalated to aspirin and P2Y12 inhibitor monotherapy, respectively. At a median follow-up of 12 months, compared with 12 months of DAPT, there was no significant difference in cardiovascular mortality between 1-month DAPT followed by P2Y12 inhibitor monotherapy [hazard ratio (HR) 0.84 (95% credible interval 0.29-2.43)], 3 months of DAPT followed by P2Y12 inhibitor monotherapy [HR 0.74 (0.39-1.46)], or 3 months of DAPT [HR 1.00 (0.54-1.86)] followed by aspirin monotherapy. Except for de-escalation of DAPT to aspirin monotherapy after 3 months [HR 0.75 (0.43-1.20)], de-escalation to P2Y12 inhibitor monotherapy after 1 month [HR 0.28 (0.10-0.83)], or 3 months [HR 0.57 (0.33-0.98)] were associated with significant decrease in total bleeding events. There were no significant differences in terms of ischaemic endpoints among different DAPT strategies. CONCLUSION: Early de-escalation of DAPT (1-3 months) to monotherapy with a P2Y12 inhibitor instead of aspirin might be a safer and equally effective approach compared with 12 months of DAPT in patients with PCI and DES.","journal":"European Heart Journal - Cardiovascular Pharmacotherapy","year":2020,"id":70949,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":18,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9502,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":258308,"name":"Muhammad Zia Khan","orcid":"0000-0001-8473-8069","position":1,"is_corresponding":false},{"id":61208,"name":"Muhammad Shahzeb Khan","orcid":"0000-0003-1250-6351","position":2,"is_corresponding":false},{"id":374924,"name":"Ahmed Mahmood","orcid":"0000-0002-5761-4025","position":3,"is_corresponding":false},{"id":262183,"name":"Ankur Kalra","orcid":"0000-0003-0080-1660","position":4,"is_corresponding":false},{"id":374925,"name":"Edo Kaluski","orcid":"0000-0002-1400-3988","position":5,"is_corresponding":false},{"id":236349,"name":"Erin D. Michos","orcid":"0000-0002-5547-5084","position":6,"is_corresponding":false},{"id":258311,"name":"Mohamad Alkhouli","orcid":"0000-0003-3847-0959","position":7,"is_corresponding":false},{"id":258307,"name":"Safi U. Khan","orcid":"0000-0003-1559-6911","position":0,"is_corresponding":true}],"reference_count":27,"raw_metadata":null,"created_at":"2026-07-18T21:43:32.585486Z","pmid":"32271872","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}