Related Experiment Video
Updated: Jan 26, 2026
Design of a Biocompatible Drug-Eluting Tracheal Stent in Mice with Laryngotracheal Stenosis
Published on: January 21, 2020
Duration of Dual Antiplatelet Therapy in Patients with CKD and Drug-Eluting Stents: A Meta-Analysis
Thomas A Mavrakanas1,2, Yiannis S Chatzizisis3, Karim Gariani4
1Renal Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Insights
Shorter dual antiplatelet therapy (DAPT) is as effective as longer DAPT for patients with chronic kidney disease (CKD) and drug-eluting stents, with similar rates of major adverse cardiovascular events. Further research is needed to confirm findings on stent thrombosis.
Area of Science:
- Cardiology
- Nephrology
- Pharmacology
Background:
- Dual antiplatelet therapy (DAPT) duration is critical for patients with drug-eluting stents.
- Optimal DAPT duration in patients with chronic kidney disease (CKD) remains uncertain.
- CKD is a significant risk factor for adverse cardiovascular events and bleeding.
Purpose of the Study:
- To compare the efficacy and safety of shorter versus longer DAPT durations in patients with CKD and drug-eluting stents.
- To evaluate if shorter DAPT is associated with lower mortality or major adverse cardiovascular events.
- To assess the impact of DAPT duration on major bleeding events in this patient population.
Main Methods:
- Meta-analysis of randomized controlled trials identified through Medline literature research.
- Inclusion criteria required randomized trials comparing DAPT durations in patients with drug-eluting stents and CKD.
- Primary outcome: composite of all-cause mortality, myocardial infarction, stroke, or stent thrombosis. Secondary outcome: major bleeding.
Main Results:
- Short DAPT (≤6 months) showed similar primary outcome rates compared to 12-month DAPT in CKD patients (RR, 0.93; 95% CI, 0.64-1.36).
- Twelve-month DAPT demonstrated similar primary outcome rates compared to extended DAPT (≥30 months) in the CKD subgroup (RR, 1.04; 95% CI, 0.67-1.62).
- Major bleeding event rates were numerically lower with shorter DAPT durations, though not statistically significant.
Conclusions:
- Shorter DAPT durations (≤6 months or 12 months) do not appear inferior to longer DAPT in patients with CKD and drug-eluting stents regarding major adverse cardiovascular events.
- Due to imprecision from few events and wide confidence intervals, definitive conclusions regarding stent thrombosis cannot be drawn.
- Further research with larger sample sizes is warranted to clarify the optimal DAPT strategy in CKD patients with drug-eluting stents.
Background And Objectives:
Whether prolonged dual antiplatelet therapy (DAPT) is more protective in patients with CKD and drug-eluting stents compared with shorter DAPT is uncertain. The purpose of this meta-analysis was to examine whether shorter DAPT in patients with drug-eluting stents and CKD is associated with lower mortality or major adverse cardiovascular event rates compared with longer DAPT.
Design, Setting, Participants, & Measurements:
A Medline literature research was conducted to identify randomized trials in patients with drug-eluting stents comparing different DAPT duration strategies. Inclusion of patients with CKD was also required. The primary outcome was a composite of all-cause mortality, myocardial infarction, stroke, or stent thrombosis (definite or probable). Major bleeding was the secondary outcome. The risk ratio (RR) was estimated using a random-effects model.
Results:
Five randomized trials were included (1902 patients with CKD). Short DAPT (≤6 months) was associated with a similar incidence of the primary outcome, compared with 12-month DAPT among patients with CKD (48 versus 50 events; RR, 0.93; 95% confidence interval [95% CI], 0.64 to 1.36; P=0.72). Twelve-month DAPT was also associated with a similar incidence of the primary outcome compared with extended DAPT (≥30 months) in the CKD subgroup (35 versus 35 events; RR, 1.04; 95% CI, 0.67 to 1.62; P=0.87). Numerically lower major bleeding event rates were detected with shorter versus 12-month DAPT (9 versus 13 events; RR, 0.69; 95% CI, 0.30 to 1.60; P=0.39) and 12-month versus extended DAPT (9 versus 12 events; RR, 0.83; 95% CI, 0.35 to 1.93; P=0.66) in patients with CKD.
Conclusions:
Short DAPT does not appear to be inferior to longer DAPT in patients with CKD and drug-eluting stents. Because of imprecision in estimates (few events and wide confidence intervals), no definite conclusions can be drawn with respect to stent thrombosis.
More Related Videos
09:49Dual-phase Cone-beam Computed Tomography to See, Reach, and Treat Hepatocellular Carcinoma during Drug-eluting Beads Transarterial Chemo-embolization
Published on: December 2, 2013
04:34Meta-Analysis of the Effectiveness and Safety of Shugan Jieyu Capsules for the Treatment of Insomnia
Published on: February 17, 2023
Related Concept Videos
01:28Drug Therapy
Antianxiety Medications
01:20Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
01:15Drug Dosing: Geriatric Patients
01:21Drug Dosing: Obese Patients
01:26Drug Administration and Therapy Phases: Overview
The pharmaceutical phase focuses on leveraging the physicochemical properties of the drug to design and manufacture an effective product. Variants include orally administered tablets or capsules, topical creams or ointments, and parenteral-delivery solutions or emulsions.
The pharmacokinetic phase...
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion