Related Experiment Video
Updated: Feb 13, 2026
Meta-Analysis of the Effectiveness and Safety of Shugan Jieyu Capsules for the Treatment of Insomnia
Published on: February 17, 2023
Effect of triple versus dual antiplatelet therapy in patients undergoing percutaneous intervention: systematic review
Islam Mohsen Elhaddad1, Hesham Elsayed2, Reem Sayad3
1Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt.
Insights
Triple antiplatelet therapy (TAT) significantly reduces major adverse cardiac events (MACEs), target lesion revascularization (TLR), and target vessel revascularization (TVR) after percutaneous coronary intervention (PCI). TAT is as safe as dual antiplatelet therapy (DAT), with no significant increase in bleeding events.
Area of Science:
- Cardiology
- Interventional Cardiology
- Pharmacology
Background:
- Antiplatelet therapy is crucial after percutaneous coronary intervention (PCI) to prevent major adverse cardiac events (MACEs).
- Comparing triple antiplatelet therapy (TAT) with standard dual antiplatelet therapy (DAT) is essential for optimizing post-PCI treatment strategies.
Purpose of the Study:
- To systematically review and meta-analyze the efficacy and safety of TAT compared to DAT in patients undergoing PCI.
- To evaluate the impact of TAT on MACEs, target lesion revascularization (TLR), and target vessel revascularization (TVR).
Main Methods:
- Systematic search of PubMed, Scopus, and Web of Science databases for relevant studies.
- Inclusion of 27 studies for meta-analysis, assessing the effect of TAT versus DAT after PCI.
- Evaluation of evidence levels using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach.
Main Results:
- TAT significantly reduced MACEs at 9 and 12 months (RR=0.39, P=0.006; RR=0.57, P<0.00001).
- TAT also showed significant reductions in TLR (RR=0.33, P=0.006; RR=0.45, P=0.001) and TVR at 9 months (RR=0.62, P=0.0004).
- No statistically significant difference in any-degree bleeding was observed between TAT and DAT at 6 and 12 months.
Conclusions:
- Triple antiplatelet therapy (TAT) is more effective than dual antiplatelet therapy (DAT) in reducing MACEs, TLR, and TVR in patients after PCI.
- TAT demonstrates comparable safety to DAT, with no significant increase in adverse bleeding events.
- The findings support the consideration of TAT in specific patient populations undergoing PCI for coronary artery disease.
Introduction:
To lower major adverse cardiac events following percutaneous coronary intervention (PCI), antiplatelet therapy should be continued. We evaluated triple antiplatelet therapy (TAT) versus standard dual treatment (DAT) in patients having percutaneous intervention for coronary artery disease.
Methods:
On 17 July 2023, we systematically searched PubMed, Scopus, and the Web of Science databases. This systematic review included studies that assessed the effect of TAT versus DAT after PCI. The level of evidence of the included trials was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation approach.
Results:
Twenty-seven studies were included in this systematic review and meta-analysis. The meta-analysis showed that TAT is associated with a significant reduction in major adverse cardiac events (MACEs) at 9- and 12-month follow-up periods (risk ratio [RR] = 0.39, 95% confidence interval [CI], 0.20-0.77; P = 0.006 and RR = 0.57, 95% CI, 0.45-0.71; P < 0.00001), and also showed a significant reduction in target lesion revascularization (RR = 0.33, 95% CI, 0.15-0.73; P = 0.006, and RR = 0.45, 95% CI, 0.28-0.73; P = 0.001), respectively. It also showed a significant reduction in target vessel revascularization during the 9-month follow-up period (RR = 0.62, 95% CI, 0.48-0.81; P = 0.0004). While dual therapy has an insignificant reduction in any-degree bleeding at 6 and 12-month follow-up periods (RR = 1.02, 95% CI, 0.54-1.94; P = 0.94 and (RR = 1.28, 95% CI, 0.92-1.77; P = 0.14), compared with triple therapy. The level of evidence for MACEs, target lesion revascularization (TLR), and any degree of bleeding is moderate, but it is low for TVR, any cause of death, cardiac death, and stent thrombosis. All of them are assessed with a 12-month follow-up duration.
Conclusion:
TAT appears to be more effective than DAT in reducing MACEs, TLR, and TVR in acute coronary syndrome patients after PCI. TAT is almost as safe as DAT in these patients because there is a statistically insignificant difference in most of the adverse effects between these two groups.
Related Concept Videos
01:19Sieve Analysis and Grading Curves
01:10Review and Preview
Percentiles are a type of fractile that partition data into...
01:13Review and Preview
01:19Graded Potential
Graded potentials fall into two categories: depolarizing and hyperpolarizing. Depolarizing graded potentials typically occur when sodium (Na+) or...
01:03Nursing Interventions I: Taxonomy of Nursing Interventions
A nursing intervention is a treatment or action based on scientific concepts and knowledge from the nursing, behavioral, and physical sciences. Identifying and prioritizing nursing interventions based on the desired outcome...
01:29Nursing Interventions II: Selecting and Classifying the Nursing Interventions