ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: FR-PO373

Duration of Dual Antiplatelet Therapy in Patients with CKD and Drug-Eluting Stents: A Meta-Analysis

Session Information

Category: Hypertension and CVD

  • 1402 Hypertension and CVD: Clinical, Outcomes, and Trials

Authors

  • Mavrakanas, Thomas, Brigham & Women's Hospital, Boston, United States
  • Chatzizisis, Yiannis, UNMC, Omaha, Nebraska, United States
  • Gariani, Karim, Geneva University Hospital, Geneva, Switzerland
  • Kereiakes, Dean J., The Christ Hospital, Cincinnati, Ohio, United States
  • Gargiulo, Giuseppe, Bern University Hospital, Bern, Switzerland
  • Feres, Fausto, Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil
  • Morice, Marie claude, Générale de Santé - Institut Cardiovasculaire Paris Sud, MASSY, France
  • Georges, Jean-Louis, Centre Hospitalier de Versailles, LE CHESNAY, France
  • Valgimigli, Marco, University Hospital Bern, Bern, Switzerland
  • Bhatt, Deepak L., Brigham and Women''s Hospital, Newton, Massachusetts, United States
  • Mauri, Laura, Brigham and Women''s Hospital, Newton, Massachusetts, United States
  • Charytan, David M., Brigham and Women's Hospital/Harvard Medical School, Brookline, Massachusetts, United States
Background

Whether prolonged dual antiplatelet therapy (DAPT) is more protective in chronic kidney disease (CKD) patients with drug-eluting stents (DES) compared with shorter DAPT is uncertain. This meta-analysis examined whether shorter DAPT in patients with DES and CKD is associated with lower mortality or major adverse cardiovascular event rates compared with longer DAPT.

Methods

A Medline literature research was conducted to identify randomized trials in patients with DES comparing different DAPT duration strategies. The primary outcome was a composite of all-cause mortality, myocardial infarction, stroke, or stent thrombosis (definite- probable). The secondary outcome was major bleeding. A random-effects model was used.

Results

Five randomized controlled trials were included (1,902 CKD patients). Short DAPT (≤6 months) was associated with a similar incidence of the primary outcome, compared with 12-months DAPT among patients with CKD (Figure). Twelve-months DAPT was also associated with a similar incidence of the primary outcome compared with extended DAPT (≥30 months) in the CKD subgroup (Figure). Numerically lower major bleeding event rates were detected with shorter vs. 12-month DAPT (RR 0.68, 95% CI 0.29-1.60, p=0.38) and 12-month vs. extended DAPT (RR 0.82, 95% CI 0.34-1.94, p=0.65) in CKD patients.

Conclusion

Short DAPT may be preferred to longer DAPT in CKD patients with DES.

Forest plot showing the impact of short (≤6 months), 12-month, and extended (>=30 months) dual antiplatelet therapy on the composite primary outcome, a composite of all-cause mortality, myocardial infarction, stroke, and stent thrombosis (definite or probable) in patients with chronic kidney disease.