What question did this study set out to answer?

This study aims to evaluate the outcomes of short-duration dual antiplatelet therapy versus standard duration following PCI for ACS.

June 20, 2026CureusOpen Access

Short- Versus Standard-Duration Dual Antiplatelet Therapy After Percutaneous Coronary Intervention in Acute Coronary Syndrome: A Systematic Review and Meta-Analysis

Q: What is the clinical evidence from this study?

Study design: Meta-Analysis. Population: Acute Coronary Syndrome (n=23586). Intervention: Short-duration dual antiplatelet therapy (≤6 months) vs. Standard-duration dual antiplatelet therapy (12 months). Primary outcome: Major bleeding (HR 0.60, 95% CI 0.49-0.73, p=<0.001).

Q: What does this research mean for the field?

In patients with acute coronary syndrome undergoing percutaneous coronary intervention, short-duration dual antiplatelet therapy (≤6 months) followed by potent P2Y12 inhibitor monotherapy reduces major bleeding without increasing ischemic risk compared to standard 12-month therapy, whereas early transition to clopidogrel monotherapy increases the risk of myocardial infarction. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

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Why the study?

Does short-duration dual antiplatelet therapy (≤6 months) reduce major bleeding without increasing MACE in adults undergoing PCI with drug-eluting stents for ACS compared to standard 12-month DAPT?

Population

7 RCTs comprising 23,586 adults undergoing percutaneous coronary intervention with drug-eluting stents for…

Comparison

Short-duration dual antiplatelet therapy… vs Standard-duration dual antiplatelet therapy.

Design

Meta-analysis

Key result

Short-duration DAPT (≤6 months) significantly reduced major bleeding by 40% (HR 0.60) compared to standard 12-month DAPT without increasing major adverse cardiovascular events.

Authors

MKMohammad Khalil YKYahia Khalil

Discussion

Member takes

Overview

Supports shorter DAPT (≤6 months) post-ACS PCI to cut bleeding; confirms ischemic safety versus 12-month regimens in meta-analysis.

Key Points

This study aims to evaluate the outcomes of short-duration dual antiplatelet therapy versus standard duration following PCI for ACS.
Conducted a systematic review and meta-analysis of randomized controlled trials (RCTs)
Searched MEDLINE, EMBASE, and CENTRAL databases until March 2026
Included 7 RCTs with 23,586 patients comparing short DAPT (≤6 months) and standard DAPT (12 months)
Short DAPT significantly reduced the risk of major bleeding by 40% (HR 0.60, 95% CI 0.49-0.73; p<0.001)
No significant increase in major adverse cardiovascular events (MACE) (HR 1.02, 95% CI 0.88-1.17; p=0.79)
Risk of myocardial infarction was doubled with early clopidogrel versus potent P2Y12 inhibitors

Study Design

Type

Meta-Analysis (n=23,586)

Blinding

Open-label

Randomization

Parallel-group or non-inferiority

Multicenter

Yes

Structured PICO

Does short-duration dual antiplatelet therapy (≤6 months) reduce major bleeding without increasing MACE in adults undergoing PCI with drug-eluting stents for ACS compared to standard 12-month DAPT?

Population

23,586 adult patients with acute coronary syndrome undergoing percutaneous coronary intervention with drug-eluting stents, followed for 12 months.

Intervention

Short-duration dual antiplatelet therapy (≤6 months) followed by single antiplatelet therapy.

Comparator

Standard-duration dual antiplatelet therapy (12 months).

Outcome

Co-primary endpoints: major bleeding and major adverse cardiovascular events (MACE), defined as a composite of death, myocardial infarction (MI), and stroke.composite

Main Result

Hazard Ratio: 0.6 (95% CI 0.49–0.73)

p-value: p=<0.001

In ACS patients undergoing PCI, short DAPT (≤6 months) followed by potent P2Y12 inhibitor monotherapy reduces major bleeding without increasing ischemic risk compared to standard 12-month DAPT.

Limitations

Included trials inherently utilized an open-label design, which may introduce potential detection bias.
Trials evaluating clopidogrel-based abbreviations predominantly enrolled East Asian populations, requiring careful clinical contextualization for Western populations.

Cite This Study

Khalil et al. (2026) conducted a meta-analysis in Acute Coronary Syndrome (n=23,586). Short-duration dual antiplatelet therapy (≤6 months) vs. Standard-duration dual antiplatelet therapy (12 months) was evaluated on Major bleeding (HR 0.60, 95% CI 0.49-0.73, p=<0.001). Short-duration DAPT (≤6 months) significantly reduced major bleeding by 40% (HR 0.60) compared to standard 12-month DAPT without increasing major adverse cardiovascular events.

synapsesocial.com/papers/6a3721e201fe431c251889a1 https://doi.org/10.7759/cureus.111160

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June 20, 2026CureusOpen Access

Short- Versus Standard-Duration Dual Antiplatelet Therapy After Percutaneous Coronary Intervention in Acute Coronary Syndrome: A Systematic Review and Meta-Analysis

View Full Paper

Ask AI

Bookmark

Why the study?

Does short-duration dual antiplatelet therapy (≤6 months) reduce major bleeding without increasing MACE in adults undergoing PCI with drug-eluting stents for ACS compared to standard 12-month DAPT?

Population

7 RCTs comprising 23,586 adults undergoing percutaneous coronary intervention with drug-eluting stents for…

Comparison

Short-duration dual antiplatelet therapy… vs Standard-duration dual antiplatelet therapy.

Design

Meta-analysis

Key result

Short-duration DAPT (≤6 months) significantly reduced major bleeding by 40% (HR 0.60) compared to standard 12-month DAPT without increasing major adverse cardiovascular events.

Authors

MKMohammad Khalil YKYahia Khalil

Discussion

Member takes

Overview

Supports shorter DAPT (≤6 months) post-ACS PCI to cut bleeding; confirms ischemic safety versus 12-month regimens in meta-analysis.

Key Points

This study aims to evaluate the outcomes of short-duration dual antiplatelet therapy versus standard duration following PCI for ACS.
Conducted a systematic review and meta-analysis of randomized controlled trials (RCTs)
Searched MEDLINE, EMBASE, and CENTRAL databases until March 2026
Included 7 RCTs with 23,586 patients comparing short DAPT (≤6 months) and standard DAPT (12 months)
Short DAPT significantly reduced the risk of major bleeding by 40% (HR 0.60, 95% CI 0.49-0.73; p<0.001)
No significant increase in major adverse cardiovascular events (MACE) (HR 1.02, 95% CI 0.88-1.17; p=0.79)
Risk of myocardial infarction was doubled with early clopidogrel versus potent P2Y12 inhibitors

Study Design

Type

Meta-Analysis (n=23,586)

Blinding

Open-label

Randomization

Parallel-group or non-inferiority

Multicenter

Yes

Structured PICO

Does short-duration dual antiplatelet therapy (≤6 months) reduce major bleeding without increasing MACE in adults undergoing PCI with drug-eluting stents for ACS compared to standard 12-month DAPT?

Population

23,586 adult patients with acute coronary syndrome undergoing percutaneous coronary intervention with drug-eluting stents, followed for 12 months.

Intervention

Short-duration dual antiplatelet therapy (≤6 months) followed by single antiplatelet therapy.

Comparator

Standard-duration dual antiplatelet therapy (12 months).

Outcome

Co-primary endpoints: major bleeding and major adverse cardiovascular events (MACE), defined as a composite of death, myocardial infarction (MI), and stroke.composite

Main Result

Hazard Ratio: 0.6 (95% CI 0.49–0.73)

p-value: p=<0.001

In ACS patients undergoing PCI, short DAPT (≤6 months) followed by potent P2Y12 inhibitor monotherapy reduces major bleeding without increasing ischemic risk compared to standard 12-month DAPT.

Limitations

Included trials inherently utilized an open-label design, which may introduce potential detection bias.
Trials evaluating clopidogrel-based abbreviations predominantly enrolled East Asian populations, requiring careful clinical contextualization for Western populations.

Cite This Study

synapsesocial.com/papers/6a3721e201fe431c251889a1 https://doi.org/10.7759/cureus.111160

Also Consider

Synapse has enriched 3 closely related papers on similar clinical questions. Consider them for comparative context:

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