TY - JOUR A2 - 德·罗萨，萨尔瓦多AU - 徐益盟 - 沉益民AU - 陈，德隆AU - 赵鹏飞AU - 姜君PY - 2021 DA - 2021年5月6日TI - 疗效和安全性双重抗血小板治疗患者接受冠状动脉支架植入术的系统评价和网络Meta分析SP - 9934535 VL - 2021 AB - 介绍。这个网络荟萃分析的目的是评估经皮冠状动脉介入治疗（PCI）与药物洗脱支架（DESS）后，不同的双联抗血小板治疗（DAPTs）的有效性和安全性。 方法。随机对照试验（RCT）比较长期的（> 12个月）DAPT（L-DAPT），12个月DAPT（DAPT 12MO），6个月DAPT（DAPT 6Mo），3个月DAPT随后阿司匹林单一疗法（DAPT3Mo + ASA), 3-month DAPT followed by a P2Y12 receptor inhibitor monotherapy (DAPT 3Mo + P2Y12), or 1-month DAPT with a P2Y12 receptor inhibitor monotherapy (DAPT 1Mo + P2Y12) were searched. Primary endpoints were all-cause mortality, cardiac death, myocardial infarction (MI), major bleeding, any bleeding, definite or probable stent thrombosis (ST), and net adverse clinical events (NACE). This Bayesian network meta-analysis was performed with the random-effects model. 结果。二十四随机对照试验（ N. = 81339) were included. In comparison with L-DAPT, DAPT 6Mo (OR: 0.50, 95% CI: 0.29–0.83), DAPT 3Mo + P2Y12 (OR: 0.38, 95% CI: 0.18–0.82), DAPT 3Mo + ASA (OR: 0.44, 95% CI: 0.17–0.98), and DAPT 1Mo + P2Y12 (OR: 0.45, 95% CI: 0.14–0.93) were associated with a lower risk of major bleeding. DAPT 3Mo + P2Y12 (OR: 0.58, 95% CI: 0.38–0.88) reduced the risk of any bleeding when compared with DAPT 12Mo. L-DAPT decreased the risk of MI and definite or probable stent ST when compared with DAPT 6Mo. DAPT 3Mo + P2Y12 decreased the risk of NACE in comparison with DAPT 6Mo and DAPT 12Mo. No significant difference in all-cause mortality and cardiac death was observed. In patients with acute coronary syndrome, DAPT 6Mo was comparable to DAPT 12Mo. 结论。短期（1-3个月）DAPT是DESS植入后不劣于DAPT 6Mo，而L-DAPT减少心肌梗死和明确或可能的ST率。DAPT 3Mo + P2Y12 might be a reasonable trade-off in patients with high risk of bleeding accompanied by ischemia. SN - 0896-4327 UR - https://doi.org/10.1155/2021/9934535 DO - 10.1155/2021/9934535 JF - Journal of Interventional Cardiology PB - Hindawi KW - ER -