<h2 class="section-title u-h3 u-margin-l-top u-margin-xs-bottom">Abstract</h2> <div id="as0005"> <h3 id="st0010" class="u-h4 u-margin-m-top u-margin-xs-bottom">Background</h3> <p id="sp0050"><a title="Learn more about Antithrombotic from ScienceDirect's AI-generated Topic Pages" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/antithrombotic">Anti-thrombotic</a> regimen in patients on long term <a title="Learn more about Anticoagulation from ScienceDirect's AI-generated Topic Pages" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/anticoagulation">anticoagulation</a> requiring coronary intervention remains a clinical challenge.</p> </div> <div id="as0010"> <h3 id="st0015" class="u-h4 u-margin-m-top u-margin-xs-bottom">Methods</h3> <p id="sp0055">We performed a meta-analysis of <a title="Learn more about Observational Study from ScienceDirect's AI-generated Topic Pages" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/observational-study">observational studies</a> and randomized controlled trials comparing outcomes of triple therapy (dual <a title="Learn more about Antiplatelet from ScienceDirect's AI-generated Topic Pages" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/antiplatelet">antiplatelet</a> therapy and anticoagulant) with dual therapy (P2Y12 inhibitor and anticoagulant) in patients on long-term anticoagulants after percutaneous coronary intervention (PCI). Major bleeding was the primary outcome.</p> </div> <div id="as0015"> <h3 id="st0020" class="u-h4 u-margin-m-top u-margin-xs-bottom">Results</h3> <p id="sp0060">Three observational studies and 3 randomized controlled trials with a total of 6654 patients met our selection criteria. At a mean follow up of 12.5 months major bleeding was lower in dual therapy cohort compared to triple therapy (2.2% vs 5.2%, RR 0.60, 95% CI 0.44–0.81, <em>P</em> = 0.001). No difference was observed between the two groups for <a title="Learn more about Major Adverse Cardiac Event from ScienceDirect's AI-generated Topic Pages" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/major-adverse-cardiac-event">major adverse cardiac events</a> (11.8% vs 13.0%, RR 1.03, CI 0.79–1.34, <em>P</em> = 0.85), <a title="Learn more about All Cause Mortality from ScienceDirect's AI-generated Topic Pages" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/all-cause-mortality">all-cause mortality</a> (3.9% vs 5.6%, RR 0.94, CI 0.65–1.36, <em>P</em> = 0.76), myocardial infarction (3.7% vs 3.9%, RR 1.12, CI 0.83–1.50, <em>P</em> = 0.47), <a title="Learn more about Target Vessel Revascularization from ScienceDirect's AI-generated Topic Pages" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/target-vessel-revascularization">target vessel revascularization</a> (6.8% vs 7.1%, RR 1.12, CI 0.72–1.74, <em>P</em> = 0.60), <a title="Learn more about Thromboembolism from ScienceDirect's AI-generated Topic Pages" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/thromboembolism">thromboembolic</a> events (1.3% vs 1.6%, RR 0.95, CI 0.55–1.64, <em>P</em> = 0.85) and <a title="Learn more about Stent Thrombosis from ScienceDirect's AI-generated Topic Pages" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/stent-thrombosis">stent thrombosis</a> (1.3% vs 1.4%, RR1.36, CI 0.84–2.21, <em>P</em> = 0.21).</p> </div> <div id="as0020"> <h3 id="st0025" class="u-h4 u-margin-m-top u-margin-xs-bottom">Conclusion</h3> <p id="sp0065">For patients undergoing PCI and requiring long term anticoagulation, a strategy of <a title="Learn more about P2Y12 from ScienceDirect's AI-generated Topic Pages" href="https://www.sciencedirect.com/topics/biochemistry-genetics-and-molecular-biology/p2y12">P2Y12</a> inhibitor plus anticoagulant confers a benefit of less major bleeding with no difference in major adverse cardiac events, mortality, myocardial infarction, target vessel revascularization, stent thrombosis or thromboembolism compared with triple therapy.</p> </div>