De-escalation of antiplatelet therapy after percutaneous coronary intervention among East Asians and non-East Asians: a meta-analysis of randomized controlled trials

Table1 Study design and clinical characteristics of included studies

Study name	Period	Reigon	Center	Population	D-DAPT	S-DAPT	Timing of de-escalation	Switching strategy	MACE	Bleeding	Follow-up time
HOST-REDUCE-POLYTECH-ACS	2014–2018	Korea	M	ACS	1170	1168	1 month after PCI	Prasugrel 10 mg–5 mg	Cardiac death + MI + stent thrombosis + ischemic stroke	BARC	1Y
TWILIGHT	2015–2017	North America + Europe + Asia	M	ACS + SCAD	3555	3564	3 months after discharge	Ticagrelor monotherapy	All-cause death + nonfatal MI + nonfatal stroke	BARC	15 mon
TICO	2015–2018	Korea	M	ACS	1527	1529	3-months after DAPT	Ticagrelor monotherapy	Death + MI + stent thrombosis + stroke + target-vessel revascularization	TIMI	1Y
TOPIC	2014–2016	France	S	ACS	323	323	1 month after ACS	Ticagrelor /prasugrel-clopidogrel	Cardiovascular death + unplanned urgent coronary revascularization + stroke	TIMI	1Y
TROPICAL-ACS	2013–2016	European	M	ACS	1304	1306	P(1-week) + c(1-week) and PFT-guided therapy from day 14	Prasugrel-clopidogrel (PFT-guided)	Cardiovascular death + MI + stroke	BARC	1Y
SMART CHOICE	2014–2018	Korea	M	SCAD + ACS	1495	1498	3-months after DAPT	A P2Y12 inhibitor monotherapy	All-cause mortality + MI + stroke	BARC	1Y
STOPDAPT-2	2015–2017	Japan	M	SCAD + ACS	1523	1522	1 month after DAPT	Clopidogrel monotherapy	Cardiovascular death + MI + definite stent thrombosis + stroke	BARC	1Y
GLOBAL-LEADERS	2013–2015	European	M	SCAD + ACS	7980	7988	1 month after DAPT	Ticagrelor monotherapy	All-cause mortality + stroke + new Q-wave MI	BARC	2Y

RCT, randomized controlled trials; ACS, acute coronary syndrome; SCAD, stable coronary artery disease; PCI, percutaneous coronary intervention; M, multi-center; S, single center; MACE, major adverse cardiovascular events; BARC, Bleeding Academic Research Consortium; TIMI, Thrombolysis In Myocardial Infraction major bleeding; Y, year; mon, month; P, prasugrel; C, clopidogrel; PFT, platelet function testing; DAPT, dual antiplatelet therapy; D-DAPT, de-escalation of dual antiplatelet therapy; S-DAPT, standard dual antiplatelet therapy; MI, myocardial infraction

ISSN: 1471-2261