https://orcid.org/0000-0003-3841-2951
Figures
Abstract
Background
Despite widespread adoption of abbreviated (<12 months) dual antiplatelet therapy (DAPT) strategies after percutaneous coronary intervention (PCI), the optimal threshold for DAPT abbreviation remains undefined.
Methods
We conducted a network meta-analysis of randomized controlled trials (RCTs) evaluating various abbreviated DAPT durations in patients undergoing PCI with contemporary drug-eluting stents (DES). We searched PubMed, Embase, and Scopus from January 2008 through March 21, 2026. The efficacy and safety outcomes were major adverse cardiovascular events (MACE) and major bleeding, respectively. Relative treatment effects were estimated using risk ratios (RR) with 95% confidence intervals (CI) using random-effects models. Treatment ranking was assessed using surface under the cumulative ranking curve (SUCRA). The study protocol was registered on PROSPERO (CRD420261349664).
Findings
Twenty-eight RCTs comprising 84,325 patients were included. Compared with 12-month DAPT, abbreviated strategies (1-, 3-, and 6-month) were not associated with a significant difference in MACE (1-month: RR 1.03 [95% CI 0.88–1.22]; 3-month: RR 0.95 [95% CI 0.82–1.10]; 6-month: RR 1.06 [95% CI 0.88–1.27]). In contrast, these shorter durations were associated with significantly reduced major bleeding (1-month: RR 0.59 [95% CI 0.42–0.82]; 3-month: RR 0.64 [95% CI 0.49–0.84]), with a consistent trend for 6-month DAPT (RR 0.68, 95% CI: 0.46–1.00). SUCRA rankings indicated that the 3-month DAPT strategy ranked highest for MACE (lowest ischemic risk); whereas the 1-month strategy ranked highest for major bleeding (lowest bleeding risk), followed by the 3-month strategy.
Conclusion
Shorter DAPT durations (1 & 3 months) were associated with reduced bleeding without evidence of increased ischemic risk compared with the conventional 12-month strategy. Among the abbreviated strategies, the 3-month regimen consistently demonstrated the most favorable overall profile across analyses, suggesting it may represent a pragmatic threshold for DAPT abbreviation. However, these findings should be interpreted cautiously given the absence of statistically significant differences in efficacy and the limitations inherent to study-level network meta-analysis.
Citation: Hlupeni A, Jalilzadehbinazar M, Liceralde RJ, Khan HAM, Donepudi R, Arora S (2026) Dual antiplatelet therapy duration after percutaneous coronary intervention with contemporary drug-eluting stents: A systematic review and network meta-analysis of randomized trials. PLoS One 21(9): e0357462. https://doi.org/10.1371/journal.pone.0357462
Editor: Haipeng Liu, Coventry University, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
Received: May 11, 2026; Accepted: August 18, 2026; Published: September 2, 2026
Copyright: © 2026 Hlupeni et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: All data are in the manuscript and/or supporting information files.
Funding: The author(s) received no specific funding for this work.
Competing interests: The authors have declared that no competing interests exist.
Introduction
The evolution of drug-eluting stents (DES) and potent P2Y12 inhibitors has reshaped the balance between ischemic and bleeding risks following percutaneous coronary intervention (PCI) [1,2]. Historically, prolonged dual antiplatelet therapy (DAPT) of 12 months or longer was recommended to reduce the risk of stent thrombosis and recurrent ischemic events. However, extended DAPT may be associated with an increased risk of morbid and fatal bleeding [1,3]. With improvements in stent design and biocompatibility, several randomized controlled trials (RCTs) have evaluated abbreviated DAPT strategies, including 1-month [4–7] and 3-month regimens [8–11], to reduce bleeding risk while preserving ischemic protection.
Contemporary ACC/AHA and ESC guidelines have integrated this evolving evidence, increasingly endorsing shorter regimens or early transitions to P2Y12 inhibitor monotherapy [12,13]. However, these guidelines primarily rely on pairwise comparisons between individual abbreviated regimens and the conventional 12-month standard, and do not provide direct comparative guidance across multiple abbreviated durations. Consequently, the clinical question has shifted from whether DAPT can be safely shortened to how different abbreviated strategies compare with one another. Moreover, individual trials were often underpowered to detect differences in relatively infrequent ischemic events and frequently relied on composite endpoints, which may obscure the distinct trade-offs between ischemic and bleeding outcomes. As a result, uncertainty persists regarding how specific abbreviated strategies, such as 1-, 3-, or 6-month DAPT, perform relative to each other.
In this context, network meta-analysis enables the integration of direct and indirect evidence, allowing simultaneous comparison and ranking of multiple DAPT strategies within a unified analytical framework. Therefore, we conducted this network meta-analysis to compare the performance of various distinct abbreviated DAPT durations and further clarify the relative balance between ischemic protection and bleeding risk, with the aim of informing more individualized decision-making in contemporary clinical practice.
Materials and methods
Study design
This systematic review and network meta-analysis was prospectively registered with PROSPERO (CRD420261349664) [14]. It was conducted and reported in accordance with PRISMA guidelines (S1 Checklist) [15].
Eligibility criteria
Population: Adult patients (≥18 years) undergoing PCI with second- or third-generation DES. We excluded trials involving atrial fibrillation if most patients required concomitant oral anticoagulation.
Intervention and comparator: We evaluated distinct DAPT durations, including abbreviated (<12 months), standard (12 months), and extended (>12 months) regimens. For presentation of relative treatment effects, the 12-month DAPT duration was used as the reference comparator in both the efficacy and safety networks.
Outcomes: The primary efficacy and safety outcomes were major adverse cardiovascular events (MACE) and major bleeding, respectively, both as defined by the individual trials. Studies were excluded if they had missing clinical outcomes.
Study Design: Eligible studies were parallel-group RCTs comparing at least two distinct DAPT durations, at least one of which was an abbreviated regimen. We excluded non-randomized studies, single-arm or historical-control designs, secondary analyses or post-hoc studies, and trials in which <80% of stents were contemporary.
Search strategy
We systematically searched PubMed, Embase, and Scopus from January 2008 through March 21, 2026 using a search strategy described in the published protocol [14]. We limited the search to studies published from 2008 onward to reflect the contemporary era of DES, characterized by the widespread adoption of second-generation DES with improved safety profiles and lower rates of stent thrombosis. The search was restricted to peer-reviewed, human-subject clinical trials published in English language.
Study selection
Study selection was managed in Rayyan, which automatically identified potential duplicates for manual verification by a single investigator. Two reviewers then independently screened titles and abstracts for relevance. Full-text articles of potentially eligible studies were subsequently retrieved and assessed against the inclusion criteria. Any discrepancies were resolved through consensus or by consultation with a third reviewer.
Data extraction
Two reviewers independently extracted study and patient characteristics, treatment variables and outcomes using a standardized data extraction form. Any disagreements were resolved through consensus. Methodological quality was assessed at the study level using the Cochrane Risk of Bias 2 tool. These appraisals informed the risk-of-bias domain within the GRADE framework, which was used to rate the overall certainty of the evidence.
Data synthesis
We performed a frequentist network meta-analysis using a multivariate random-effects model implemented in Stata 19.5, College Station, Texas 77845 USA. Model parameters were estimated using the restricted maximum likelihood method. As all included trials were two-arm designs, no adjustment for within-study correlation was required. Relative treatment effects were estimated as risk ratios (RR) with 95% confidence intervals (CI). Forest plots were used to visually display results of individual studies and syntheses.
Inconsistency assessment
The assumption of consistency was evaluated using a global inconsistency test based on a chi-squared statistic comparing direct and indirect evidence across the networks. Local inconsistency was assessed using node-splitting (side-splitting) analysis to evaluate discrepancies within individual treatment comparisons. Subgroup analysis was used to explore possible causes of inconsistency where relevant. Statistical significance for all inconsistency tests was defined as p < 0.05.
Treatment ranking
The relative hierarchy of DAPT durations was assessed using surface under the cumulative ranking curve (SUCRA) values, which estimate the probability that each strategy ranks among the most effective or safest options across all treatment durations.
Publication bias
Potential publication bias and small-study effects were evaluated via visual inspection of comparison-adjusted funnel plots and quantified using a network-wide adaptation of Egger’s precision-weighted linear regression tests. Funnel plots asymmetry was considered statistically significant at a two-tailed p-value of <0.05.
Results
Study selection
Of 2,684 identified records, 28 trials (84,325 patients) met inclusion criteria [4–11, 16–35] (Fig 1). One trial (HOST-BR) [11] randomized and reported outcomes separately for high and non-high bleeding risk populations; these were included as independent comparisons within the network. Trial characteristics and outcome definitions (MACE and major bleeding) are summarized in Table 1 and S1 Table, respectively. Several high-profile trials were excluded based on predefined criteria, including those evaluating extended (>12 months) [36–43] or ultrashort (<1 month) [44–46] DAPT durations, single-arm designs [47], or inclusion of substantial first-generation stents [48–50] to maintain focus on contemporary abbreviated DAPT strategies.
Flow diagram illustrating the study selection process. DAPT = dual antiplatelet therapy; PRISMA = Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
Quality assessment for included trials
Using the Cochrane RoB 2 tool, most trials were judged to be at low risk of bias across all domains, reflecting high methodological quality (Fig 2). A few studies had some concerns, mainly due to post-randomization treatment variability, but these were unlikely to affect objective outcomes. Only a small number of trials were at high risk of bias, primarily related to selective reporting, and these did not materially influence the overall findings. Overall, the evidence base was considered robust with a low risk of bias.
Risk of bias for each included randomized trial was evaluated using the Cochrane RoB 2 tool across five domains (D1 to D5). Domain-specific and overall judgments are displayed for each study. Green (+) indicates low risk, yellow (-) indicates some concerns, and red (x) indicates high risk of bias.
Efficacy outcome: MACE
Of the 28 trials, 24 were included in the MACE analysis, as four trials did not report MACE as a standalone endpoint [19,23,24,27]. Because two of these excluded trials [24,27] evaluated the extended DAPT, the > 12 months duration node was absent from the MACE network. The efficacy network therefore comprised four DAPT duration nodes (1-, 3-, 6-, and 12-month), with the 12-month DAPT used as the reference comparator (Fig 3).
Each node represents a dual antiplatelet therapy (DAPT) duration, and node size is proportional to the number of patients assigned to that treatment across included trials. Connecting lines indicate direct comparisons between treatment strategies. Line thickness reflects the number of trials contributing to each direct comparison. In panel A (major adverse cardiovascular events), the network includes four DAPT duration nodes (1 month, 3 months, 6 months, and 12 months). In panel B (major bleeding), an additional node (>12 months) is included based on available data from trials reporting bleeding outcomes. m = months.
The global inconsistency test indicated marginal inconsistency within the network (p = 0.05), with local side-splitting analysis identifying discrepancies in comparisons involving the 3-month DAPT strategy (12m vs. 3m, p = 0.01; 1m vs. 3m, p = 0.007) (S2 Table). However, subgroup analyses stratified by study setting demonstrated attenuation of the previously observed inconsistency, with no significant global inconsistency detected among multicountry trials (p = 0.94) or single-country trials (p = 0.34).
After synthesizing direct and indirect evidence, no DAPT duration significantly differed from the 12-month reference regarding MACE: 1m vs. 12m (RR 1.03; 95% CI: 0.88–1.22), 3m vs. 12m (RR 0.95; 95% CI: 0.82–1.10), and 6m vs. 12m (RR 1.06; 95% CI: 0.88–1.27). Effect estimates were close to unity with confidence intervals spanning the null (Fig 4). Despite these non-significant differences, SUCRA ranking analysis suggested the 3-month strategy had the highest probability of being the most effective (60.0%), while the 6-month duration was most likely to be the least effective (49.0%; Fig 5).
Forest plots show pairwise comparisons of dual antiplatelet therapy (DAPT) durations for major adverse cardiovascular events derived from the network meta-analysis. Blue squares represent individual trial estimates with corresponding 95% confidence intervals (horizontal lines). Green squares represent pooled direct estimates from conventional meta-analyses, and red squares represent pooled network estimates. The size of the squares is proportional to study weight. Risk ratios (RRs) are presented on a logarithmic scale; values <1 or >1 should be interpreted based on the direction of the comparison. The vertical reference line indicates no difference (RR = 1). m = months.
Bar chart showing the probability of each dual antiplatelet therapy (DAPT) duration strategy ranking at each position (best, second, third, or worst) for major adverse cardiovascular events (MACE), based on the network meta-analysis. Ranking probabilities were derived from the relative treatment effects across the network using a frequentist framework. Each bar represents the probability of a given DAPT duration (1 month, 3 months, 6 months, and 12 months) being ranked at a specific position. The “best” rank indicates the highest probability of achieving the most favorable outcome (lowest risk of MACE), whereas the “worst” rank indicates the least favorable outcome. m = months.
Sensitivity analyses demonstrated consistent findings across clinically relevant subgroups and endpoint definitions (S3 Table and S2 Fig). In trials enrolling exclusively patients with acute coronary syndrome (ACS; n = 8), no abbreviated DAPT duration was associated with a statistically significant difference in MACE compared to the 12-month duration, with 3-month regimen ranking highest (64.3%) and 12-month ranking lowest (7.3%). Similarly, in non-ACS-exclusive trials (n = 16), effect estimates remained non-significant, with 3-month DAPT again ranking highest (39.3%) and 6-month ranking lowest (13.9%), although with greater uncertainty in ranking.
In the network of trials reporting composite (non-hard) MACE definitions that included stent thrombosis and revascularization (n = 20), findings were consistent, with effect estimates close to unity and 3-month DAPT demonstrating the highest probability of being most effective (61.1%), while 1-month ranked lowest (4.1%). In contrast, sensitivity analysis restricted to trials reporting standardized hard ischemic endpoints (death, myocardial infarction, and stroke; n = 4) yielded less precise estimates and variable ranking patterns, with 1-month DAPT ranking highest (64.0%) and 3-month lowest (11.7%); however, these findings should be interpreted cautiously given the limited number of studies and associated imprecision. Overall, these analyses support the robustness of the primary findings across varying clinical populations and MACE endpoint definitions.
Safety outcome: Major bleeding
All 28 trials reported major bleeding as a standalone outcome and were included in the safety analysis. The safety network included five DAPT treatment duration nodes: 1-month, 3-month, 6-month, 12-month (reference), and >12-month (Fig 3). The bleeding network demonstrated strong consistency, with no evidence of global inconsistency (p = 0.74). Local side-splitting analyses did not identify any significant discrepancies between direct and indirect estimates.
Shorter DAPT durations were associated with lower bleeding risk compared with the 12-month reference. Specifically, 1-month DAPT was associated with a significantly reduced risk of bleeding (RR 0.59, 95% CI: 0.42–0.82), as was 3-month DAPT (RR 0.64, 95% CI: 0.49–0.84). The 6-month strategy showed a similar trend (RR 0.68, 95% CI: 0.46–1.00), although this did not reach conventional statistical significance. In contrast, extended DAPT (>12 months) was not associated with a significant difference in bleeding risk (RR 0.89, 95% CI: 0.32–2.45) (Fig 6).
Forest plots showing pairwise comparisons of dual antiplatelet therapy (DAPT) durations for major bleeding derived from the network meta-analysis. Blue squares represent individual trial estimates with corresponding 95% confidence intervals (horizontal lines). Green squares represent pooled direct estimates from conventional meta-analyses, and red squares represent pooled network estimates. The size of the squares is proportional to study weight. Risk ratios (RRs) are presented on a logarithmic scale, with direction of effect determined by the order of treatment comparison. The vertical reference line indicates no difference (RR = 1). m = months.
SUCRA ranking analysis demonstrated that the 1-month DAPT duration had the highest probability of being the safest regimen (44.2%), followed by the 3-month strategy (23.7%). In contrast, 12-month (58.4%) and >12-month (40.7%) durations were most likely to rank as the least safe strategies (Fig 7).
Bar chart shows the probability of each dual antiplatelet therapy (DAPT) duration strategy ranking at each position (best, second, third, fourth, or worst) for major bleeding, based on the network meta-analysis. Ranking probabilities were derived from the relative treatment effects across the network using a frequentist framework. Each bar represents the probability of a given DAPT duration (1 month, 3 months, 6 months, 12 months, and >12 months) being ranked at a specific position. The “best” rank indicates the lowest risk of major bleeding, whereas the “worst” rank indicates the highest risk.
Publication bias
Comparison-adjusted funnel plots for both MACE and major bleeding demonstrated symmetric distributions of studies (S1 Fig). Consistently, network-wide adaptations of Egger’s regression test showed no significant evidence of small-study effects for either outcome (MACE: p = 0.63; major bleeding: p = 0.20).
Certainty of evidence
Using the GRADE framework, the overall certainty of evidence was rated as moderate for the efficacy outcome (MACE) and high for the safety outcome (major bleeding). The certainty rating for MACE was downgraded for inconsistency (borderline global network-wide inconsistency and varying clinical trial definitions of MACE), and imprecision (wide confidence intervals that span unity and fail to rule out clinical harm or benefit).
In contrast, the certainty of evidence for major bleeding was rated as high, reflecting the consistency of findings across the network and the robustness of treatment effects.
Discussion
In this network meta-analysis of 28 RCTs encompassing 84,325 patients, we found that abbreviated DAPT durations (1 and 3 months) following PCI with contemporary DES were associated with a lower risk of major bleeding risk without evidence of increased ischemic risk compared to 12 months. While a 12-month DAPT regimen is the conventional standard of care [12], our findings suggest that shorter durations offer a more favorable safety profile, with no statistically significant difference in MACE across all studied timeframes.
The comparable ischemic protection observed between abbreviated and conventional DAPT durations likely stems from the iterative evolution of stent technology [1]. Contemporary thin-strut DES, characterized by biocompatible fluoropolymers and optimized drug-release kinetics, promote faster and more complete endothelialization. This technological maturation, coupled with more potent P2Y12 inhibitors, has effectively shifted the risk-benefit ratio toward minimizing systemic antithrombotic exposure [1–3].
SUCRA rankings indicated that the 3-month strategy had the highest probability of favorable ranking for MACE. The consistent direction of this finding across the primary and sensitivity analyses suggests that the 3-month duration may represent a clinically relevant threshold at which ischemic protection is preserved while bleeding risk is reduced. However, these findings reflect largely overlapping effect estimates and should be viewed as hypothesis-generating rather than evidence of superiority. Furthermore, the initial network inconsistency identified in the 3-month node was successfully resolved through stratification by study setting (single-country vs. multi-country trials). This suggests that regional practice patterns, such as the East Asian Paradox where patients exhibit higher bleeding but lower ischemic risks [51], or specific patient selection criteria in localized trials may influence outcomes more than DAPT duration alone.
Conversely, safety outcomes demonstrated a clear biological gradient, with progressively shorter DAPT durations associated with lower risk of major bleeding. The 1-month and 3-month strategies emerged as the most favorable for minimizing major bleeding, which is critical given that post-PCI bleeding is a powerful independent predictor of long-term mortality [1–3].
Compared with prior studies and current guidelines, our results extend the findings of individual landmark trials by providing a high-powered, simultaneous comparison of multiple durations. While individual trials were often underpowered to detect differences in infrequent endpoints and frequently relied on composite measures such as net clinical adverse events, our network meta-analysis pools data across studies and separately evaluates ischemic and bleeding outcomes across commonly used DAPT durations, thereby providing more precise estimates and greater granularity in understanding the trade-offs between these competing risks. These findings align with the latest ACC/AHA and ESC guidelines, which increasingly advocate for individualized DAPT durations [12,13], while offering additional comparative insight to inform the selection among abbreviated strategies.
From a clinical perspective, our study findings support the use of shorter DAPT durations in appropriately selected patients, particularly those at elevated bleeding risk. The absence of a meaningful increase in ischemic events with abbreviated DAPT reinforces the safety of shorter regimens in contemporary practice. In this context, early discontinuation of aspirin with continuation of high potent P2Y12 inhibitor monotherapy represents a reasonable treatment approach supported by current evidence [52,53].
Importantly, our analysis extends beyond current guidelines by providing a comparative insight across commonly used abbreviated DAPT strategies; we demonstrate no clear ischemic advantage of one specific regimen over another, while highlighting a consistent pattern of reduced bleeding with shorter courses. Rather than identifying a single optimal duration, this metanalysis underscores that different abbreviated strategies may be tailored to individual patient characteristics. In alignment with current recommendations, shorter regimens may be favored in patients with higher bleeding risk, whereas longer courses remain appropriate for those with elevated ischemic risk or complex coronary anatomy [12,13]. Consistent with this individualized approach, the recently published DAPT-MVD trial demonstrated an ischemic benefit of extending DAPT beyond 12 months in selected patients with multivessel coronary disease [54].
Overall, this study findings supports a transition from fixed-duration DAPT toward a more flexible, patient-centered model, where treatment decisions are guided by individualized risk assessment rather than convention alone.
Strenghts and limitations
The primary strength of this study lies in its scale and the use of network meta-analysis to generate indirect comparisons where head-to-head trials are lacking. Also, by focusing strictly on trials utilizing contemporary DES, we ensured the findings are applicable to modern interventional practice.
However, several limitations persist. Our use of study-level data precludes the granular analysis of patient-level confounders, such as complexity of coronary anatomy or specific P2Y12 inhibitor selection. Furthermore, post-DAPT antiplatelet strategies varied across trials, with patients transitioning to aspirin, P2Y12 inhibitor monotherapy, or protocol-specific regimens, representing an additional source of heterogeneity that could not be accounted for in this analysis. Additionally, the heterogeneity in outcome definitions across trials and the reliance on subgroup analysis to resolve efficacy inconsistency mean that residual confounding cannot be entirely excluded.
Conclusion
In patients undergoing PCI with contemporary DES, shorter DAPT durations (1- & 3-month) were associated with reduced bleeding without evidence of increased ischemic risk compared with the conventional 12-month strategy. Among the abbreviated strategies, the 3-month regimen consistently demonstrated a more favorable overall profile across analyses, suggesting it may represent a pragmatic threshold for DAPT abbreviation; however, these findings should be interpreted cautiously given the absence of statistically significant differences in efficacy and the limitations inherent to study-level network meta-analysis. Overall, these results provide comparative evidence across abbreviated DAPT strategies, offering additional insight to refine selection among commonly used regimens in contemporary practice, while reinforcing that DAPT duration should remain individualized based on clinical presentation, ischemic and bleeding risk, procedural complexity, and the planned post-DAPT antiplatelet strategy.
Supporting information
S1 Fig. Comparison-adjusted funnel plot for assessment of small-study effects in the efficacy (MACE) and safety (major bleeding) networks.
Visual inspection of the comparison-adjusted funnel plots demonstrated symmetric distributions for both outcomes, MACE (Panel A) and major bleeding (Panel B), with no evidence of small-study effects, consistent with Egger’s regression test (MACE: p = 0.63; major bleeding: p = 0.20). A: 12-month, B: 1-month, C: 3-month, D: 6-month, E: > 12-month.
https://doi.org/10.1371/journal.pone.0357462.s001
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S2 Fig. Ranking probabilities of DAPT duration strategies across primary and sensitivity analyses.
Panel A: Sensitivity analysis restricted to trials enrolling exclusively patients with acute coronary syndrome (ACS). Panel B: Sensitivity analysis restricted to trials not exclusively enrolling ACS patients (<100% ACS; mixed and stable-dominant populations). Panel C: Sensitivity analysis restricted to trials reporting standardized hard ischemic endpoints (death, myocardial infarction, and stroke). Panel D: Primary analysis including trials reporting composite MACE (soft ischemic endpoints). Bar plots display the probability of each DAPT duration (1-month, 3-month, 6-month, and 12-month) being ranked best, second, third, or worst based on network meta-analysis. Higher probabilities of being ranked “best” indicate greater likelihood of optimal performance for reducing MACE.
https://doi.org/10.1371/journal.pone.0357462.s002
(TIFF)
S1 Table. Detailed trial characteristics, outcome definitions, and bleeding criteria of included randomized trials.
Detailed characteristics of randomized controlled trials included in the network meta-analysis, presented by treatment arm. For each study, information is provided on dual antiplatelet therapy (DAPT) duration, antiplatelet regimen during DAPT, post-DAPT single antiplatelet therapy (SAPT), sample size, and baseline patient characteristics. Baseline variables include mean/median age, female proportion, prevalence of diabetes mellitus, proportion of patients presenting with acute coronary syndrome (ACS), and high bleeding risk status (as defined in the original trials). Definitions of major adverse cardiovascular events (MACE) and bleeding criteria are reported as specified in each trial. For the HOST-BR trial, high bleeding risk (#) and non-high bleeding (£) risk populations are presented separately and treated as independent comparisons. ACS = acute coronary syndrome; asa = aspirin; BARC = Bleeding Academic Research Consortium; CABG = coronary artery bypass grafting; clop = clopidogrel; DAPT = dual antiplatelet therapy; GUSTO = Global Use of Strategies to Open Occluded Coronary Arteries; MACE = major adverse cardiovascular events; MI = myocardial infarction; na = not applicable; p2y12=P2Y12 inhibitor; pras = prasugrel; SAPT = single antiplatelet therapy; ST = stent thrombosis; TIMI = Thrombolysis in Myocardial Infarction; TLR = target lesion revascularization; TVR = target vessel revascularization; tica = ticagrelor.
https://doi.org/10.1371/journal.pone.0357462.s003
(DOCX)
S3 Table. Sensitivity analyses for MACE across clinical subgroups and endpoint definitions.
Sensitivity analyses evaluating the association between DAPT duration and major adverse cardiovascular events (MACE) across clinical subgroups and endpoint definitions. Risk ratios (RR) are presented relative to the 12-month DAPT strategy.
https://doi.org/10.1371/journal.pone.0357462.s005
(DOCX)
S1 Checklist. PRISMA 2020 checklist.
Completed PRISMA 2020 checklist for reporting of this systematic review and network meta-analysis.
https://doi.org/10.1371/journal.pone.0357462.s006
(DOCX)
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