{"id":"812db3817001","type":"article","url":"https://hartvaat.nl/2017/11/07/stentontwerp-en-dapt-duur-effect-op-ischemie-en-bloedingen-netwerkmeta-analyse/","title":"Stentontwerp en DAPT-duur: effect op ischemie en bloedingen — netwerkmeta-analyse","title_en":"Impact of design of coronary stents and length of dual antiplatelet therapies on ischaemic and bleeding events: a network meta-analysis of 64 randomized controlled trials and 102 735 patients.","category":"algemeen","category_label":"Algemeen","professions":["cardioloog"],"tags":[],"journal":"European heart journal","doi":"10.1093/eurheartj/ehx437","source_url":"https://doi.org/10.1093/eurheartj/ehx437","authors":["Fabrizio D'Ascenzo","Mario Iannaccone","Gaelle Saint-Hilary","Maurizio Bertaina","Stefanie Schulz-Schüpke","Cheol Wahn Lee","Alaide Chieffo","Gerard Helft","Sebastiano Gili","Umberto Barbero","Giuseppe Biondi Zoccai","Claudio Moretti","Fabrizio Ugo","Maurizio D'Amico","Roberto Garbo","Gregg Stone","Sara Rettegno","Pierluigi Omedè","Federico Conrotto","Christian Templin","Antonio Colombo","Seung-Jung Park","Adnan Kastrati","David Hildick-Smith","Mauro Gasparini","Fiorenzo Gaita"],"significance":7,"published":"2017-11-07","source_date":"2017-11-07","image":"","kennis":[],"congress":"","summary_en":"This network meta-analysis examined the interaction between coronary stent design (durable vs biodegradable polymer) and DAPT duration on ischemic and bleeding outcomes, exploring whether stent technology influences the optimal antiplatelet duration.","created":"2026-07-03T10:27:00Z","updated":"2026-07-03T13:26:16Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Netwerkmeta-analyse die de interactie onderzocht tussen coronair stentontwerp en DAPT-duur op ischemische en bloedingsuitkomsten.","abstract_original":"AIMS: The differential impact on ischaemic and bleeding events of the type of drug-eluting stent [durable polymer stents [DES] vs. biodegradable polymer stents vs. bioresorbable scaffolds (BRS)] and length of dual antiplatelet therapy (DAPT) remains to be defined. METHODS AND RESULTS: Randomized controlled trials comparing different types of DES and/or DAPT durations were selected. The primary endpoint was Major Adverse Cardiovascular Events (MACE) [a composite of death, myocardial infarction (MI), and target vessel revascularization]. Definite stent thrombosis (ST) and single components of MACE were secondary endpoints. The arms of interest were: BRS with 12 months of DAPT (12mDAPT), biodegradable polymer stent with 12mDAPT, durable polymer stent [everolimus-eluting (EES), zotarolimus-eluting (ZES)] with 12mDAPT, EES/ZES with <12 months of DAPT, and EES/ZES with >12 months of DAPT (DAPT > 12 m). Sixty-four studies with 150 arms and 102 735 patients were included. After a median follow-up of 20 months, MACE rates were similar in the different arms of interest. EES/ZES with DAPT > 12 m reported a lower incidence of MI than the other groups, while BRS showed a higher rate of ST when compared to EES/ZES, irrespective of DAPT length. A higher risk of major bleedings was observed for DAPT > 12 m as compared to shorter DAPT. CONCLUSION: Durable and biodegradable polymer stents along with BRS report a similar rate of MACE irrespective of DAPT length. Fewer MI are observed with EES/ZES with DAPT > 12 m, while a higher rate of ST is reported for BRS when compared to EES/ZES, independently from DAPT length. Stent type may partially affect the outcome together with DAPT length."}