{"id":"26af0e8d5734","type":"article","url":"https://hartvaat.nl/2018/05/14/dubbele-versus-triple-antitrombotische-therapie-bij-af-na-pci-meta-analyse/","title":"Dubbele versus triple antitrombotische therapie bij AF na PCI: meta-analyse","title_en":"Safety and efficacy of dual vs. triple antithrombotic therapy in patients with atrial fibrillation following percutaneous coronary intervention: a systematic review and meta-analysis of randomized clinical trials.","category":"atriumfibrilleren","category_label":"Atriumfibrilleren","professions":["apotheker","cardioloog"],"tags":["dubbele-trombocytenremming"],"journal":"European heart journal","doi":"10.1093/eurheartj/ehy162","source_url":"https://doi.org/10.1093/eurheartj/ehy162","authors":["Harsh B Golwala","Christopher P Cannon","Ph Gabriel Steg","Gheorghe Doros","Arman Qamar","Stephen G Ellis","Jonas Oldgren","Jurrien M Ten Berg","Takeshi Kimura","Stefan H Hohnloser","Gregory Y H Lip","Deepak L Bhatt"],"significance":8,"published":"2018-05-14","source_date":"2018-05-14","image":"","kennis":["https://hartvaat.nl/kennis/atriumfibrilleren/af-bij-ouderen/","https://hartvaat.nl/kennis/antistolling/doac-versus-vka-keuze/"],"congress":"","summary_en":"This systematic meta-analysis confirmed that dual antithrombotic therapy (DOAC plus P2Y12 inhibitor, without aspirin) reduces bleeding compared with triple therapy in AF patients after PCI, with similar ischemic event rates. The analysis supported the paradigm shift toward aspirin-free regimens.","created":"2026-07-03T10:27:17Z","updated":"2026-07-03T13:26:32Z","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":"Systematische meta-analyse die duale versus triple antitrombotische therapie vergeleek bij AF-patiënten na PCI. Bevestigt het gunstigere veiligheidsprofiel van duale therapie.","abstract_original":"AIMS: Of patients with atrial fibrillation (AF), approximately 10% undergo percutaneous coronary intervention (PCI). We studied the safety and efficacy of dual vs. triple antithrombotic therapy (DAT vs. TAT) in this population. METHODS AND RESULTS: A systematic review and meta-analysis was conducted using PubMed, Embase, EBSCO, Cochrane database of systematic reviews, Web of Science, and relevant meeting abstracts for Phase 3, randomized trials that compared DAT vs. TAT in patients with AF following PCI. Four trials including 5317 patients were included, of whom 3039 (57%) received DAT. Compared with the TAT arm, Thrombolysis in Myocardial Infarction (TIMI) major or minor bleeding showed a reduction by 47% in the DAT arm [4.3% vs. 9.0%; hazard ratio (HR) 0.53, 95% credible interval (CrI) 0.36-0.85, I2 = 42.9%]. In addition, there was no difference in the trial-defined major adverse cardiac events (MACE) (10.4% vs. 10.0%, HR 0.85, 95% CrI 0.48-1.29, I2 = 58.4%), or in individual outcomes of all-cause mortality, cardiac death, myocardial infarction, stent thrombosis, or stroke between the two arms. CONCLUSION: Compared with TAT, DAT shows a reduction in TIMI major or minor bleeding by 47% with comparable outcomes of MACE. Our findings support the concept that DAT may be a better option than TAT in many patients with AF following PCI."}