Single antiplatelet therapy (SAPT) is associated with a lower risk for major bleeding events in a population of patients with acute coronary syndrome (ACS), according to research results presented at the American College of Cardiology 2021 Annual Meeting, held virtually May 15-17, 2021, and published in a supplemental issue of the Journal of the American College of Cardiology.

Researchers conducted a meta-analysis to evaluate the safety and efficacy of SAPT vs dual antiplatelet therapy (DAPT) in a population of patients with ACS, as the safety and efficacy of these therapies remains controversial.

The analysis involved 16 studies including 65,577 patients (SAPT: n=31,858; DAPT: n=33,719) were included in the analysis. Over a median 1-year follow-up period, SAPT was preferred because of a significantly lower risk of major bleeding (odds ratio [OR] 0.69 [95% CI, 0.54-0.88]). DAPT was, per researchers, superior because of “a lower rate of repeat ACS events” (OR 1.23 [95% CI, 1.03-1.47]).


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Major adverse cardiovascular events, stroke, cardiovascular mortality, and all-cause mortality odds were identical between patients in both groups (ORs 1.05, 0.97, 0.84, and 0.93, respectively). Heterogeneity across studies ranged from minimal to moderate (I2 =0 to I2 =72%).

ACS incidence was similar across patients receiving clopidogrel and ticagrelor (ORs 1.11 and 0.99, respectively) compared with corresponding DAPT arms.

“Patients with ACS receiving SAPT have a lower risk of major bleeding events with no increase in the overall rate of major adverse events and mortality at one year,” the researchers concluded.

Reference

Ullah W, Uddin MF, Sandhyavenu H, et al. Single vs dual antiplatelet therapy in patients with acute coronary syndrome—a meta-analysis. Presented at: American College of Cardiology 2021 Annual Meeting, May 15-17, 2021. Abstract.