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American Heart Association

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Final ID: MP1978

P2Y12 Inhibitor Monotherapy as a Safer and Equally Effective Alternative to Dual Antiplatelet Therapy in Patients Undergoing Percutaneous Coronary Intervention: A Comprehensive Meta-Analysis of 52,475 Patients

Abstract Body (Do not enter title and authors here): Background: Current guidelines recommend 12 months of DAPT after PCI in ACS patients; however, prolonged use is associated with increased bleeding risk. Emerging strategies propose shortened DAPT followed by P2Y12 inhibitor (P2Y12i) monotherapy as a safer alternative without loss of efficacy.
Methods: We conducted a comprehensive systematic review of PubMed, Embase, Scopus, and Web of Science up to March 12, 2025. We included RCTs and cohort studies comparing short DAPT (≤3 months) followed by P2Y12i monotherapy versus standard DAPT (≥12 months) in ACS patients undergoing PCI. Primary outcomes were NACE, Net Clinical Benefit events, MACCE, cardiovascular death, myocardial infarction (MI), and major bleeding at 12 months. Risk ratios (RR) with 95% confidence intervals (CI) were calculated using a random-effects model.
Results: Thirteen studies involving 52,475 patients were included. P2Y12i monotherapy significantly reduced NACE (RR=0.77; 95% CI [0.69–0.85]; p<0.00001), Net Clinical Benefit events (RR=0.58; 95% CI [0.43–0.79]; p=0.0002), MACCE (RR=0.85; 95% CI [0.73–0.98]; p=0.03), and major bleeding (RR=0.48; 95% CI [0.36–0.64]; p<0.00001). No significant differences were observed in cardiovascular death (RR=0.81; 95% CI [0.61–1.08]; p=0.14) or MI (RR=0.97; 95% CI [0.79–1.19]; p=0.71).
Conclusion: In ACS patients post-PCI, P2Y12i monotherapy after short DAPT significantly reduces adverse clinical events and bleeding, with comparable ischemic protection to standard DAPT.
  • Campos, Arath  ( Universidad Cuauhtemoc , Aguascalientes , Mexico )
  • Rodríguez Rodríguez, Sandra Lizeth  ( Universidad Cuauhtemoc , Aguascalientes , Mexico )
  • Calderon-fernandez, Adolfo  ( UABC , Tijuana , Mexico )
  • Torres-chavez, Mario Cesar  ( Facultad de Medicina Mexicali , Mexicali , Mexico )
  • Cueva, Luis E.  ( Universidad Nacional de Piura , Piura , Peru )
  • Palacios-navas, Andrea Gabriela  ( Universidad de Guayaquil , Guayaquil , Ecuador )
  • Ccallalli Ruiz, Jimmy Cristhian  ( Facultad de Medicina Humana de la Universidad Nacional de Piura , Piuria , Peru )
  • Manjarrez Granados, Elva  ( UABC , Mexicali , Mexico )
  • Castillo, Victor  ( UABC , Tijuana , Mexico )
  • Author Disclosures:
    Arath Campos: DO NOT have relevant financial relationships | Sandra Lizeth Rodríguez Rodríguez: No Answer | Adolfo Calderon-Fernandez: DO NOT have relevant financial relationships | Mario Cesar Torres-Chavez: DO NOT have relevant financial relationships | Luis E. Cueva: DO NOT have relevant financial relationships | Andrea Gabriela Palacios-Navas: DO NOT have relevant financial relationships | Jimmy Cristhian Ccallalli Ruiz: No Answer | Elva Manjarrez Granados: DO NOT have relevant financial relationships | Victor Castillo: DO NOT have relevant financial relationships
Meeting Info:

Scientific Sessions 2025

2025

New Orleans, Louisiana

Session Info:

Pharmacology and Coronary Revasc

Monday, 11/10/2025 , 10:45AM - 11:35AM

Moderated Digital Poster Session

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