Benefits and harms of extended dual antiplatelet therapy (DAPT; > 12 mo) compared with standard DAPT (6–12 mo), by smoking status*
| Outcome† | Smokers | Nonsmokers | ||||||
|---|---|---|---|---|---|---|---|---|
| RCTs | No. events (no. participants) | RR (95% CI); I2 | RCTs | No. events (no. participants) | RR (95% CI); I2 | |||
| > 12 mo | 6–12 mo | > 12 mo | 6–12 mo | |||||
| All-cause death | PRODIGY10 | NR | NR | HR 0.90 (0.42–1.92); NA | PRODIGY | NR | NR | HR 0.99 (0.67–1.47); NA |
| Myocardial infarction | DAPT11 | 25 (1222) | 65 (1210) | 0.38 (0.24–0.60); NA | DAPT | 74 (3743) | 133 (3683) | 0.55 (0.41–0.72); NA |
| Probable or definite ST | DAPT11 | 6 (1222) | 29 (1210) | 0.20 (0.09–0.49); NA | DAPT | 13 (3743) | 36 (3683) | 0.36 (0.19–0.67); NA |
| MACCE‡ | DAPT;11 PRODIGY10 | 74 (1444) | 109 (1457) | 0.69 (0.52–0.91); 0% | DAPT, PRODIGY | 236 (4505) | 274 (4414) | 0.87 (0.64–1.20); 68% |
| GUSTO moderate or severe bleeding | DAPT11 | 15 (1222) | 17 (1210) | 0.87 (0.44–1.74); NA | DAPT | 104 (3743) | 73 (4893) | 1.83 (1.32–2.52); NA |
| BARC type 2, 3, 5 bleeding | PRODIGY10 | 12 (222) | 10 (247) | 1.34 (0.59–3.03); NA | PRODIGY | 61 (762) | 24 (731) | 2.44 (1.54–3.87); NA |
Note: BARC = Bleeding Academic Research Consortium, CI = confidence interval, GUSTO = Global Use of Strategies to Open Occluded Coronary Arteries, HR = hazard ratio, MACCE = major adverse cardiovascular and cerebrovascular event, NA = not applicable, NR = not reported, RCT = randomized controlled trial, RR = relative risk, ST = stent thrombosis.
↵* Corresponding forest plots are presented in Appendix 1 and Figure 2. See Table 2 for bleeding outcome definitions.
↵† No outcome data available: cardiovascular death, noncardiovascular death, stroke, definite ST, urgent revascularization, gastrointestinal bleeding, TIMI major bleeding, TIMI minor bleeding, GUSTO moderate bleeding, GUSTO severe bleeding, BARC type 3 bleeding, BARC type 5 bleeding.
↵‡ Composite outcome: all-cause death, myocardial infarction or stroke.