How Short Is Safe? Duration of Dual Antiplatelet Therapy Before Aspirin Withdrawal After Percutaneous Coronary Intervention: A Dose-Response Network Meta-Analysis

Background: Trials of P2Y12 inhibitor monotherapy after percutaneous coronary intervention (PCI) withdrew aspirin at fixed times, mostly against 12-month dual antiplatelet therapy (DAPT), and categorical syntheses disagree. Methods: Bayesian model-based network meta-analysis of randomized trials of aspirin withdrawal with P2Y12 inhibitor continuation, with 12-month myocardial infarction (MI) and major bleeding modeled as functions of DAPT duration (Emax and spline). The prespecified estimand was the shortest duration at which the upper 95% credible limit of the odds ratio (OR) for MI versus 12

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