Cardiovascular and Bleeding Events of Ticagrelor Monotherapy after Short-term DualAntiplatelet Therapy (DAPT) in Diabetics and Non-Diabetics Patients UndergoingPercutaneous Coronary Intervention: A Systematic Review and Meta-Analysis

Introduction: ticagrelor monotherapy after short-term (1-3 months) dual antiplatelet therapy (dapt)with aspirin and ticagrelor can reduce bleeding without increasing ischemic events after percutaneouscoronary intervention (pci). however, its effect in diabetic and non-diabetic individuals has not beenevaluated as a meta-analysis so far.method: this systematic review and meta-analysis were conducted covering pubmed, isi web ofscience, and scopus without date restrictions for english published clinical trials. the authors searched thementioned databases, wherein the screening led to 151 studies, of which 40 were assessed for eligibility, andfinally, three studies were included. these trials compared ticagrelor monotherapy after a short duration ofaspirin plus ticagrelor with conventional 12 months dapt.results: the results showed that the risk of major bleeding (based on bleeding academic researchconsortium (barc) type 3 or 5) for ticagrelor monotherapy subjects was lower in both diabetics and nondiabetics.it was especially significant in non-diabetic patients (hr 95%ci: 0.79(0.64, 0.98); p=0.029). incardiovascular events assessment, the pooled estimate on cardiac deaths was significantly lower in diabeticsubjects treated by ticagrelor monotherapy (hr 95%ci: 0.71(0.51, 1); p=0.05), while this reduction was notsignificant for non-diabetics (p=0.843) in comparison to patients treated by 12 months dapt. however,there was no significant decrease or rise in myocardial infarction (mi) and ischemic stroke in patients treatedby short-term dapt strategy.conclusion: in conclusion, discontinuing aspirin after short-duration dapt could minimize theincidence of cardiac death and barc type 3 or 5 bleeding in diabetic and non-diabetic patients whounderwent pci, with no increase in mi and ischemic stroke.