1. Palmerini T, ….Stone GW. Lancet 2015:on-line
Mortality with Extended Duration DAPT After DES: A Pairwise and Bayesian Network Meta-Analysis of 10 RCTs and 31,666 Pts
All-cause Death HR
(95% CI)
Weight
(%)
Events
Group 1
Events
Group 2
Study
22% ↑
mortality
with
prolonged
DAPT
(p=0.02)
ARTIC Interruption
DAPT
DES LATE
EXCELLENT
ISAR SAFE
ITALIC
OPTIMIZE
PRODIGY
RESET
SECURITY
1.32 (0.49, 3.55)
0.75 (0.56, 1.02)
0.71 (0.45, 1.10)
0.57 (0.17, 1.95)
0.66 (0.27, 1.63)
1.14 (0.41, 3.15)
0.95 (0.63, 1.45)
0.91 (0.61, 1.37)
0.62 (0.20, 1.88)
1.00 (0.37, 2.66)
0.82 (0.69, 0.98)
3.03
33.00
14.85
1.99
3.67
2.85
17.07
18.12
2.36
3.05
100.00
9/624
74/4941
32/2514
4/722
8/1997
8/912
43/1563
45/751
5/1059
8/682
236/
15765
7/635
98/5020
46/251
7/721
12/2003
7/910
45/1556
49/750
8/1058
8/717
287/1590
I-V (I2=0.0%, p=0.93); p value for ES=0.02
D+L: p value for ES=0.02 .1 .5 1 2 3 5
Shorter DAPT better
Longer DAPT better
ES=effect size
Palmerini T, ….Stone GW. Lancet 2015:on-line

2. Palmerini T, ….Stone GW. Lancet 2015:on-line
Mortality with Extended Duration DAPT After DES: A Pairwise and Bayesian Network Meta-Analysis of 10 RCTs and 31,666 Pts
Cardiac Death HR
(95% CI)
Weight
(%)
Events
Group 1
Events
Group 2
Study
8% ↑
cardiac mortality
with
prolonged
DAPT
(p=NS)
DAPT
DES LATE
EXCELLENT
ITALIC
OPTIMIZE
PRODIGY
RESET
SECURITY
1.04 (0.70, 1.53)
0.68 (0.38, 1.23)
0.67 (0.11, 3.99)
1.67 (0.40, 6.97)
0.90 (0.55, 1.49)
0.92 (0.53, 1.58)
0.50 (0.91, 2.73)
1.64 (0.41, 6.59)
0.93 (0.73, 1.17)
35.40
15.69
1.68
2.65
21.79
18.14
1.86
2.81
100.00
52/4941
19/2514
2/722
5/912
29/1563
25/751
2/1059
5/682
139/
13144
50/5020
28/2531
3/721
3/910
32/1556
27/750
4/1058
3/717
150/13263
I-V (I2=0.0%, p=0.85); p value for ES=0.52
D+L: p value for ES=0.52 .1 .5 1 2 3 5
Shorter DAPT better
Longer DAPT better
ES=effect size
Palmerini T, ….Stone GW. Lancet 2015:on-line

3. Non- cardiac mortality Palmerini T, ….Stone GW. Lancet 2015:on-line
Mortality with Extended Duration DAPT After DES: A Pairwise and Bayesian Network Meta-Analysis of 10 RCTs and 31,666 Pts
Non-cardiac Death HR
(95% CI)
Weight
(%)
Events
Group 1
Events
Group 2
49% ↑
Non- cardiac mortality
with
prolonged
DAPT
(p=0.006)
Study
DAPT
DES LATE
EXCELLENT
ITALIC
OPTIMIZE
PRODIGY
RESET
SECURITY
0.47 (0.29, 0.76)
0.68 (0.34, 1.37)
0.50 (0.09, 2.74)
0.75 (0.17, 3.30)
1.07 (0.50, 2.28)
0.90 (0.49, 1.65)
0.73 (0.16, 3.26)
0.60 (0.15, 2.42)
0.67 (0.51, 0.89)
34.27
16.38
2.73
3.62
13.82
21.58
3.50
4.11
100.00
22/4941
13/2514
2/722
3/912
14/1563
20/751
3/1059
3/682
80/
13144
48/5020
19/2531
4/721
4/910
13/1556
22/750
4/1058
5/717
119/13263
I-V (I2=0.0%, p=0.71); p value for ES=0.006
D+L: p value for ES=0.006 .1 .5 1 2 3 5
Shorter DAPT better
Longer DAPT better
ES=effect size
Palmerini T, ….Stone GW. Lancet 2015:on-line

4. Palmerini T, ….Stone GW. Lancet 2015:on-line
Mortality with Extended Duration DAPT After DES: A Pairwise and Bayesian Network Meta-Analysis of 10 RCTs and 31,666 Pts
Major Bleeding HR
(95% CI)
Weight
(%)
Events
Group 1
Events
Group 2
Study
72% ↑
bleeding
with
prolonged
DAPT
(p<0.0001)
ARTIC Interruption
DAPT
DES LATE
EXCELLENT
ISAR SAFE
ITALIC
OPTIMIZE
PRODIGY
RESET
SECURITY
0.15 (0.02, 1.20)
0.57 (0.43, 0.75)
0.71 (0.42, 1.20)
0.50 (0.09, 2.73)
0.80 (0.21, 2.98)
0.13 (0.01, 1.30)
0.71 (0.32, 1.60)
0.38 (0.14, 1.07)
0.75 (0.17, 3.35)
0.51 (0.16, 1.59)
0.58 (0.47, 0.72)
1.10
59.86
16.81
1.59
2.63
0.78
7.16
4.48
2.08
3.51
100.00
1/624
72/4941
24/2514
2/722
4/1997
0/912
10/1563
5/751
2/1059
4/682
124/
15765
7/635
129/5020
34/2531
4/721
5/2003
3/910
12/1556
6/750
6/1058
8/717
221/15901
I-V (I2=0.0%, p=0.83); p value for ES<0.0001
D+L: p value for ES<0.0001 .1 .5 1 2 3 5
Shorter DAPT better
Longer DAPT better
ES=effect size
Palmerini T, ….Stone GW. Lancet 2015:on-line

5. Palmerini T, ….Stone GW. Lancet 2015:on-line
Mortality with Extended Duration DAPT After DES: A Pairwise and Bayesian Network Meta-Analysis of 10 RCTs and 31,666 Pts MI HR
(95% CI)
Weight
(%)
Events
Group 1
Events
Group 2
Study
25% ↓ MI
with
prolonged
DAPT
(p=0.01)
ARTIC Interruption
DAPT
DES LATE
EXCELLENT
ISAR SAFE
ITALIC
OPTIMIZE
PRODIGY
RESET
SECURITY
1.04 (0.41, 2.62)
1.94 (1.55, 2.44)
1.43 (0.80, 2.58)
1.86 (0.74, 4.67)
0.93 (0.44, 1.97)
1.50 (0.42, 5.32)
1.17 (0.77, 1.76)
1.04 (0.60, 1.79)
0.50 (0.91, 2.72)
1.06 (0.53, 2.16)
1.51 (1.28, 1.77)
1.34 (1.07, 1.69)
3.01
50.33
7.56
3.05
4.61
1.61
15.16
8.67
0.75
5.25
100.00
9/624
198/4941
27/2514
13/722
13/1997
6/912
49/1563
26/751
2/1059
16/682
359/
15765
9/635
99/5020
19/2531
7/721
14/2003
4/910
42/1556
25/750
1/1058
15/717
238/15901
I-V (I2=29.3%, p=0.17); p value for ES<0.0001
D+L: p value for ES=0.01 .1 .5 1 2 3 5
Shorter DAPT better
Longer DAPT better
ES=effect size
Palmerini T, ….Stone GW. Lancet 2015:on-line

6. Palmerini T, ….Stone GW. Lancet 2015:on-line
Mortality with Extended Duration DAPT After DES: A Pairwise and Bayesian Network Meta-Analysis of 10 RCTs and 31,666 Pts
Definite/ Probable ST HR
(95% CI)
Weight
(%)
Events
Group 1
Events
Group 2
Study
41% ↓
stent
thrombosis
with
prolonged
DAPT
(p=0.06)
DAPT
EXCELLENT
ISAR SAFE
ITALIC
OPTIMIZE
PRODIGY
RESET
SECURITY
2.98 (1.95, 4.58)
6.02 (0.72, 49.96)
1.25 (0.33, 4.65)
7.38 (0.76, 71.00)
1.08 (0.49, 2.36)
1.24 (0.49, 3.14)
0.66 (0.11, 3.98)
0.67 (0.11, 3.86)
2.04 (1.48, 2.80)
55.53
2.25
5.79
1.97
16.38
11.73
3.14
3.20
100.00
65/4941
6/722
5/1997
3/912
13/1563
10/751
2/1059
2/682
106/
13251
19/5020
1/721
4/2003
0/910
12/1556
8/750
3/1058
3/717
53/
13370
I-V (I2=43.7%, p=0.09); p value for ES<0.0001
D+L: p value for ES=0.06
1.68 (0.98, 2.87) .1 .5 1 2 3 5
Shorter DAPT better
Longer DAPT better
ES=effect size
Palmerini T, ….Stone GW. Lancet 2015:on-line

7. Palmerini T, ….Stone GW. Lancet 2015:on-line
Mortality with Extended Duration DAPT After DES: A Pairwise and Bayesian Network Meta-Analysis of 10 RCTs and 31,666 Pts
Yellow: sig ↓ w/short DAPT
Orange: sig ↑ w/short DAPT
≤6-month vs year DAPT
HR (95% CrI)
6-month vs >1-year DAPT
1-year vs >1-year DAPT
All-cause death
0.95 ( )
0.78 ( )
0.82 ( )
- Cardiac
0.96 ( )
0.90 ( )
0.93 ( )
- Non-cardiac
1.00 ( )
0.65 ( )
0.61 ( )
Myocardial infarction
1.00 ( )
1.70 ( )
1.70 ( )
Def/prob stent thrombosis
1.10 ( )
2.70 ( )
2.50 ( )
Major bleeding
0.59 ( )
0.34 ( )
0.58 ( )
Palmerini T, ….Stone GW. Lancet 2015:on-line