Abstract

IntroductionP2Y12 inhibitor monotherapy has emerged as a potential alternative to aspirin following dual antiplatelet therapy (DAPT) in patients undergoing percutaneous coronary intervention (PCI), but the optimal choice remains uncertain.MethodsA systematic literature search compared P2Y12 inhibitors with aspirin post PCI. A random-effects model pooled odds ratios (ORs) with 95% confidence intervals (CIs) for outcomes.ResultsSeven studies (29,756 patients) were included. P2Y12 inhibitors significantly reduced MACE compared to aspirin [OR = 0.73; 95% CI: 0.64-0.84]. No significant difference was observed in all-cause mortality [OR = 0.90; 95% CI: 0.77-1.05], cardiac death [OR = 0.86; 95% CI: 0.68-1.09], major bleeding [OR = 1.06; 95% CI: 0.67-1.68], MI [OR = 0.78; 95% CI: 0.56-1.08], or stent thrombosis [OR = 0.71; 95% CI: 0.41-1.22]. P2Y12 inhibitors significantly reduced repeat revascularisation [OR = 0.83; 95% CI: 0.73-0.94] and stroke [OR = 0.63; 95% CI: 0.48-0.81].ConclusionsP2Y12 inhibitors may be a safer, more effective alternative to aspirin alone after PCI.