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Shortened (one or three months) DAPT in comparison with conventional strategy for patients with diabetes undergoing PCI

Prognosis of patients with out-of-hospital cardiac arrest (OHCA) is poor, with high mortality rates and worse neurological outcomes. Coronary angiography (CAG) is recommended in patients with ST-segment elevation myocardial infarction (STEMI) associated with cardiac arrest; however, timing of performing CAG in patients with OHCA without STEMI is unclear. Aim of our meta - analysis is to investigate the optimal time frame.

Glaucoma is a progressive optic neuropathy causing retinal nerve fiber layer (RNFL) thinning, retinal ganglion cell (RGC) apoptosis, and visual loss. Accumulating evidence suggests that blood pressure (BP), whether too high or too low, can predispose to negative glaucoma outcomes. Initial hypertensive or hypotensive damage to the RGCs and their axons is a likely explanation. With the constant increase in population and life expectancy, by 2040, the projected number of people with glaucoma worldwide exceeds 110 million, while hypertension already affects approximately one third of the adult population. Nevertheless, the growing disease burden related to the coexistence of glaucoma and suboptimal BP control is currently understated in clinical practice. In this regard, we conducted a systematic review on the relationship between arterial hypertension (AHT) and hypotension with inner retinal thickness, as assessed by structural optical coherence tomography. For this purpose, we searched five databases for studies reporting on BP and the RNFL or ganglion cell-inner plexiform layer thickness (GCIPL) in healthy subjects and in patients with ophthalmic or systemic disease. Findings revealed a U-shaped (or J-shaped) effect, but study design limited the conclusions drawn, especially due to the confounding role of antihypertensive medication. Last, we summarize current AHT treatment standards and call for collaborative management of patients with coexisting glaucomatous and cardiovascular risk.

Review question(s) The aim of this systematic review and meta-analysis was to compare the safety and efficacy of a short (≤3 months) versus longer (>3 months) duration of DAPT after complex PCI. Searches We will search the current literature by conducting an electronic bibliographic databases screening in three databases; Medline, Cochrane Central Register of Controlled Trials (CENTRAL) and Scopus. Types of study to be included RCTs Participants/ population (1) randomized-control studies (RCT) including human subjects, (2) DAPT duration ≤90 days in the intervention arm, (3) DAPT duration of at least 91 days in the comparator arm, (4) complex PCI in all included patients. The definition of complex PCI is not universal, so we used it as per trial defined Outcome(s) net adverse clinical event (NACE), Major Adverse Cardiovascular Events (MACE), myocardial infraction, stroke, stent thrombosis, repeat revascularization and major bleeding. Risk of bias (quality) assessment We wll assess the risk of bias in the included studies using the revised Cochrane ‘Risk of bias’ tool for randomized trials (RoB 2.0) Strategy for data synthesis Odds ratio with 95% confidence intervals (CIs) were used for the estimation of the effect of the different DAPT regimens. The pooled OR was estimated applying a fixed-effect model.

Systematic review and meta-analysis