Background: Guidelines from the American Heart Association/American College of Cardiology recommend a\nhigher dosage of aspirin daily following Percutaneous Coronary Intervention (PCI), whereas guidelines from the\nEuropean Society of Cardiology recommend a lower dosage. This study aimed to compare the adverse clinical\noutcomes associated with a low dose and a high dose of aspirin following PCI.\nMethods: Electronic databases were searched for studies comparing a low dose with a high dose aspirin following PCI.\nAdverse clinical outcomes were considered as the endpoints in this study. We calculated Odds Ratios (OR) with 95 %\nConfidence Intervals (CIs) for categorical variables. The pooled analyses were performed with RevMan 5.3 software.\nResults: A total number of 25,083 patients were included. Results from this analysis showed that the combination of\nCardiovascular (CV) death/Myocardial Infarction (MI) or stroke was not significantly different between a low and high\ndose of aspirin with OR: 1.08, 95 % CI: 0.98ââ?¬â??1.18; P = 0.11. Mortality and MI were also not significantly different between\nthese two treatment regimens following PCI with OR: 0.95, 95 % CI: 0.74ââ?¬â??1.23; P = 0.71 and OR: 1.17, 95 % CI: 0.97ââ?¬â??1.41;\nP = 0.09 respectively. However, a high dose of aspirin was associated with a significantly higher rate of Major Adverse\nCardiac Events (MACEs) with OR: 1.20, 95 % CI: 1.02ââ?¬â??1.41; P = 0.03. Thrombolysis In Myocardial Infarction (TIMI) defined\nminor bleeding was also significantly higher with a high dose aspirin with OR: 1.22, 95 % CI: 1.02ââ?¬â??1.47; P = 0.03. When\nStent thrombosis (ST) was compared, no significant difference was found with OR: 1.28, 95 % CI: 0.59ââ?¬â??2.58; P = 0.53.\nEven if TIMI defined major bleeding favored a low dose of aspirin, with OR: 1.42, 95 % CI: 0.95ââ?¬â??2.13; P = 0.09, or even if\nmajor bleeding was insignificantly higher with a high dose aspirin, with OR: 1.78, 95 % CI: 1.01ââ?¬â??3.13; P = 0.05; I2 = 94 %,\nhigher levels of heterogeneity observed in these subgroups could not be considered significant to any extent. Conclusion: According to the results of this analysis, a high dose of aspirin following PCI was not associated with any\nsignificantly higher rate of CV death/MI/stroke, mortality or MI. However, MACEs significantly favored a low dose of\naspirin. In addition, TIMI defined minor bleeding was significantly higher with a high dose of aspirin whereas the results\nfor the major bleeding outcomes were not statistically significant. However, due to limited data availability and since\nthe subgroups analyzing major bleeding were highly heterogeneous, further studies are recommended to completely\nsolve this issue.
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