Background: The optimal duration of dual antiplatelet therapy is a matter of ongoing research. Clinical studies are assessing the optimal duration with the most favourable risk to benefit ratio. The efficacy of P2Y12 receptor inhibitors has been shown comparable to aspirin in preventing recurrent ischaemic events in patients with coronary artery diseases. Objectives: To investigate the outcomes of short-duration dual antiplatelet therapy after PCI with early discontinuation of aspirin while maintaining patients on P2Y12 inhibitor through systematic review and meta-analysis of available literature. Methods: We systematically searched Pubmed, Cochrane Central Register of Controlled Trials (CENTRAL) and ClinicalTrials.gov. We included randomised controlled studies that measured clinical outcomes of efficacy (mortality and ischaemic events) and safety (bleeding) of short and standard duration dual antiplatelet therapy. The protocol of this study was registered in the International prospective register of systematic reviews PROSPERO registry (CRD42020171468). Results: Four randomised controlled trials were included; GLOBAL LEADERS, SMART-CHOICE, STOPDAPT-2 and TWILIGHT. The total number of patients was 29,089. The safety outcomes showed a significant reduction in major bleeding events with short-duration dual antiplatelet therapy; risk ratio is 0.61 (95% CI 0.38-0.99; z=2,00, p=0.05). There was no difference between short and standard duration dual antiplatelet therapy regarding efficacy outcomes (all-cause death, major adverse cardiovascular events, myocardial infarction, stroke and stent thrombosis). Conclusion: Short-duration dual antiplatelet therapy followed by P2Y12 inhibitor monotherapy after PCI is a feasible option and can be adopted, especially in patients with a high risk of bleeding.

Background: Atrial fibrillation is a relatively common complication of acute myocardial infarction with significant impact on the short and long-term prognosis. Methods: A systematic literature review was done through Pubmed and CENTRAL to extract data related to new-onset atrial fibrillation following primary PCI. Results: Searching resulted in twenty-one matched studies. Extraction of data showed an incidence rate of new-onset atrial fibrillation (2.8%-58%). A negative impact was found on the outcomes of patients treated with primary PCI with increased short and long-term mortality and morbidity. Conclusion: New-onset atrial fibrillation is an adverse prognostic marker in patients with acute myocardial infarction treated invasively. Preventive measures and anticoagulant therapy should be considered more intensively in this subset of patients.