{
  "abstract": "Background: Trials of P2Y12 inhibitor monotherapy after percutaneous coronary intervention (PCI) withdrew aspirin at fixed times, mostly against 12-month dual antiplatelet therapy (DAPT), and categorical syntheses disagree. Methods: Bayesian model-based network meta-analysis of randomized trials of aspirin withdrawal with P2Y12 inhibitor continuation, with 12-month myocardial infarction (MI) and major bleeding modeled as functions of DAPT duration (Emax and spline). The prespecified estimand was the shortest duration at which the upper 95% credible limit of the odds ratio (OR) for MI versus 12-month DAPT fell below 1.15. Results: Sixteen trials (17 randomized comparisons, 58,068 patients) contributed 929 MIs and 1,102 major bleeding events. The OR for MI was 1.31 (95% credible interval 0.95-2.09) at 0 days, 1.17 (0.96-1.43) at 30 days, and 1.09 (0.98-1.25) at 90 days. Under every model the point estimate exceeded 1.15 below about 3 weeks and fell below it from about 90 days; a 30-day change-point did not fit better. The credible bound was met at 158 days (Emax) and 282 days (spline). Bleeding decreased with shorter duration (OR 0.40 at 0 days, 0.62 at 90 days). Certainty was low for MI below 90 days and the estimand, moderate for bleeding. Conclusions: Shorter DAPT reduced major bleeding, and the ischemic cost of aspirin withdrawal declined with duration; a step at 1 month was not supported. A 15% excess of MI could be excluded from about 5 months (Emax) or 9 months (spline). The curves match duration to each patient's ischemic margin.",
  "abstract_shown": true,
  "affiliations": [
    "Dongguk University Ilsan Hospital"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "J.-S. Jang"
    },
    {
      "name": "K.-H. Kim"
    },
    {
      "name": "J. S. Park"
    },
    {
      "name": "E.-M. Lee"
    },
    {
      "name": "M.-Y. Rhee"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/1y9pjtdad8b91.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.10.28.26366775",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.10.28.26366775v1.full",
  "id": "1y9pjtdad8b91",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.10.28.26366775v1",
  "language": null,
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "cardiovascular medicine"
    ]
  ],
  "openalex": null,
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.10.28.26366775v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-28",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/1y9pjtdad8b91.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T00:20:43Z",
      "native_id": "10.64898/2026.10.28.26366775",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.10.28.26366775v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:cardiovascular medicine",
      "subfield": "cardiovascular"
    }
  ],
  "title": "How Short Is Safe? Duration of Dual Antiplatelet Therapy Before Aspirin Withdrawal After Percutaneous Coronary Intervention: A Dose-Response Network Meta-Analysis",
  "title_text": "How Short Is Safe? Duration of Dual Antiplatelet Therapy Before Aspirin Withdrawal After Percutaneous Coronary Intervention: A Dose-Response Network Meta-Analysis",
  "type": "preprint",
  "updated_at": "2026-11-01T00:20:33Z",
  "url": "https://research.draconitic.com/paper/1y9pjtdad8b91",
  "venue": "medRxiv",
  "versions": []
}