We found that 1–3 months of DAPT followed by P2Y12 inhibitor monotherapy had a lower risk of major bleeding compared with those applying DAPT in patients with CAD and CKD (RR: 0.69, 95% CI: 0.51–0.95, P = 0.02, I2 = 31%, PHeterogeneity = 0.22) and non-CKD (RR: 0.66, 95% CI: 0.49–0.89, P = 0.01, PHeterogeneity = 0.06) with low evidence of heterogeneity among studies (Figure 3; Supplementary Figure S3). This evidence concerns the gene P2RY12 and chronic kidney disease.