دورية أكاديمية
Reduced Mortality With Antiplatelet Therapy Deescalation After Percutaneous Coronary Intervention in Acute Coronary Syndromes: A Meta-Analysis
| العنوان: | Reduced Mortality With Antiplatelet Therapy Deescalation After Percutaneous Coronary Intervention in Acute Coronary Syndromes: A Meta-Analysis |
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| المؤلفون: | Palmerini, Tullio, Bruno, Antonio Giulio, Gasparini, Mauro, Rizzello, Giulia, Kim, Hyo-Soo, Kang, Jeehoon, Park, Kyung-Woo, Hahn, Joo-Yong, Song, Young Bin, Gwon, Hyeon-Cheol, Choo, Eun Ho, Park, Mahn-Won, Kim, Chan Joon, Chang, Kiyuk, Cuisset, Thomas, Taglieri, Nevio, Kim, Byeong-Keuk, Jang, Yangsoo, Nardi, Elena, Saia, Francesco, Orzalkiewicz, Matheusz, Chietera, Francesco, Ghetti, Gabriele, Galiè, Nazzareno, Stone, Gregg W |
| المساهمون: | Palmerini, Tullio, Bruno, Antonio Giulio, Gasparini, Mauro, Rizzello, Giulia, Kim, Hyo-Soo, Kang, Jeehoon, Park, Kyung-Woo, Hahn, Joo-Yong, Song, Young Bin, Gwon, Hyeon-Cheol, Choo, Eun Ho, Park, Mahn-Won, Kim, Chan Joon, Chang, Kiyuk, Cuisset, Thoma, Taglieri, Nevio, Kim, Byeong-Keuk, Jang, Yangsoo, Nardi, Elena, Saia, Francesco, Orzalkiewicz, Matheusz, Chietera, Francesco, Ghetti, Gabriele, Galiè, Nazzareno, Stone, Gregg W |
| بيانات النشر: | LIPPINCOTT WILLIAMS & WILKINS |
| سنة النشر: | 2022 |
| المجموعة: | PORTO@iris (Publications Open Repository TOrino - Politecnico di Torino) |
| مصطلحات موضوعية: | acute coronary syndrome, ischemia, mortality, percutaneous coronary intervention, stent |
| الوصف: | Background:Antiplatelet therapy deescalation has been suggested as an alternative to standard treatment with potent dual antiplatelet therapy (DAPT) for 1 year in low bleeding risk patients with acute coronary syndromes undergoing percutaneous coronary intervention to mitigate the increased risk of bleeding. Whether this strategy preserves the ischemic and survival benefits of potent DAPT is uncertain. Methods:We performed a pairwise meta-analysis in patients with acute coronary syndrome undergoing percutaneous coronary intervention treated with either 1-year standard potent DAPT versus deescalation therapy (potent DAPT for 1-3 months followed by either reduced potency DAPT or ticagrelor monotherapy for up to 1 year). Randomized trials comparing standard DAPT versus deescalation therapy in patients with acute coronary syndrome undergoing percutaneous coronary intervention were searched through MEDLINE, EMBASE, Cochrane databases, and proceedings of international meetings. The primary end point was 1-year all-cause mortality. Results:The meta-analysis included 6 trials in which 20 837 patients were randomized to potent DAPT for 1 to 3 months followed by deescalation therapy for up to 1 year (n=10 392) or standard potent DAPT for 1 year (n=10 445). Deescalation therapy was associated with lower 1-year rates of all-cause mortality compared with standard therapy (odds ratio, 0.75 [95% CI, 0.59-0.95]; P=0.02). Deescalation therapy was also associated with lower rates of major bleeding (odds ratio, 0.59 [95% CI, 0.48-0.72]; P<0.0001), with no significant difference in major adverse cardiac events (major adverse cardiovascular events; odds ratio, 0.89 [95% CI, 0.77-1.04]; P=0.14). Conclusions:In low bleeding risk patients with acute coronary syndrome undergoing percutaneous coronary intervention, compared with 1-year of potent DAPT, antiplatelet therapy deescalation therapy after 1 to 3 months was associated with decreased mortality and major bleeding with similar rates of major adverse cardiovascular events. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | info:eu-repo/semantics/altIdentifier/wos/WOS:000883717400008; volume:15; issue:11; firstpage:906; lastpage:914; numberofpages:9; journal:CIRCULATION. CARDIOVASCULAR INTERVENTIONS.; https://hdl.handle.net/11583/2976410Test; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85141976220 |
| DOI: | 10.1161/CIRCINTERVENTIONS.122.012245 |
| الإتاحة: | https://doi.org/10.1161/CIRCINTERVENTIONS.122.012245Test https://hdl.handle.net/11583/2976410Test |
| حقوق: | info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsbas.85E6C0D7 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1161/CIRCINTERVENTIONS.122.012245 |
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