Impact of chronic obstructive pulmonary disease and dyspnoea on clinical outcomes in ticagrelor treated patients undergoing percutaneous coronary intervention in the randomized GLOBAL LEADERS trial
| العنوان: | Impact of chronic obstructive pulmonary disease and dyspnoea on clinical outcomes in ticagrelor treated patients undergoing percutaneous coronary intervention in the randomized GLOBAL LEADERS trial |
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| المؤلفون: | Norihiro Kogame, Krzysztof J. Filipiak, Mariusz Tomaniak, Franz-Josef Neumann, Osama Ibrahim Ibrahim Soliman, Valeri Gelev, Ply Chichareon, Robert-Jan van Geuns, Jan G.P. Tijssen, Philippe Brunel, Zoltan Jambrik, Yoshinobu Onuma, Global Leaders Study Investigators, Jean-François Morelle, Rodrigo Modolo, Chun Chin Chang, Patrick W. Serruys, Mariana Konteva, Tessa Rademaker-Havinga, Marco Valgimigli, Sylvain Plante, Philippe Gabriel Steg, Stephan Windecker, Ernest Spitzer, Kuniaki Takahashi, Farzin Beygui, Rosana Hernandez Antolin, Robert F. Storey, Christian W. Hamm |
| المساهمون: | Cardiology, Graduate School, ACS - Heart failure & arrhythmias, ACS - Atherosclerosis & ischemic syndromes, ACS - Microcirculation, University of Zurich |
| المصدر: | European Heart Journal-Cardiovascular Pharmacotherapy, 6, 222-230 European Heart Journal. Cardiovascular pharmacotherapy, 6(4), 222-230. Oxford University Press Tomaniak, Mariusz; Chichareon, Ply; Takahashi, Kuniaki; Kogame, Norihiro; Modolo, Rodrigo; Chang, Chun Chin; Spitzer, Ernest; Neumann, Franz-Josef; Plante, Sylvain; Hernández Antolin, Rosana; Jambrik, Zoltan; Gelev, Valeri; Brunel, Philippe; Konteva, Mariana; Beygui, Farzin; Morelle, Jean-Francois; Filipiak, Krzysztof J; van Geuns, Robert-Jan; Soliman, Osama; Tijssen, Jan; ... (2020). Impact of chronic obstructive pulmonary disease and dyspnoea on clinical outcomes in ticagrelor treated patients undergoing percutaneous coronary intervention in the randomized GLOBAL LEADERS trial. European heart journal. Cardiovascular pharmacotherapy, 6(4), pp. 222-230. Oxford University Press 10.1093/ehjcvp/pvz052 <http://dx.doi.org/10.1093/ehjcvp/pvz052Test> European heart journal. Cardiovascular pharmacotherapy, 6(4), 222-230. Oxford University Press European Heart Journal-Cardiovascular Pharmacotherapy, 6, 4, pp. 222-230 |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Male, Ticagrelor, Time Factors, medicine.medical_treatment, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], Coronary Artery Disease, 030204 cardiovascular system & hematology, Percutaneous coronary intervention, Pulmonary Disease, Chronic Obstructive, 0302 clinical medicine, Risk Factors, Aspirin-free antiplatelet strategies after percutaneous coronary intervention, Clinical endpoint, 2736 Pharmacology (medical), Pharmacology (medical), Prospective Studies, 030212 general & internal medicine, Myocardial infarction, 610 Medicine & health, COPD, Dual Anti-Platelet Therapy, Incidence, Chronic obstructive pulmonary disease, Hazard ratio, Middle Aged, Treatment Outcome, Female, Cardiology and Cardiovascular Medicine, medicine.drug, medicine.medical_specialty, Risk Assessment, 11171 Cardiocentro Ticino, 2705 Cardiology and Cardiovascular Medicine, Drug Administration Schedule, 03 medical and health sciences, Internal medicine, medicine, Humans, Aged, business.industry, medicine.disease, Dyspnoea adverse event, Clinical trial, Dyspnea, Conventional PCI, business, Platelet Aggregation Inhibitors |
| الوصف: | Aims To evaluate long-term safety and efficacy of ticagrelor monotherapy in patients undergoing percutaneous coronary interventions (PCIs) in relation to chronic obstructive pulmonary disease (COPD) at baseline and the occurrence of dyspnoea reported as adverse event (AE) that may lead to treatment non-adherence. Methods and results This is a non-prespecified, post hoc analysis of the randomized GLOBAL LEADERS trial (n = 15 991), comparing the experimental strategy of 23-month ticagrelor monotherapy following 1-month dual antiplatelet therapy (DAPT) after PCI with the reference strategy of 12-month DAPT followed by 12-month aspirin monotherapy. Impact of COPD and dyspnoea AE (as a time-dependent covariate) on clinical outcomes was evaluated up to 2 years. The primary endpoint was a 2-year all-cause mortality or non-fatal, centrally adjudicated, new Q-wave myocardial infarction. The presence of COPD (n = 832) was the strongest clinical predictor of 2-year all-cause mortality after PCI [hazard ratio (HR) 2.84; 95% confidence interval (CI) 2.21–3.66; P adjusted = 0.001] in this cohort (n = 15 991). No differential treatment effects on 2-year clinical outcomes were found in patients with and without COPD (primary endpoint: HR 0.88; 95% CI 0.58–1.35; P = 0.562; P int = 0.952). Overall, at 2 years dyspnoea was reported as an AE in 2101 patients, more frequently among COPD patients, irrespective of treatment allocation (27.2% in experimental arm vs. 14.5% in reference arm, P = 0.001). Its occurrence was not associated with a higher rate of the primary endpoint (P adjusted = 0.640) in the experimental vs. the reference arm. Conclusion In this exploratory analysis, COPD negatively impacted long-term prognosis after PCI. Despite higher incidence of dyspnoea in the experimental arm, in particular among COPD patients, the safety of the experimental treatment strategy appeared not to be affected. Clinical trial registration unique identifier NCT01813435. |
| وصف الملف: | application/pdf |
| اللغة: | English |
| تدمد: | 2055-6837 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::1e5d902c3324f4e20a9b1ea818ba76c5Test https://doi.org/10.1093/ehjcvp/pvz052Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....1e5d902c3324f4e20a9b1ea818ba76c5 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 20556837 |
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