دورية أكاديمية
Assessment of Platelet REACtivity After Transcatheter Aortic Valve Replacement: The REAC-TAVI Trial.
| العنوان: | Assessment of Platelet REACtivity After Transcatheter Aortic Valve Replacement: The REAC-TAVI Trial. |
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| المؤلفون: | Jimenez Diaz, Victor Alfonso, Tello-Montoliu, Antonio, Moreno, Raul, Cruz Gonzalez, Ignacio, Baz Alonso, Jose Antonio, Romaguera, Rafael, Molina Navarro, Eduardo, Juan Salvadores, Pablo, Paredes Galan, Emilio, De Miguel Castro, Antonio, Bastos Fernandez, Guillermo, Ortiz Saez, Alberto, Fernandez Barbeira, Saleta, Raposeiras Roubin, Sergio, Ocampo Miguez, Juan, Serra Peñaranda, Antonio, Valdes Chavarri, Mariano, Cequier Fillat, Angel, Calvo Iglesias, Francisco, Iñiguez Romo, Andres |
| سنة النشر: | 2019 |
| المجموعة: | Sistema Sanitario Público de Andalucía (SSPA): Repositorio |
| مصطلحات موضوعية: | VerifyNow, antithrombotic therapy, aortic stenosis, high platelet reactivity, transcatheter aortic valve replacement, Aged, 80 and over, Aortic Valve, Aortic Valve Stenosis, Aspirin, Blood Platelets, Clopidogrel, Drug Resistance, Drug Therapy, Combination, Female, Humans, Male, Middle Aged, Pilot Projects, Platelet Aggregation Inhibitors, Prospective Studies, Registries, Spain, Ticagrelor, Time Factors, Treatment Outcome |
| الوصف: | The REAC-TAVI (Assessment of platelet REACtivity after Transcatheter Aortic Valve Implantation) trial enrolled patients with aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR) pre-treated with aspirin + clopidogrel, aimed to compare the efficacy of clopidogrel and ticagrelor in suppressing high platelet reactivity (HPR) after TAVI. Current recommendations support short-term use of aspirin + clopidogrel for patients with severe AS undergoing TAVR despite the lack of compelling evidence. This was a prospective, randomized, multicenter investigation. Platelet reactivity was measured at 6 different time points with the VerifyNow assay (Accriva Diagnostics, San Diego, California). HPR was defined as (P2Y12 reaction units (PRU) ≥208. Patients with HPR before TAVR were randomized to either aspirin + ticagrelor or aspirin + clopidogrel for 3 months. Patients without HPR continued with aspirin + clopidogrel (registry cohort). The primary endpoint was non-HPR status (PRU A total of 68 patients were included. Of these, 48 (71%) had HPR (PRU 273 ± 09) and were randomized to aspirin + ticagrelor (n = 24, PRU 277 ± 08) or continued with aspirin + clopidogrel (n = 24, PRU 269 ± 49). The remaining 20 patients (29%) without HPR (PRU 133 ± 12) were included in the registry. Overall, platelet reactivity across all the study time points after TAVR was lower in patients randomized to ticagrelor compared with those treated with clopidogrel, including those enrolled in the registry (p HPR to clopidogrel is present in a considerable number of patients with AS undergoing TAVR. Ticagrelor achieves a better and faster effect, providing sustained suppression of HPR to these patients. (Platelet Reactivity After TAVI: A Multicenter Pilot Study [REAC-TAVI]; NCT02224066). |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| تدمد: | 1876-7605 |
| العلاقة: | http://hdl.handle.net/10668/13393Test; https://doi.org/10.1016/j.jcin.2018.10.005Test |
| DOI: | 10.1016/j.jcin.2018.10.005 |
| الإتاحة: | https://doi.org/10.1016/j.jcin.2018.10.005Test http://hdl.handle.net/10668/13393Test |
| حقوق: | Attribution-NonCommercial-NoDerivatives 4.0 International ; http://creativecommons.org/licenses/by-nc-nd/4.0Test/ ; open access |
| رقم الانضمام: | edsbas.94572576 |
| قاعدة البيانات: | BASE |
Full Text Finder | تدمد: | 18767605 |
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| DOI: | 10.1016/j.jcin.2018.10.005 |