Association of Pulse Pressure With Clinical Outcomes in Patients Under Different Antiplatelet Strategies After Percutaneous Coronary Intervention: Analysis of GLOBAL LEADERS
| العنوان: | Association of Pulse Pressure With Clinical Outcomes in Patients Under Different Antiplatelet Strategies After Percutaneous Coronary Intervention: Analysis of GLOBAL LEADERS |
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| المؤلفون: | Joanna J. Wykrzykowska, Philippe Gabriel Steg, Rui Cruz Ferreira, Amanda G. M. R. Sousa, Kuniaki Takahashi, Norihiro Kogame, Mariusz Tomaniak, Pascal Vranckx, Rob J. de Winter, Peter Jüni, Marco Valgimigli, Yoshinobu Onuma, Tessa Rademaker-Havinga, Chun-Chin Chang, Pedro A. Lemos, Rodrigo Modolo, Stephan Windecker, Patrick W. Serruys, Scot Garg, Ana Paula de Faria, Ply Chichareon, Christian Campus Hamm |
| المساهمون: | Graduate School, ACS - Atherosclerosis & ischemic syndromes, Cardiology, ACS - Heart failure & arrhythmias, ACS - Microcirculation, University of Zurich, Serruys, Patrick W |
| المصدر: | Canadian journal of cardiology, 36(5), 747-755. Pulsus Group Inc. Canadian Journal of Cardiology, 36(5), 747-755. Elsevier Inc. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Male, medicine.medical_specialty, Ticagrelor, medicine.medical_treatment, Population, Myocardial Infarction, 610 Medicine & health, Blood Pressure, Hemorrhage, 030204 cardiovascular system & hematology, Lower risk, 11171 Cardiocentro Ticino, 2705 Cardiology and Cardiovascular Medicine, 03 medical and health sciences, 0302 clinical medicine, Percutaneous Coronary Intervention, Internal medicine, medicine, Humans, 030212 general & internal medicine, Myocardial infarction, Mortality, education, Aged, education.field_of_study, business.industry, Dual Anti-Platelet Therapy, Hazard ratio, Percutaneous coronary intervention, Middle Aged, medicine.disease, Confidence interval, 3. Good health, Conventional PCI, Cardiology, Female, Cardiology and Cardiovascular Medicine, business, Platelet Aggregation Inhibitors, medicine.drug |
| الوصف: | Background: We evaluated the association of pulse pressure (PP) and different antiplatelet regimes with clinical and safety outcomes in an all-comers percutaneous coronary intervention (PCI) population. Methods: In this analysis of GLOBAL LEADERS (n = 15,936) we compared the experimental therapy of 23 months of ticagrelor after 1 month of dual-antiplatelet therapy (DAPT) versus standard DAPT for 12 months followed by aspirin monotherapy in subjects who underwent PCI and were divided into 2 groups according to the median PP (60 mm Hg). The primary end point (all-cause death or new Q-wave myocardial infarction) and the composite end points: patient-oriented composite end points (POCE), Bleeding Academic Research Consortium (BARC) 3 or 5, and net adverse clinical events (NACE) were evaluated. Results: At 2 years, subjects in the high-PP group (n = 7971) had similar rates of the primary end point (4.3% vs 3.9%; P = 0.058), POCE (14.9% vs 12.7%; P = 0.051), and BARC 3 or 5 (2.5% vs 1.7%; P = 0.355) and higher rates of NACE (16.4% vs 13.7%; P = 0.037) compared with the low-PP group (n = 7965). Among patients with PP < 60 mm Hg, the primary end point (3.4% vs 4.4%, adjusted hazard ratio [aHR] 0.77, 95% confidence interval [CI] 0.61-0.96), POCE (11.8% vs 13.5%, aHR 0.86, 95% CI 0.76-0.98), NACE (12.8% vs 14.7%, aHR 0.85, 95% CI 0.76-0.96), and BARC 3 or 5 (1.4% vs 2.1%, aHR 0.69, 95% CI 0.49-0.97) were lower with ticagrelor monotherapy compared with DAPT. The only significant interaction was for BARC 3 or 5 (P = 0.008). Conclusions: After contemporary PCI, subjects with high PP levels experienced high rates of NACE at 2 years. In those with low PP, ticagrelor monotherapy led to a lower risk of bleeding events compared with standard DAPT. |
| وصف الملف: | application/pdf |
| تدمد: | 1916-7075 0828-282X |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::3df6ed8ceab85617bac12a264798bd9aTest https://pubmed.ncbi.nlm.nih.gov/32007351Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....3df6ed8ceab85617bac12a264798bd9a |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 19167075 0828282X |
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