دورية أكاديمية
Ticagrelor Monotherapy Versus Dual-Antiplatelet Therapy After PCI: An Individual Patient-Level Meta-Analysis
| العنوان: | Ticagrelor Monotherapy Versus Dual-Antiplatelet Therapy After PCI: An Individual Patient-Level Meta-Analysis |
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| المؤلفون: | Valgimigli M., Mehran R., Franzone A., da Costa B. R., Baber U., Piccolo R., McFadden E. P., Vranckx P., Angiolillo D. J., Leonardi S., Cao D., Dangas G. D., Mehta S. R., Serruys P. W., Gibson C. M., Steg G. P., Sharma S. K., Hamm C., Shlofmitz R., Liebetrau C., Briguori C., Janssens L., Huber K., Ferrario M., Kunadian V., Cohen D. J., Zurakowski A., Oldroyd K. G., Yaling H., Dudek D., Sartori S., Kirkham B., Escaned J., Heg D., Windecker S., Pocock S., Juni P., Serruys P., Mehta S., Gibson M. C., Kastrati A., Krucoff M., Ohman M. E., Gurbel P., Henry T. D., Moliterno D., McFadden E., Marx S. O., Darrow B., Corvaja N., DeStefano D., Ghodsi N., Meller J., Franklin-Bond T., Cha J. Y., Waseem Z., Weisz G., Kornowski R., Oldroyd K., Kaul U., Witzenbichler B., Dzavik V., Gil R., Sardella G., Benit E., Diletti R., Dominici M., Slagboom T., Buszman P., Bolognese L., Tumscitz C., Bryniarski K., Aminian A., Vrolix M., Petrov I., Garg S., Naber C., Prokopczuk J., Steg P. G. |
| المساهمون: | Valgimigli, M., Mehran, R., Franzone, A., da Costa, B. R., Baber, U., Piccolo, R., Mcfadden, E. P., Vranckx, P., Angiolillo, D. J., Leonardi, S., Cao, D., Dangas, G. D., Mehta, S. R., Serruys, P. W., Gibson, C. M., Steg, G. P., Sharma, S. K., Hamm, C., Shlofmitz, R., Liebetrau, C., Briguori, C., Janssens, L., Huber, K., Ferrario, M., Kunadian, V., Cohen, D. J., Zurakowski, A., Oldroyd, K. G., Yaling, H., Dudek, D., Sartori, S., Kirkham, B., Escaned, J., Heg, D., Windecker, S., Pocock, S., Juni, P., Serruys, P., Mehta, S., Gibson, M. C., Kastrati, A., Krucoff, M., Ohman, M. E., Gurbel, P., Henry, T. D., Moliterno, D., Mcfadden, E., Marx, S. O., Darrow, B., Corvaja, N., Destefano, D., Ghodsi, N., Meller, J., Franklin-Bond, T., Cha, J. Y., Waseem, Z., Weisz, G., Kornowski, R., Oldroyd, K., Kaul, U., Witzenbichler, B., Dzavik, V., Gil, R., Sardella, G., Benit, E., Diletti, R., Dominici, M., Slagboom, T., Buszman, P., Bolognese, L., Tumscitz, C., Bryniarski, K., Aminian, A., Vrolix, M., Petrov, I., Garg, S., Naber, C., Prokopczuk, J., Steg, P. G. |
| سنة النشر: | 2021 |
| المجموعة: | IRIS UNIPV (Università degli studi di Pavia) |
| مصطلحات موضوعية: | aspirin, DAPT, meta-analysi, P2Y, inhibitor, ticagrelor |
| الوقت: | 12 |
| الوصف: | Objectives: The aim of this study was to compare ticagrelor monotherapy with dual-antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) with drug-eluting stents. Background: The role of abbreviated DAPT followed by an oral P2Y12 inhibitor after PCI remains uncertain. Methods: Two randomized trials, including 14,628 patients undergoing PCI, comparing ticagrelor monotherapy with standard DAPT on centrally adjudicated endpoints were identified, and individual patient data were analyzed using 1-step fixed-effect models. The protocol was registered in PROSPERO (CRD42019143120). The primary outcomes were the composite of Bleeding Academic Research Consortium type 3 or 5 bleeding tested for superiority and, if met, the composite of all-cause death, myocardial infarction, or stroke at 1 year, tested for noninferiority against a margin of 1.25 on a hazard ratio (HR) scale. Results: Bleeding Academic Research Consortium type 3 or 5 bleeding occurred in fewer patients with ticagrelor than DAPT (0.9% vs. 1.7%, respectively; HR: 0.56; 95% confidence interval [CI]: 0.41 to 0.75; p < 0.001). The composite of all-cause death, myocardial infarction, or stroke occurred in 231 patients (3.2%) with ticagrelor and in 254 patients (3.5%) with DAPT (HR: 0.92; 95% CI: 0.76 to 1.10; p < 0.001 for noninferiority). Ticagrelor was associated with lower risk for all-cause (HR: 0.71; 95% CI: 0.52 to 0.96; p = 0.027) and cardiovascular (HR: 0.68; 95% CI: 0.47 to 0.99; p = 0.044) mortality. Rates of myocardial infarction (2.01% vs. 2.05%; p = 0.88), stent thrombosis (0.29% vs. 0.38%; p = 0.32), and stroke (0.47% vs. 0.36%; p = 0.30) were similar. Conclusions: Ticagrelor monotherapy was associated with a lower risk for major bleeding compared with standard DAPT, without a concomitant increase in ischemic events. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | info:eu-repo/semantics/altIdentifier/pmid/33602441; info:eu-repo/semantics/altIdentifier/wos/WOS:000632036700014; volume:14; issue:4; firstpage:444; lastpage:456; numberofpages:13; journal:JACC: CARDIOVASCULAR INTERVENTIONS; http://hdl.handle.net/11571/1438748Test; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85100435785 |
| DOI: | 10.1016/j.jcin.2020.11.046 |
| الإتاحة: | https://doi.org/10.1016/j.jcin.2020.11.046Test http://hdl.handle.net/11571/1438748Test |
| رقم الانضمام: | edsbas.CFAE01B3 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1016/j.jcin.2020.11.046 |
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