Real-world dual antiplatelet therapy following polymer-free sirolimus-eluting stent implantations to treat coronary artery disease

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023001%3A_____%2F20%3A00079671" target="_blank" >RIV/00023001:_____/20:00079671 - isvavai.cz</a>

Alternative codes found

RIV/00064173:_____/20:N0000092

Result on the web

<a href="https://link.springer.com/content/pdf/10.1007/s10557-020-06963-5.pdf" target="_blank" >https://link.springer.com/content/pdf/10.1007/s10557-020-06963-5.pdf</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1007/s10557-020-06963-5" target="_blank" >10.1007/s10557-020-06963-5</a>

Result language

angličtina

Original language name

Real-world dual antiplatelet therapy following polymer-free sirolimus-eluting stent implantations to treat coronary artery disease

Original language description

Objectives: The objective of this post hoc analysis was to analyze real-world dual antiplatelet therapy (DAPT) regimens following polymer-free sirolimus-eluting stent (PF-SES) implantations in an unselected patient population. Methods: Patient-level data from two all-comers observational studies (ClinicalTrials.gov Identifiers: NCT02629575 and NCT02905214) were pooled and analyzed in terms of their primary endpoint. During the data verification process, we observed substantial deviations from DAPT guideline recommendations. To illuminate this gap between clinical practice and guideline recommendations, we conducted a post hoc analysis of DAPT regimens and clinical event rates for which we defined the net adverse event rate (NACE) consisting of target lesion revascularization (TLR, primary endpoint of all-comers observational studies) all-cause death, myocardial infarction (MI), stent thrombosis (ST), and bleeding events. A logistic regression was utilized to determine predictors why ticagrelor was used in stable coronary artery disease (CAD) patients instead of the guideline-recommended clopidogrel. Results: For stable CAD, the composite endpoint of clinical, bleeding, and stent thrombosis, i.e., NACE, between the clopidogrel and ticagrelor treatment groups was not different (5.4% vs. 5.1%, p = 0.745). Likewise, in the acute coronary syndrome (ACS) cohort, the NACE rates were not different between both DAPT strategies (9.2% vs. 9.3%, p = 0.927). There were also no differences in the accumulated rates for TLR, myocardial infarction ([MI], mortality, bleeding events, and stent thrombosis in elective and ACS patients. The main predictors for ticagrelor use in stable CAD patients were age &lt; 65 years, smaller vessels, treatment of ostial and calcified lesions, and in-stent restenosis. Conclusion: Within the framework of a post hoc analysis based on a real-world, large cohort study, there were no differences in the combined endpoint of major adverse cardiac events (MACE), bleeding and thrombotic events for clopidogrel and ticagrelor in stable CAD or ACS patients. Despite the recommendation for clopidogrel by the European Society of Cardiology (ESC), real-world ticagrelor use was observed in subgroups of stable CAD patients that ought to be explored in future trials. © 2020, Springer Science+Business Media, LLC, part of Springer Nature.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30201 - Cardiac and Cardiovascular systems

Project

—

Continuities

N - Vyzkumna aktivita podporovana z neverejnych zdroju

Publication year

2020

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Cardiovascular drugs and therapy

ISSN

0920-3206

e-ISSN

—

Volume of the periodical

34

Issue of the periodical within the volume

3

Country of publishing house

NL - THE KINGDOM OF THE NETHERLANDS

Number of pages

10

Pages from-to

335-344

UT code for WoS article

000521696500002

EID of the result in the Scopus database

2-s2.0-85083391587