Real-World Dual Antiplatelet Therapy Following Polymer-Free Sirolimus-Eluting Stent Implantations to Treat Coronary Artery Disease

  1. Krackhardt, Florian ORCID logo
  2. Waliszewski, Matthias
  3. Kočka, Viktor
  4. Toušek, Petr
  5. Janek, Bronislav
  6. Hudec, Martin
  7. Lozano, Fernando
  8. Roman, Koldobika Garcia-San
  9. del Blanco, Bruno Garcia
  10. Mauri, Josepa
  11. Heang, Tay Mok
  12. Ahn, Tae Hoon
  13. Jeong, Myung Ho
  14. Herberger, Denny
  15. Tomulic, Vjekoslav
  16. Levy, Gilles
  17. Sebagh, Laurent
  18. Rischner, Jérôme
  19. Pansieri, Michel

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1000 Titel
  • Real-World Dual Antiplatelet Therapy Following Polymer-Free Sirolimus-Eluting Stent Implantations to Treat Coronary Artery Disease
1000 Autor/in
  1. Krackhardt, Florian |
  2. Waliszewski, Matthias |
  3. Kočka, Viktor |
  4. Toušek, Petr |
  5. Janek, Bronislav |
  6. Hudec, Martin |
  7. Lozano, Fernando |
  8. Roman, Koldobika Garcia-San |
  9. del Blanco, Bruno Garcia |
  10. Mauri, Josepa |
  11. Heang, Tay Mok |
  12. Ahn, Tae Hoon |
  13. Jeong, Myung Ho |
  14. Herberger, Denny |
  15. Tomulic, Vjekoslav |
  16. Levy, Gilles |
  17. Sebagh, Laurent |
  18. Rischner, Jérôme |
  19. Pansieri, Michel |
1000 Erscheinungsjahr 2020
1000 Publikationstyp
  1. Artikel |
1000 Online veröffentlicht
  • 2020-03-24
1000 Erschienen in
1000 Quellenangabe
  • 34(3):335-344
1000 Copyrightjahr
  • 2020
1000 Lizenz
1000 Verlagsversion
  • https://doi.org/10.1007/s10557-020-06963-5 |
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8626401/ |
1000 Publikationsstatus
1000 Sprache der Publikation
1000 Abstract/Summary
  • 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 < 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.
1000 Sacherschließung
lokal Aged, 80 and over [MeSH]
lokal Cardiovascular Agents/administration
lokal Aged [MeSH]
lokal Risk Assessment [MeSH]
lokal Practice Guidelines as Topic [MeSH]
lokal Clopidogrel
lokal Risk Factors [MeSH]
lokal Coronary Thrombosis/prevention
lokal Dual Anti-Platelet Therapy/mortality [MeSH]
lokal Cardiovascular Agents/adverse effects [MeSH]
lokal Polymer-free
lokal Original Article
lokal Platelet Aggregation Inhibitors/administration
lokal Male [MeSH]
lokal Drug-Eluting Stents [MeSH]
lokal Observational Studies as Topic [MeSH]
lokal Prosthesis Design [MeSH]
lokal Female [MeSH]
lokal Percutaneous Coronary Intervention/instrumentation [MeSH]
lokal Coronary Artery Disease/mortality [MeSH]
lokal Hemorrhage/chemically induced [MeSH]
lokal Humans [MeSH]
lokal Sirolimus-eluting stent
lokal Ticagrelor
lokal Treatment Outcome [MeSH]
lokal Coronary Artery Disease/therapy [MeSH]
lokal Coronary Thrombosis/etiology [MeSH]
lokal Dual Anti-Platelet Therapy/adverse effects [MeSH]
lokal Middle Aged [MeSH]
lokal Dual antiplatelet therapy
lokal Multicenter Studies as Topic [MeSH]
lokal Practice Patterns, Physicians' [MeSH]
lokal Time Factors [MeSH]
lokal Percutaneous Coronary Intervention/adverse effects [MeSH]
lokal Guideline Adherence [MeSH]
lokal Platelet Aggregation Inhibitors/adverse effects [MeSH]
lokal Sirolimus/adverse effects [MeSH]
lokal Coronary Artery Disease/diagnostic imaging [MeSH]
lokal Percutaneous Coronary Intervention/mortality [MeSH]
lokal Sirolimus/administration
1000 Liste der Beteiligten
  1. https://orcid.org/0000-0001-5965-8817|https://frl.publisso.de/adhoc/uri/V2FsaXN6ZXdza2ksIE1hdHRoaWFz|https://frl.publisso.de/adhoc/uri/S2-EjWthLCBWaWt0b3I=|https://frl.publisso.de/adhoc/uri/VG91xaFlaywgUGV0cg==|https://frl.publisso.de/adhoc/uri/SmFuZWssIEJyb25pc2xhdg==|https://frl.publisso.de/adhoc/uri/SHVkZWMsIE1hcnRpbg==|https://frl.publisso.de/adhoc/uri/TG96YW5vLCBGZXJuYW5kbw==|https://frl.publisso.de/adhoc/uri/Um9tYW4sIEtvbGRvYmlrYSBHYXJjaWEtU2Fu|https://frl.publisso.de/adhoc/uri/ZGVsIEJsYW5jbywgQnJ1bm8gR2FyY2lh|https://frl.publisso.de/adhoc/uri/TWF1cmksIEpvc2VwYQ==|https://frl.publisso.de/adhoc/uri/SGVhbmcsIFRheSBNb2s=|https://frl.publisso.de/adhoc/uri/QWhuLCBUYWUgSG9vbg==|https://frl.publisso.de/adhoc/uri/SmVvbmcsIE15dW5nIEhv|https://frl.publisso.de/adhoc/uri/SGVyYmVyZ2VyLCBEZW5ueQ==|https://frl.publisso.de/adhoc/uri/VG9tdWxpYywgVmpla29zbGF2|https://frl.publisso.de/adhoc/uri/TGV2eSwgR2lsbGVz|https://frl.publisso.de/adhoc/uri/U2ViYWdoLCBMYXVyZW50|https://frl.publisso.de/adhoc/uri/UmlzY2huZXIsIErDqXLDtG1l|https://frl.publisso.de/adhoc/uri/UGFuc2llcmksIE1pY2hlbA==
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1000 Erstellt am 2023-11-18T08:46:37.471+0100
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