dc.contributor.author
Krackhardt, Florian
dc.contributor.author
Waliszewski, Matthias
dc.contributor.author
Kočka, Viktor
dc.contributor.author
Toušek, Petr
dc.contributor.author
Janek, Bronislav
dc.contributor.author
Hudec, Martin
dc.contributor.author
Lozano, Fernando
dc.contributor.author
Roman, Koldobika Garcia-San
dc.contributor.author
Blanco, Bruno Garcia del
dc.contributor.author
Mauri, Josepa
dc.contributor.author
Heang, Tay Mok
dc.contributor.author
Ahn, Tae Hoon
dc.contributor.author
Jeong, Myung Ho
dc.contributor.author
Herberger, Denny
dc.contributor.author
Tomulic, Vjekoslav
dc.contributor.author
Levy, Gilles
dc.contributor.author
Sebagh, Laurent
dc.contributor.author
Rischner, Jérôme
dc.contributor.author
Pansieri, Michel
dc.date.accessioned
2022-07-25T11:58:08Z
dc.date.available
2022-07-25T11:58:08Z
dc.identifier.uri
https://refubium.fu-berlin.de/handle/fub188/35658
dc.identifier.uri
http://dx.doi.org/10.17169/refubium-35372
dc.description.abstract
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.
en
dc.rights.uri
https://creativecommons.org/licenses/by/4.0/
dc.subject
Dual antiplatelet therapy
en
dc.subject
Polymer-free
en
dc.subject
Sirolimus-eluting stent
en
dc.subject.ddc
600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit
dc.title
Real-World Dual Antiplatelet Therapy Following Polymer-Free Sirolimus-Eluting Stent Implantations to Treat Coronary Artery Disease
dc.type
Wissenschaftlicher Artikel
dcterms.bibliographicCitation.doi
10.1007/s10557-020-06963-5
dcterms.bibliographicCitation.journaltitle
Cardiovascular Drugs and Therapy
dcterms.bibliographicCitation.originalpublishername
Springer Nature
dcterms.bibliographicCitation.pagestart
335
dcterms.bibliographicCitation.pageend
344
dcterms.bibliographicCitation.volume
34
refubium.affiliation
Charité - Universitätsmedizin Berlin
refubium.funding
Springer Nature DEAL
refubium.resourceType.isindependentpub
no
dcterms.accessRights.openaire
open access
dcterms.bibliographicCitation.pmid
32212061
dcterms.isPartOf.issn
0920-3206
dcterms.isPartOf.eissn
1573-7241