Results of an international crowdsourcing survey on the treatment of non-ST segment elevation ACS patients at high-bleeding risk undergoing percutaneous intervention.
| Autor: | Bhatt DL; Brigham and Women's Hospital Heart & Vascular Center, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA. Electronic address: dlbhattmd@post.harvard.edu., Kaski JC; Molecular and Clinical Sciences Research Institute, St George's, University of London, London, UK. Electronic address: jkaski@sgul.ac.uk., Delaney S; Radcliffe Cardiology Bourne End Business Park, Cores End Rd, Wooburn Green, Bourne End SL8 5AS, UK. Electronic address: sean.delaney@radcliffe-group.com., Alasnag M; King Fahd Armed Forces Hospital, Jeddah-KSA, Al Kurnaysh Rd, Al Andalus, Jeddah 23311, Saudi Arabia. Electronic address: mirvat@jeddacath.com., Andreotti F; Scientific Directorate, FPUG IRCCS, Rome, Italy; Cardiovascular Dept, Catholic University, Rome, Italy. Electronic address: felicita.andreotti@unicatt.it., Angiolillo DJ; University of Florida College of Medicine-Jacksonville, Division of Cardiology, ACC Building 5th floor 655 West 8th Street, Jacksonville, FL 32209, USA. Electronic address: Dominick.angiolillo@jax.ufl.edu., Ferro A; King's College London, School of Cardiovascular Medicine and Sciences, British Heart Foundation Centre of Research Excellence, Franklin-Wilkins Building, 150 Stamford Street, London SE1 9NH, UK. Electronic address: albert.ferro@kcl.ac.uk., Gorog DA; Faculty of Medicine, National Heart & Lung Institute, Imperial College, Dovehouse Street, London SW3 6LY, UK; School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK. Electronic address: d.gorog@imperial.ac.uk., Lorenzatti AJ; Instituto Medico DAMIC, Av. Colon 2057, Cordoba, Argentina; Departamento de Cardiologia, Hospital Córdoba, Av. Patria 656, Córdoba, Argentina., Mamas M; University Hospitals of North Midlands NHS Trust, Keel University, Staffordshire ST5 5BG, UK., McNeil J; School of Public Health and Preventive Medicine, Monash University, Wellington Rd, Clayton VIC, Melbourne 3800, Australia. Electronic address: john.mcneil@monash.edu., Nicolau JC; Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Av. Dr. Arnaldo, 455 - Cerqueira César, São Paulo, Brazil. Electronic address: jose.nicolau@incor.usp.br., Steg PG; Université de Paris, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, FACT (French Alliance for Cardiovascular Trials), INSERM U1148, Paris, France. Electronic address: gabriel.steg@bch.aphp.fr., Tamargo J; Faculty of Medicine of the Complutense University of Madrid, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain. Electronic address: jtamargo@med.ucm.es., Tan D; Dept of Pharmacy, National University of Singapore, 8 Science Drive 4, 117543, Singapore. Electronic address: doreen.tan.sy@nus.edu.sg., Valgimigli M; Inselspital, University Hospital Bern, Bern, Switzerland. Electronic address: Marco.Valgimigli@cardiocentro.org. |
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| Jazyk: | angličtina |
| Zdroj: | International journal of cardiology [Int J Cardiol] 2021 Aug 15; Vol. 337, pp. 1-8. Date of Electronic Publication: 2021 May 15. |
| DOI: | 10.1016/j.ijcard.2021.05.012 |
| Abstrakt: | Aims: Choosing an antiplatelet strategy in patients with non-ST segment elevation acute coronary syndrome (NSTE-ACS) at high bleeding risk (HBR), undergoing post-percutaneous coronary intervention (PCI), is complex. We used a unique open-source approach (crowdsourcing) to document if practices varied across a small, global cross-section of antiplatelet prescribers in the post-PCI setting. Methods and Results: Five-hundred and fifty-nine professionals from 70 countries (the 'crowd') completed questionnaires containing single- or multi-option and free form questions regarding antiplatelet clinical practice in post-PCI NSTE-ACS patients at HBR. A threshold of 75% defined 'agreement'. There was strong agreement favouring monotherapy with either aspirin or a P2Y Conclusion: The crowdsourcing methodology showed potential as a tool to assess current practice and variation on a global scale and to achieve a broad demographic representation. These preliminary results indicate a high degree of variation with respect to duration of DAPT, monotherapy drug of choice following DAPT and how thrombotic and bleeding risk are assessed. Further investigations should concentrate on interrogating practice variation between key demographic groups. Competing Interests: Declaration of Competing Interest All authors (except SD) received an honorarium from Radcliffe Cardiology for this work. Additional disclosures detailed below. Dr Deepak L. Bhatt discloses the following relationships – Advisory Board: Cardax, CellProthera, Cereno Scientific, Elsevier Practice Update Cardiology, Janssen, Level Ex, Medscape Cardiology, MyoKardia, Novo Nordisk, PhaseBio, PLx Pharma, Regado Biosciences; Board of Directors: Boston VA Research Institute, Society of Cardiovascular Patient Care, TobeSoft; Chair: American Heart Association Quality Oversight Committee; Data Monitoring Committees: Baim Institute for Clinical Research (formerly Harvard Clinical Research Institute, for the PORTICO trial, funded by St. Jude Medical, now Abbott), Cleveland Clinic (including for the ExCEED trial, funded by Edwards), Contego Medical (Chair, PERFORMANCE 2), Duke Clinical Research Institute, Mayo Clinic, Mount Sinai School of Medicine (for the ENVISAGE trial, funded by Daiichi Sankyo), Population Health Research Institute; Honoraria: American College of Cardiology (Senior Associate Editor, Clinical Trials and News, ACC.org; Vice-Chair, ACC Accreditation Committee), Baim Institute for Clinical Research (formerly Harvard Clinical Research Institute; RE-DUAL PCI clinical trial steering committee funded by Boehringer Ingelheim; AEGIS-II executive committee funded by CSL Behring), Belvoir Publications (Editor in Chief, Harvard Heart Letter), Canadian Medical and Surgical Knowledge Translation Research Group (clinical trial steering committees), Duke Clinical Research Institute (clinical trial steering committees, including for the PRONOUNCE trial, funded by Ferring Pharmaceuticals), HMP Global (Editor in Chief, Journal of Invasive Cardiology), Journal of the American College of Cardiology (Guest Editor; Associate Editor), K2P (Co-Chair, interdisciplinary curriculum), Level Ex, Medtelligence/ReachMD (CME steering committees), MJH Life Sciences, Population Health Research Institute (for the COMPASS operations committee, publications committee, steering committee, and USA national co‑leader, funded by Bayer), Slack Publications (Chief Medical Editor, Cardiology Today's Intervention), Society of Cardiovascular Patient Care (Secretary/Treasurer), WebMD (CME steering committees); Other: Clinical Cardiology (Deputy Editor), NCDR-ACTION Registry Steering Committee (Chair), VA CART Research and Publications Committee (Chair); Research Funding: Abbott, Afimmune, Amarin, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol-Myers Squibb, Cardax, Chiesi, CSL Behring, Eisai, Ethicon, Ferring Pharmaceuticals, Forest Laboratories, Fractyl, HLS Therapeutics, Idorsia, Ironwood, Ischemix, Janssen, Lexicon, Lilly, Medtronic, MyoKardia, Novo Nordisk, Owkin, Pfizer, PhaseBio, PLx Pharma, Regeneron, Roche, Sanofi, Synaptic, The Medicines Company; Royalties: Elsevier (Editor, Cardiovascular Intervention: A Companion to Braunwald's Heart Disease); Site Co-Investigator: Abbott, Biotronik, Boston Scientific, CSI, St. Jude Medical (now Abbott), Svelte; Trustee: American College of Cardiology; Unfunded Research: FlowCo, Merck, Takeda. Prof Juan-Carlos Kaski discloses the following relationships – Speaker fees: Menarini Farmaceutica srl. Dr Sean Delaney Conflicts of interest: none declared. Dr Mirvat Alasnag Conflicts of interest: none declared. Prof Felicita Andreotti discloses the following relationships – Speaker or consultancy fees: Amgen, Bayer, BMS/Pfizer and Daiichi Sankyo. Dr Dominick Angiolillo discloses the following relationships – Consulting fee or honorarium: Abbott, Amgen, Aralez, AstraZeneca, Bayer, Biosensors, Boehringer Ingelheim, Bristol-Myers Squibb, Chiesi, Daiichi-Sankyo, Eli Lilly, Haemonetics, Janssen, Merck, PhaseBio, PLx Pharma, Pfizer, Sanofi, and The Medicines Company; Participation in review activities: CeloNova and St. Jude Medical; Institutional payments for grants from Amgen, AstraZeneca, Bayer, Biosensors, CeloNova, CSL Behring, Daiichi-Sankyo, Eisai, Eli-Lilly, Gilead, Idorsia, Janssen, Matsutani Chemical Industry Co., Merck, Novartis, Osprey Medical, Renal Guard Solutions and the Scott R. MacKenzie Foundation. Prof Albert Ferro Conflicts of interest: none declared. Prof Diana Gorog discloses the following relationships – Institutional grants: Bayer, Medtronic, Werfen; Lecture fees: AstraZeneca, Boehringer Ingelheim. Dr Alberto Lorenzatti discloses the following relationships – Consultant and/or speaker honorarium: PTC Therapeutics, Pfizer, Amgen and NovoNordisk; Research grant: NovoNordisk, Amgen and Esperion Therapeutics. Prof Mamas Mamas discloses the following relationships – Unrestricted educational grant: Daiichi Sankyo and speakers bureau; Consulting: Pfizer. Prof John McNeil Conflicts of interest: none declared. Prof Jose Carlos Nicolau discloses the following relationships – Personal fees: Amgen, Bayer, Daiichi-Sankyo, Novartis, Sanofi, Servier; Grants: AstraZeneca, Bayer, Esperion, CLS Behring, Dalcor, Janssen, Novartis, NovoNordisk, Sanofi, Vifor. Prof Philippe Gabriel Steg discloses the following relationships – Research grants: Amarin, Bayer, Sanofi, and Servier; Speaking/consulting fees: Amarin, Amgen, AstraZeneca, Bayer/Janssen, Bristol-Myers-Squibb, Idorsia, Myokardia, Novartis, Novo-Nordisk, PhaseBio, Pfizer, Regeneron, Sanofi, Servier. Prof Juan Tamargo Conflicts of interest: none declared. Prof Doreen Tan Conflicts of interest: none declared. Prof Marco Valglimigli Conflicts of interest: none declared. (Copyright © 2021 The Author(s). Published by Elsevier B.V. All rights reserved.) |
| Databáze: | MEDLINE |
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