| Autor: |
Caterina, Raffaele De, Agewall, Stefan, Andreotti, Felicita, Angiolillo, Dominick J, Bhatt, Deepak L, Byrne, Robert A, Collet, Jean-Philippe, Eikelboom, John, Fanaroff, Alexander C, Gibson, C Michael, Goette, Andreas, Hindricks, Gerhard, Lip, Gregory Y H, Potpara, Tatjana, Thiele, Holger, Lopes, Renato D, Galli, Mattia |
| Předmět: |
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| Zdroj: |
European Heart Journal; 10/1/2022, Vol. 43 Issue 37, p3512-3527, 16p |
| Abstrakt: |
The RCTs of AF-PCI/ACS patients lack such information (Table 1).[[5], [7]] A subgroup analysis of the REDUAL PCI trial showed that only 9.9% of included patients had high-risk procedural factors and only 10% had both high-risk procedural and clinical complexity factors.[13] Although high-risk procedural features were not explicit exclusion criteria, the dearth of procedural details and the absence of statistically powered outcome stratification by PCI complexity prevent generalization of the four RCT results to PCI patients with high ischaemic risk PCI, which may represent up to 60% of cases according to a recent study.[12] Sub-analyses and specific high-risk subgroups. These patients made up only a fraction of the patients enrolled in WOEST (27%), PIONEER AF-PCI (29%), RE-DUAL (50%), AUGUSTUS (51%), and ENTRUST-AF PCI (52%), and individual trials were not powered to detect a treatment by subgroup interaction. The low thrombogenicity of new stent platforms, together with the increasing awareness of the prognostic impact of bleeding events have prompted the design of many RCTs testing a de-escalation or shortening of antithrombotic therapy, aiming at reducing bleeding without any trade-off in ischaemic events (Table 1).[38] Among them, the RCTs including patients with AF-PCI/ACS were the only ones in which: (i) the primary endpoints did not include ischaemic outcomes; (ii) procedural details were not reported; (iii) ACS patients were not well represented, as none focused entirely on the acute setting; (iv) "de-escalation" was started very early after PCI (Table 1). [Extracted from the article] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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