| Autor: |
Tomaniak, Mariusz, Chichareon, Ply, Modolo, Rodrigo, Takahashi, Kuniaki, Chang, Chun Chin, Kogame, Norihiro, Spitzer, Ernest, Buszman, Pawel E, Van Geuns, Robert-Jan M, Valkov, Veselin, Steinwender, Clemens, Geisler, Tobias, Prokopczuk, Janusz, Sabaté, Manel, Zmudka, Krzysztof, Rademaker-Havinga, Tessa, Tijssen, Jan G P, Jüni, Peter, Hamm, Christian, Steg, Philippe Gabriel, Onuma, Yoshinobu, Vranckx, Pascal, Valgimigli, Marco, Windecker, Stephan, Baber, Usman, Anderson, Richard, Dominici, Marcello, Serruys, Patrick W |
| Jazyk: |
angličtina |
| Rok vydání: |
2020 |
| Předmět: |
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| DOI: |
10.7892/boris.139036 |
| Popis: |
AIMS Antiplatelet treatment in the elderly post percutaneous coronary interventions (PCI) remains a complex issue. METHODS AND RESULTS A pre-specified analysis of randomized GLOBAL LEADERS (n=15991), comparing 23-month ticagrelor monotherapy (after one month of DAPT) with the reference treatment (12-month DAPT followed by 12 months of aspirin). Among elderly patients (>75 years; n=2565), the primary endpoint (two-year all-cause mortality or new Q-wave corelab-adjudicated myocardial infarction [MI]) occurred in 7.2% and 9.4% of patients in the ticagrelor monotherapy and the reference group, respectively, (hazard ratio [HR]0.75, 95% confidence interval [CI] 0.58-0.99,p=0.041;pint=0.23); BARC-defined bleeding type 3/5 occurred in 5.2% and 4.1%, respectively (HR1.29; 95%CI0.89-1.86;p=0.180;pint=0.06). The elderly with stable CAD had a higher rate of BARC 3/5 type bleeding (HR2.05, 95%CI1.18-3.55) with ticagrelor monotherapy versus the reference treatment (pint=0.02). Elderly patients had a lower rate of definite or probable stent thrombosis (ST) with ticagrelor monotherapy (0.4%vs.1.4%,p=0.015,pint=0.01),compared with the reference group. CONCLUSIONS In this prespecified, exploratory analysis of the overall neutral trial, there was no differential treatment effect of ticagrelor monotherapy (after one-month dual therapy with aspirin) found in elderly patients undergoing PCI with respect to the rate of the primary endpoint of all-cause death or new Q-wave MI. The lower rate of ST in the elderly with ticagrelor monotherapy is hypothesis-generating. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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