Impact of renal function on clinical outcomes after PCI in ACS and stable CAD patients treated with ticagrelor: a prespecified analysis of the GLOBAL LEADERS randomized clinical trial.
Acute Coronary Syndrome
/ complications
Aged
Coronary Artery Disease
/ complications
Drug-Eluting Stents
Dual Anti-Platelet Therapy
Female
Glomerular Filtration Rate
Humans
Male
Middle Aged
Percutaneous Coronary Intervention
Platelet Aggregation Inhibitors
/ therapeutic use
Renal Insufficiency
/ complications
Ticagrelor
/ therapeutic use
Treatment Outcome
Aspirin-free antiplatelet strategies
Chronic kidney disease
DAPT
Impaired renal function
Percutaneous coronary intervention
Ticagrelor
Journal
Clinical research in cardiology : official journal of the German Cardiac Society
ISSN: 1861-0692
Titre abrégé: Clin Res Cardiol
Pays: Germany
ID NLM: 101264123
Informations de publication
Date de publication:
Jul 2020
Jul 2020
Historique:
received:
08
09
2019
accepted:
28
11
2019
pubmed:
12
1
2020
medline:
13
5
2021
entrez:
12
1
2020
Statut:
ppublish
Résumé
Impaired renal function (IRF) is associated with increased risks of both ischemic and bleeding events. Ticagrelor has been shown to provide greater absolute reduction in ischemic risk following acute coronary syndrome (ACS) in those with versus without IRF. A pre-specified sub-analysis of the randomized GLOBAL LEADERS trial (n = 15,991) comparing the experimental strategy of 23-month ticagrelor monotherapy (after 1-month ticagrelor and aspirin dual anti-platelet therapy [DAPT]) with 12-month DAPT followed by 12-month aspirin after percutaneous coronary intervention (PCI) in ACS and stable coronary artery disease (CAD) patients stratified according to IRF (glomerular filtration rate < 60 ml/min/1.73 m At 2 years, patients with IRF (n = 2171) had a higher rate of the primary endpoint (all-cause mortality or centrally adjudicated, new Q-wave myocardial infarction [MI](hazard ratio [HR] 1.64, 95% confidence interval [CI] 1.35-1.98, p IRF negatively impacted long-term prognosis after PCI. There were no differential treatment effects found with regard to all-cause death or new Q-wave MI after PCI in patients with IRF treated with ticagrelor monotherapy. The trial has been registered with ClinicalTrials.gov, number NCT01813435.
Sections du résumé
BACKGROUND
BACKGROUND
Impaired renal function (IRF) is associated with increased risks of both ischemic and bleeding events. Ticagrelor has been shown to provide greater absolute reduction in ischemic risk following acute coronary syndrome (ACS) in those with versus without IRF.
METHODS
METHODS
A pre-specified sub-analysis of the randomized GLOBAL LEADERS trial (n = 15,991) comparing the experimental strategy of 23-month ticagrelor monotherapy (after 1-month ticagrelor and aspirin dual anti-platelet therapy [DAPT]) with 12-month DAPT followed by 12-month aspirin after percutaneous coronary intervention (PCI) in ACS and stable coronary artery disease (CAD) patients stratified according to IRF (glomerular filtration rate < 60 ml/min/1.73 m
RESULTS
RESULTS
At 2 years, patients with IRF (n = 2171) had a higher rate of the primary endpoint (all-cause mortality or centrally adjudicated, new Q-wave myocardial infarction [MI](hazard ratio [HR] 1.64, 95% confidence interval [CI] 1.35-1.98, p
CONCLUSIONS
CONCLUSIONS
IRF negatively impacted long-term prognosis after PCI. There were no differential treatment effects found with regard to all-cause death or new Q-wave MI after PCI in patients with IRF treated with ticagrelor monotherapy.
CLINICAL TRIAL REGISTRATION
BACKGROUND
The trial has been registered with ClinicalTrials.gov, number NCT01813435.
Identifiants
pubmed: 31925529
doi: 10.1007/s00392-019-01586-9
pii: 10.1007/s00392-019-01586-9
doi:
Substances chimiques
Platelet Aggregation Inhibitors
0
Ticagrelor
GLH0314RVC
Banques de données
ClinicalTrials.gov
['NCT01813435']
Types de publication
Journal Article
Multicenter Study
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM