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Dual Antithrombotic...
Dual Antithrombotic Therapy with Dabigatran after PCI in Atrial Fibrillation.
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- Cannon, Christopher P. (author)
- Baim Institute for Clinical Research, USA; Brigham and Women’s Hospital, Heart and Vascular Center, USA; Harvard Medical School, USA,Baim Inst Clin Res, 930 Commonwealth Ave, Boston, MA 02215 USA.;Brigham & Womens Hosp, Heart & Vasc Ctr, 75 Francis St, Boston, MA 02115 USA.;Harvard Med Sch, Boston, MA USA.
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- Bhatt, Deepak L. (author)
- Brigham and Women’s Hospital, Heart and Vascular Center, USA; Harvard Medical School, USA,Brigham & Womens Hosp, Heart & Vasc Ctr, 75 Francis St, Boston, MA 02115 USA.;Harvard Med Sch, Boston, MA USA.
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- Oldgren, Jonas, 1964- (author)
- Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR),Uppsala Clinical Research Center and Department of Medical Sciences, Uppsala University, Uppsala, Sweden
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- Lip, Gregory Y. H. (author)
- Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK,Univ Birmingham, Inst Cardiovasc Sci, Birmingham, W Midlands, England.
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- Ellis, Stephen G. (author)
- Cleveland Clin, Cleveland, OH 44106 USA.
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- Kimura, Takeshi (author)
- Kyoto University, Department of Cardiovascular Medicine, Kyoto, Japan,Kyoto Univ, Dept Cardiovasc Med, Kyoto, Japan.
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- Maeng, Michael (author)
- Aarhus University Hospital, Skejby, Denmark,Aarhus Univ Hosp, Skejby, Denmark.,St Antonius Hosp, Nieuwegein, Netherlands.,St. Antonius Ziekenhuis, Nieuwegein, Netherlands
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- Merkely, Bela (author)
- University Heart and Vascular Center, Budapest, Hungary,Univ Heart & Vasc Ctr, Budapest, Hungary.
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- Zeymer, Uwe (author)
- Klinikum der Stadt Ludwigshafen am Rhein, Medizinische Klinik B, Ludwigshafen, Germany
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- Gropper, Savion (author)
- Boehringer Ingelheim GmbH & Co KG, Ingelheim, Germany.
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- Nordaby, Matias (author)
- Boehringer Ingelheim GmbH & Co KG, Ingelheim, Germany.
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- Kleine, Eva (author)
- Boehringer Ingelheim GmbH & Co KG, Ingelheim, Germany.
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- Harper, Ruth (author)
- Boehringer Ingelheim GmbH & Co KG, Bracknell, Berks, England.
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- Manassie, Jenny (author)
- Boehringer Ingelheim GmbH & Co KG, Bracknell, Berks, England.
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- Januzzi, James L. (author)
- Baim Institute for Clinical Research, USA; Cardiology Division, Massachusetts General Hospital, USA; Harvard Medical School, USA,Baim Inst Clin Res, 930 Commonwealth Ave, Boston, MA 02215 USA.;Harvard Med Sch, Boston, MA USA.;Massachusetts Gen Hosp, Div Cardiol, Boston, MA 02114 USA.
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- Ten Berg, Jurrien M. (author)
- St. Antonius Ziekenhuis, Nieuwegein, Netherlands
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- Steg, P. Gabriel (author)
- Imperial College, London, London, UK,Imperial Coll, London, England.;Univ Paris Diderot, French Alliance Cardiovasc Trials, F CRIN Network, DHU FIRE,INSERM,Unite 1148, Paris, France.;Hop Bichat Assistance Publ, Paris, France.
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- Hohnloser, Stefan H. (author)
- Johann Wolfgang Goethe University, Department of Medicine, Division of Cardiology, Frankfurt am Main, Germany,Goethe Univ Frankfurt, Dept Med, Div Cardiol, Frankfurt, Germany.
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- Swahn, Eva, 1949- (contributor)
- Linköpings universitet,Avdelningen för kardiovaskulär medicin,Medicinska fakulteten,Region Östergötland, Kardiologiska kliniken US,RE-DUAL PCI Steering Committee and Investigators
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Baim Institute for Clinical Research, USA; Brigham and Women’s Hospital, Heart and Vascular Center, USA; Harvard Medical School, USA Baim Inst Clin Res, 930 Commonwealth Ave, Boston, MA 02215 USA;Brigham & Womens Hosp, Heart & Vasc Ctr, 75 Francis St, Boston, MA 02115 USA.;Harvard Med Sch, Boston, MA USA. (creator_code:org_t)
- Massachusetts Medical Society, 2017
- 2017
- English.
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In: New England Journal of Medicine. - : Massachusetts Medical Society. - 0028-4793 .- 1533-4406. ; 377:16, s. 1513-1524
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Abstract
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- BACKGROUND: Triple antithrombotic therapy with warfarin plus two antiplatelet agents is the standard of care after percutaneous coronary intervention (PCI) for patients with atrial fibrillation, but this therapy is associated with a high risk of bleeding.METHODS: inhibitor (clopidogrel or ticagrelor) and no aspirin (110-mg and 150-mg dual-therapy groups). Outside the United States, elderly patients (≥80 years of age; ≥70 years of age in Japan) were randomly assigned to the 110-mg dual-therapy group or the triple-therapy group. The primary end point was a major or clinically relevant nonmajor bleeding event during follow-up (mean follow-up, 14 months). The trial also tested for the noninferiority of dual therapy with dabigatran (both doses combined) to triple therapy with warfarin with respect to the incidence of a composite efficacy end point of thromboembolic events (myocardial infarction, stroke, or systemic embolism), death, or unplanned revascularization.RESULTS: The incidence of the primary end point was 15.4% in the 110-mg dual-therapy group as compared with 26.9% in the triple-therapy group (hazard ratio, 0.52; 95% confidence interval [CI], 0.42 to 0.63; P<0.001 for noninferiority; P<0.001 for superiority) and 20.2% in the 150-mg dual-therapy group as compared with 25.7% in the corresponding triple-therapy group, which did not include elderly patients outside the United States (hazard ratio, 0.72; 95% CI, 0.58 to 0.88; P<0.001 for noninferiority). The incidence of the composite efficacy end point was 13.7% in the two dual-therapy groups combined as compared with 13.4% in the triple-therapy group (hazard ratio, 1.04; 95% CI, 0.84 to 1.29; P=0.005 for noninferiority). The rate of serious adverse events did not differ significantly among the groups.CONCLUSIONS: inhibitor, and aspirin. Dual therapy was noninferior to triple therapy with respect to the risk of thromboembolic events. (Funded by Boehringer Ingelheim; RE-DUAL PCI ClinicalTrials.gov number, NCT02164864)
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Publication and Content Type
- ref (subject category)
- art (subject category)
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Cannon, Christop ...
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Bhatt, Deepak L.
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Oldgren, Jonas, ...
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Lip, Gregory Y. ...
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Ellis, Stephen G ...
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Kimura, Takeshi
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Maeng, Michael
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Merkely, Bela
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Zeymer, Uwe
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Gropper, Savion
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Nordaby, Matias
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Kleine, Eva
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Harper, Ruth
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Manassie, Jenny
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Januzzi, James L ...
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Ten Berg, Jurrie ...
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Steg, P. Gabriel
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Hohnloser, Stefa ...
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Swahn, Eva, 1949 ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
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New England Jour ...
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Linköping University
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Uppsala University