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  • Navarese, Eliano PioNicolaus Copernicus Univ, Dept Cardiol & Internal Med, Bydgoszcz, Poland.;SIRIO Med Res Network, Pritzwalk, Poland. (author)

Within and beyond 12-month efficacy and safety of antithrombotic strategies in patients with established coronary artery disease : two companion network meta-analyses of the 2022 joint clinical consensus statement of the European Association of Percutaneous Cardiovascular Interventions (EAPCI), European Association for Acute CardioVascular Care (ACVC), and European Association of Preventive Cardiology (EAPC)

  • Article/chapterEnglish2023

Publisher, publication year, extent ...

  • 2023-03-03
  • Oxford University Press,2023
  • printrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:uu-503251
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-503251URI
  • https://doi.org/10.1093/ehjcvp/pvad016DOI

Supplementary language notes

  • Language:English
  • Summary in:English

Part of subdatabase

Classification

  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Aims To appraise all available antithrombotic treatments within or after 12 months following coronary revascularization and/or acute coronary syndrome in two network meta-analyses. Methods and results Forty-three (N = 189 261 patients) trials within 12 months and 19 (N = 139 086 patients) trials beyond 12 months were included for efficacy/safety endpoints appraisal. Within 12 months, ticagrelor 90 mg bis in die (b.i.d.) [hazard ratio (HR), 0.66; 95% confidence interval (CI), 0.49-0.88], aspirin and ticagrelor 90 mg (HR, 0.85; 95% CI, 0.76-0.95), or aspirin, clopidogrel and rivaroxaban 2.5 mg b.i.d. (HR, 0.66; 95% CI, 0.51-0.86) were the only treatments associated with lower cardiovascular mortality, compared with aspirin and clopidogrel, without or with greater bleeding risk for the first and the other treatment options, respectively. Beyond 12 months, no strategy lowered mortality; compared with aspirin; the greatest reductions of myocardial infarction (MI) were found with aspirin and clopidogrel (HR, 0.68; 95% CI, 0.55-0.85) or P2Y(12) inhibitor monotherapy (HR, 0.76; 95% CI: 0.61-0.95), especially ticagrelor 90 mg (HR, 0.54; 95% CI, 0.32-0.92), and of stroke with VKA (HR, 0.56; 95% CI, 0.44-0.76) or aspirin and rivaroxaban 2.5 mg (HR, 0.58; 95% CI, 0.44-0.76). All treatments increased bleeding except P2Y(12) monotherapy, compared with aspirin. Conclusion Within 12 months, ticagrelor 90 mg monotherapy was the only treatment associated with lower mortality, without bleeding risk trade-off compared with aspirin and clopidogrel. Beyond 12 months, P2Y(12) monotherapy, especially ticagrelor 90 mg, was associated with lower MI without bleeding trade-off; aspirin and rivaroxaban 2.5 mg most effectively reduced stroke, with a more acceptable bleeding risk than VKA, compared with aspirin. Registration URL: https://www.crd.york.ac.uk/PROSPERO/; Unique identifiers: CRD42021243985 and CRD42021252398. [GRAPHICS] .

Subject headings and genre

Added entries (persons, corporate bodies, meetings, titles ...)

  • Landi, AntonioCardioctr Ticino Inst, Div Cardiol, Ente Ospedaliero Cantonale, Via Tesserete 48, CH-6900 Lugano, Switzerland. (author)
  • Oliva, AngeloHuman Univ, Dept Biomed Sci, Milan, Italy. (author)
  • Piccolo, RaffaeleUniv Naples Feder II, Dept Adv Biomed Sci, Div Cardiol, Naples, Italy. (author)
  • Aboyans, VictorDupuytren Univ Hosp, Univ Limoges, Dept Cardiol, INSERM 1094 & IRD, Limoges, France. (author)
  • Angiolillo, DominickUniv Florida Coll Med Jacksonville, Div Cardiol, Jacksonville, FL USA. (author)
  • Atar, DanUniv Oslo, Oslo Univ Hosp Ulleval, Inst Clin Med, Dept Cardiol, Oslo, Norway. (author)
  • Capodanno, DavideUniv Catania, Div Cardiol, Azienda Osped Univ Policlin G Rod, Catania, Italy. (author)
  • Fox, Keith A. A.Univ Edinburgh, Ctr Cardiovasc Sci, Div Clin & Surg Sci, Edinburgh, Scotland. (author)
  • Halvorsen, SigrunUniv Oslo, Inst Clin Med, POB 1078, N-0316 Oslo, Norway.;Oslo Univ Hosp Ulleval, Dept Cardiol, Oslo, Norway. (author)
  • James, Stefan,1964-Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi(Swepub:uu)stjam367 (author)
  • Juni, PeterUniv Toronto, Toronto, ON, Canada. (author)
  • Kunadian, VijayFreeman Rd Hosp, Newcastle Tyne Hosp NHS Fdn Trust, Cardiothorac Ctr, Newcastle Upon Tyne, England. (author)
  • Leonardi, SergioUniv Pavia, Fdn IRCCS Policlin San Matteo, Coronary Care Unit, Pavia, Italy. (author)
  • Mehran, RoxanaZena & Michael A Wiener Cardiovasc Inst, Icahn Sch Med Mt Sinai, New York, NY USA. (author)
  • Montalescot, GillesSorbonne Univ, Paris, France. (author)
  • Niebauer, JosefParacelsus Med Univ Salzburg, Inst Sports Med, Prevent & Rehabil, Salzburg, Austria. (author)
  • Price, SusannaRoyal Brompton Hosp, Natl Heart & Lung Inst, Imperial Coll, London, England. (author)
  • Storey, Robert F.Univ Sheffield, Dept Infect Immun & Cardiovasc Dis, Cardiovasc Res Unit, Sheffield, England. (author)
  • Voller, HeinzUniv Potsdam, Fac Hlth Sci Brandenburg, Dept Rehabil Med, Potsdam, Germany. (author)
  • Vranckx, PascalJessa Ziekenhuis, Dept Cardiol & Crit Care Med, Hartcentrum Hasselt, Hasselt, Belgium.;Hasselt Univ, Fac Med & Life Sci, Hasselt, Belgium. (author)
  • Windecker, StephanUniv Bern, Dept Cardiol, Inselspital, Bern, Switzerland. (author)
  • Valgimigli, MarcoCardioctr Ticino Inst, Div Cardiol, Ente Ospedaliero Cantonale, Via Tesserete 48, CH-6900 Lugano, Switzerland. (author)
  • Nicolaus Copernicus Univ, Dept Cardiol & Internal Med, Bydgoszcz, Poland.;SIRIO Med Res Network, Pritzwalk, Poland.Cardioctr Ticino Inst, Div Cardiol, Ente Ospedaliero Cantonale, Via Tesserete 48, CH-6900 Lugano, Switzerland. (creator_code:org_t)

Related titles

  • In:European Heart Journal - Cardiovascular Pharmacotherapy: Oxford University Press9:3, s. 271-2902055-68372055-6845

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