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)

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Fältnamn	Indikatorer	Metadata
000		06567naa a2200589 4500
001		oai:DiVA.org:uu-503251
003		SwePub
008		230614s2023 \| \|\|\|\|\|\|\|\|\|\|\|000 \|\|eng\|
024	7	a https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-5032512 URI
024	7	a https://doi.org/10.1093/ehjcvp/pvad0162 DOI
040		a (SwePub)uu
041		a engb eng
042		9 SwePub
072	7	a ref2 swepub-contenttype
072	7	a art2 swepub-publicationtype
100	1	a Navarese, Eliano Piou Nicolaus Copernicus Univ, Dept Cardiol & Internal Med, Bydgoszcz, Poland.;SIRIO Med Res Network, Pritzwalk, Poland.4 aut
245	1 0	a Within and beyond 12-month efficacy and safety of antithrombotic strategies in patients with established coronary artery disease :b 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)
264		c 2023-03-03
264	1	b Oxford University Press,c 2023
338		a print2 rdacarrier
520		a 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] .
650	7	a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Kardiologi0 (SwePub)302062 hsv//swe
650	7	a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Cardiac and Cardiovascular Systems0 (SwePub)302062 hsv//eng
653		a Coronary artery disease
653		a Antithrombotics
653		a Network meta-analysis
700	1	a Landi, Antoniou Cardioctr Ticino Inst, Div Cardiol, Ente Ospedaliero Cantonale, Via Tesserete 48, CH-6900 Lugano, Switzerland.4 aut
700	1	a Oliva, Angelou Human Univ, Dept Biomed Sci, Milan, Italy.4 aut
700	1	a Piccolo, Raffaeleu Univ Naples Feder II, Dept Adv Biomed Sci, Div Cardiol, Naples, Italy.4 aut
700	1	a Aboyans, Victoru Dupuytren Univ Hosp, Univ Limoges, Dept Cardiol, INSERM 1094 & IRD, Limoges, France.4 aut
700	1	a Angiolillo, Dominicku Univ Florida Coll Med Jacksonville, Div Cardiol, Jacksonville, FL USA.4 aut
700	1	a Atar, Danu Univ Oslo, Oslo Univ Hosp Ulleval, Inst Clin Med, Dept Cardiol, Oslo, Norway.4 aut
700	1	a Capodanno, Davideu Univ Catania, Div Cardiol, Azienda Osped Univ Policlin G Rod, Catania, Italy.4 aut
700	1	a Fox, Keith A. A.u Univ Edinburgh, Ctr Cardiovasc Sci, Div Clin & Surg Sci, Edinburgh, Scotland.4 aut
700	1	a Halvorsen, Sigrunu Univ Oslo, Inst Clin Med, POB 1078, N-0316 Oslo, Norway.;Oslo Univ Hosp Ulleval, Dept Cardiol, Oslo, Norway.4 aut
700	1	a James, Stefan,d 1964-u Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi4 aut0 (Swepub:uu)stjam367
700	1	a Juni, Peteru Univ Toronto, Toronto, ON, Canada.4 aut
700	1	a Kunadian, Vijayu Freeman Rd Hosp, Newcastle Tyne Hosp NHS Fdn Trust, Cardiothorac Ctr, Newcastle Upon Tyne, England.4 aut
700	1	a Leonardi, Sergiou Univ Pavia, Fdn IRCCS Policlin San Matteo, Coronary Care Unit, Pavia, Italy.4 aut
700	1	a Mehran, Roxanau Zena & Michael A Wiener Cardiovasc Inst, Icahn Sch Med Mt Sinai, New York, NY USA.4 aut
700	1	a Montalescot, Gillesu Sorbonne Univ, Paris, France.4 aut
700	1	a Niebauer, Josefu Paracelsus Med Univ Salzburg, Inst Sports Med, Prevent & Rehabil, Salzburg, Austria.4 aut
700	1	a Price, Susannau Royal Brompton Hosp, Natl Heart & Lung Inst, Imperial Coll, London, England.4 aut
700	1	a Storey, Robert F.u Univ Sheffield, Dept Infect Immun & Cardiovasc Dis, Cardiovasc Res Unit, Sheffield, England.4 aut
700	1	a Voller, Heinzu Univ Potsdam, Fac Hlth Sci Brandenburg, Dept Rehabil Med, Potsdam, Germany.4 aut
700	1	a Vranckx, Pascalu Jessa Ziekenhuis, Dept Cardiol & Crit Care Med, Hartcentrum Hasselt, Hasselt, Belgium.;Hasselt Univ, Fac Med & Life Sci, Hasselt, Belgium.4 aut
700	1	a Windecker, Stephanu Univ Bern, Dept Cardiol, Inselspital, Bern, Switzerland.4 aut
700	1	a Valgimigli, Marcou Cardioctr Ticino Inst, Div Cardiol, Ente Ospedaliero Cantonale, Via Tesserete 48, CH-6900 Lugano, Switzerland.4 aut
710	2	a Nicolaus Copernicus Univ, Dept Cardiol & Internal Med, Bydgoszcz, Poland.;SIRIO Med Res Network, Pritzwalk, Poland.b Cardioctr Ticino Inst, Div Cardiol, Ente Ospedaliero Cantonale, Via Tesserete 48, CH-6900 Lugano, Switzerland.4 org
773	0	t European Heart Journal - Cardiovascular Pharmacotherapyd : Oxford University Pressg 9:3, s. 271-290q 9:3<271-290x 2055-6837x 2055-6845
856	4 8	u https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-503251
856	4 8	u https://doi.org/10.1093/ehjcvp/pvad016

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