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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)

Navarese, Eliano Pio (författare)
Nicolaus Copernicus Univ, Dept Cardiol & Internal Med, Bydgoszcz, Poland.;SIRIO Med Res Network, Pritzwalk, Poland.
Landi, Antonio (författare)
Cardioctr Ticino Inst, Div Cardiol, Ente Ospedaliero Cantonale, Via Tesserete 48, CH-6900 Lugano, Switzerland.
Oliva, Angelo (författare)
Human Univ, Dept Biomed Sci, Milan, Italy.
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Piccolo, Raffaele (författare)
Univ Naples Feder II, Dept Adv Biomed Sci, Div Cardiol, Naples, Italy.
Aboyans, Victor (författare)
Dupuytren Univ Hosp, Univ Limoges, Dept Cardiol, INSERM 1094 & IRD, Limoges, France.
Angiolillo, Dominick (författare)
Univ Florida Coll Med Jacksonville, Div Cardiol, Jacksonville, FL USA.
Atar, Dan (författare)
Univ Oslo, Oslo Univ Hosp Ulleval, Inst Clin Med, Dept Cardiol, Oslo, Norway.
Capodanno, Davide (författare)
Univ Catania, Div Cardiol, Azienda Osped Univ Policlin G Rod, Catania, Italy.
Fox, Keith A. A. (författare)
Univ Edinburgh, Ctr Cardiovasc Sci, Div Clin & Surg Sci, Edinburgh, Scotland.
Halvorsen, Sigrun (författare)
Univ Oslo, Inst Clin Med, POB 1078, N-0316 Oslo, Norway.;Oslo Univ Hosp Ulleval, Dept Cardiol, Oslo, Norway.
James, Stefan, 1964- (författare)
Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi
Juni, Peter (författare)
Univ Toronto, Toronto, ON, Canada.
Kunadian, Vijay (författare)
Freeman Rd Hosp, Newcastle Tyne Hosp NHS Fdn Trust, Cardiothorac Ctr, Newcastle Upon Tyne, England.
Leonardi, Sergio (författare)
Univ Pavia, Fdn IRCCS Policlin San Matteo, Coronary Care Unit, Pavia, Italy.
Mehran, Roxana (författare)
Zena & Michael A Wiener Cardiovasc Inst, Icahn Sch Med Mt Sinai, New York, NY USA.
Montalescot, Gilles (författare)
Sorbonne Univ, Paris, France.
Niebauer, Josef (författare)
Paracelsus Med Univ Salzburg, Inst Sports Med, Prevent & Rehabil, Salzburg, Austria.
Price, Susanna (författare)
Royal Brompton Hosp, Natl Heart & Lung Inst, Imperial Coll, London, England.
Storey, Robert F. (författare)
Univ Sheffield, Dept Infect Immun & Cardiovasc Dis, Cardiovasc Res Unit, Sheffield, England.
Voller, Heinz (författare)
Univ Potsdam, Fac Hlth Sci Brandenburg, Dept Rehabil Med, Potsdam, Germany.
Vranckx, Pascal (författare)
Jessa Ziekenhuis, Dept Cardiol & Crit Care Med, Hartcentrum Hasselt, Hasselt, Belgium.;Hasselt Univ, Fac Med & Life Sci, Hasselt, Belgium.
Windecker, Stephan (författare)
Univ Bern, Dept Cardiol, Inselspital, Bern, Switzerland.
Valgimigli, Marco (författare)
Cardioctr Ticino Inst, Div Cardiol, Ente Ospedaliero Cantonale, Via Tesserete 48, CH-6900 Lugano, Switzerland.
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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)
2023-03-03
2023
Engelska.
Ingår i: European Heart Journal - Cardiovascular Pharmacotherapy. - : Oxford University Press. - 2055-6837 .- 2055-6845. ; 9:3, s. 271-290
Relaterad länk:
https://urn.kb.se/re...
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https://doi.org/10.1...
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  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
Stäng  
  • 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] .

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

Nyckelord

Coronary artery disease
Antithrombotics
Network meta-analysis

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