Cited 2 times in
Reduced Mortality With Antiplatelet Therapy Deescalation After Percutaneous Coronary Intervention in Acute Coronary Syndromes: A Meta-Analysis
DC Field | Value | Language |
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dc.contributor.author | 김병극 | - |
dc.date.accessioned | 2023-03-21T07:23:26Z | - |
dc.date.available | 2023-03-21T07:23:26Z | - |
dc.date.issued | 2022-11 | - |
dc.identifier.issn | 1941-7640 | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/193343 | - |
dc.description.abstract | Background: Antiplatelet therapy deescalation has been suggested as an alternative to standard treatment with potent dual antiplatelet therapy (DAPT) for 1 year in low bleeding risk patients with acute coronary syndromes undergoing percutaneous coronary intervention to mitigate the increased risk of bleeding. Whether this strategy preserves the ischemic and survival benefits of potent DAPT is uncertain. Methods: We performed a pairwise meta-analysis in patients with acute coronary syndrome undergoing percutaneous coronary intervention treated with either 1-year standard potent DAPT versus deescalation therapy (potent DAPT for 1-3 months followed by either reduced potency DAPT or ticagrelor monotherapy for up to 1 year). Randomized trials comparing standard DAPT versus deescalation therapy in patients with acute coronary syndrome undergoing percutaneous coronary intervention were searched through MEDLINE, EMBASE, Cochrane databases, and proceedings of international meetings. The primary end point was 1-year all-cause mortality. Results: The meta-analysis included 6 trials in which 20 837 patients were randomized to potent DAPT for 1 to 3 months followed by deescalation therapy for up to 1 year (n=10 392) or standard potent DAPT for 1 year (n=10 445). Deescalation therapy was associated with lower 1-year rates of all-cause mortality compared with standard therapy (odds ratio, 0.75 [95% CI, 0.59-0.95]; P=0.02). Deescalation therapy was also associated with lower rates of major bleeding (odds ratio, 0.59 [95% CI, 0.48-0.72]; P<0.0001), with no significant difference in major adverse cardiac events (major adverse cardiovascular events; odds ratio, 0.89 [95% CI, 0.77-1.04]; P=0.14). Conclusions: In low bleeding risk patients with acute coronary syndrome undergoing percutaneous coronary intervention, compared with 1-year of potent DAPT, antiplatelet therapy deescalation therapy after 1 to 3 months was associated with decreased mortality and major bleeding with similar rates of major adverse cardiovascular events. | - |
dc.description.statementOfResponsibility | open | - |
dc.language | English | - |
dc.publisher | Lippincott Williams & Wilkins | - |
dc.relation.isPartOf | CIRCULATION-CARDIOVASCULAR INTERVENTIONS | - |
dc.rights | CC BY-NC-ND 2.0 KR | - |
dc.subject.MESH | Acute Coronary Syndrome* / drug therapy | - |
dc.subject.MESH | Acute Coronary Syndrome* / therapy | - |
dc.subject.MESH | Drug Therapy, Combination | - |
dc.subject.MESH | Hemorrhage | - |
dc.subject.MESH | Humans | - |
dc.subject.MESH | Percutaneous Coronary Intervention* / adverse effects | - |
dc.subject.MESH | Platelet Aggregation Inhibitors | - |
dc.subject.MESH | Randomized Controlled Trials as Topic | - |
dc.subject.MESH | Treatment Outcome | - |
dc.title | Reduced Mortality With Antiplatelet Therapy Deescalation After Percutaneous Coronary Intervention in Acute Coronary Syndromes: A Meta-Analysis | - |
dc.type | Article | - |
dc.contributor.college | College of Medicine (의과대학) | - |
dc.contributor.department | Dept. of Internal Medicine (내과학교실) | - |
dc.contributor.googleauthor | Tullio Palmerini | - |
dc.contributor.googleauthor | Antonio Giulio Bruno | - |
dc.contributor.googleauthor | Mauro Gasparini | - |
dc.contributor.googleauthor | Giulia Rizzello | - |
dc.contributor.googleauthor | Hyo-Soo Kim | - |
dc.contributor.googleauthor | Jeehoon Kang | - |
dc.contributor.googleauthor | Kyung-Woo Park | - |
dc.contributor.googleauthor | Joo-Yong Hahn | - |
dc.contributor.googleauthor | Young Bin Song | - |
dc.contributor.googleauthor | Hyeon-Cheol Gwon | - |
dc.contributor.googleauthor | Eun Ho Choo | - |
dc.contributor.googleauthor | Mahn-Won Park | - |
dc.contributor.googleauthor | Chan Joon Kim | - |
dc.contributor.googleauthor | Kiyuk Chang | - |
dc.contributor.googleauthor | Thomas Cuisset | - |
dc.contributor.googleauthor | Nevio Taglieri | - |
dc.contributor.googleauthor | Byeong-Keuk Kim | - |
dc.contributor.googleauthor | Yangsoo Jang | - |
dc.contributor.googleauthor | Elena Nardi | - |
dc.contributor.googleauthor | Francesco Saia | - |
dc.contributor.googleauthor | Matheusz Orzalkiewicz | - |
dc.contributor.googleauthor | Francesco Chietera | - |
dc.contributor.googleauthor | Gabriele Ghetti | - |
dc.contributor.googleauthor | Nazzareno Galiè | - |
dc.contributor.googleauthor | Gregg W Stone | - |
dc.identifier.doi | 10.1161/CIRCINTERVENTIONS.122.012245 | - |
dc.contributor.localId | A00493 | - |
dc.relation.journalcode | J00539 | - |
dc.identifier.eissn | 1941-7632 | - |
dc.identifier.pmid | 36378738 | - |
dc.identifier.url | https://www.ahajournals.org/doi/10.1161/CIRCINTERVENTIONS.122.012245 | - |
dc.subject.keyword | acute coronary syndrome | - |
dc.subject.keyword | ischemia | - |
dc.subject.keyword | mortality | - |
dc.subject.keyword | percutaneous coronary intervention | - |
dc.subject.keyword | stent | - |
dc.contributor.alternativeName | Kim, Byeong Keuk | - |
dc.contributor.affiliatedAuthor | 김병극 | - |
dc.citation.volume | 15 | - |
dc.citation.number | 11 | - |
dc.citation.startPage | 906 | - |
dc.citation.endPage | 914 | - |
dc.identifier.bibliographicCitation | CIRCULATION-CARDIOVASCULAR INTERVENTIONS, Vol.15(11) : 906-914, 2022-11 | - |
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