Ticagrelor Alone Versus Dual Antiplatelet Therapy From 1 Month After Drug-Eluting Coronary Stenting

医学 替卡格雷 经皮冠状动脉介入治疗 临床终点 内科学 阿司匹林 心肌梗塞 置信区间 血运重建 随机对照试验 心脏病学
作者
Anna Franzone,Eugène McFadden,Sergio Leonardi,Raffaele Piccolo,Pascal Vranckx,Patrick W. Serruys,Edouard Benit,Christoph Liebetrau,Luc Janssens,Maurizio Ferrario,Aleksander Zurakowski,Roberto Diletti,Marcello Dominici,Kurt Huber,Ton Slagboom,Paweł Buszman,Leonardo Bolognese,Carlo Tumscitz,Krzysztof Bryniarski,Adel Aminian,Mathias Vrolix,Ivo Petrov,Scot Garg,Christoph Naber,Janusz Prokopczuk,Christian W. Hamm,Philippe Gabríel Steg,Dik Heg,Peter Jüni,Stephan Windecker,Marco Valgimigli
出处
期刊:Journal of the American College of Cardiology [Elsevier BV]
卷期号:74 (18): 2223-2234 被引量:111
标识
DOI:10.1016/j.jacc.2019.08.1038
摘要

The GLOBAL LEADERS (GLOBAL LEADERS: A Clinical Study Comparing Two Forms of Anti-platelet Therapy After Stent Implantation) study randomly assigned 15,991 patients undergoing percutaneous coronary intervention to 1-month dual antiplatelet therapy (DAPT) followed by 23-month ticagrelor monotherapy or conventional 12-month DAPT followed by 12-month aspirin. Apart from Q-wave myocardial infarction (MI), all study endpoints were analyzed as investigator reported.This was a pre-specified ancillary study assessing whether experimental therapy is noninferior, and if met, superior, to conventional treatment for the coprimary efficacy endpoint of all-cause death, nonfatal MI, nonfatal stroke, or urgent target vessel revascularization and superior in preventing BARC 3 (Bleeding Academic Research Consortium) or 5 bleeding (coprimary safety endpoint) at 2 years with a 0.025 significance level to preserve nominal 5% alpha error.An independent clinical event committee adjudicated investigator-reported and eventually unreported events of 7,585 patients from the 20 top-enrolling participating sites.The 2-year coprimary efficacy endpoint occurred in 271 (7.14%) and in 319 (8.41%) patients in the experimental and conventional groups, respectively (rate ratio [RR]: 0.85; 95% confidence interval [CI]: 0.72 to 0.99), fulfilling noninferiority (p noninferiority <0.001), but not superiority (p superiority = 0.0465). The rates of BARC 3 or 5 bleeding did not differ (RR: 1.00; 95% CI: 0.75 to 1.33; p = 0.986). A time-dependent treatment effect was observed with the experimental strategy being associated with a lower risk of MI (RR: 0.54; 95% CI: 0.33 to 0.88; p interaction = 0.062) and definite stent thrombosis (RR: 0.14; 95% CI: 0.03 to 0.63; p interaction = 0.007) after 1-year post-percutaneous coronary intervention.Ticagrelor monotherapy after 1-month DAPT was noninferior, but not superior, to conventional treatment in the prevention of ischemic events, and it did not decrease major bleeding risk as compared with conventional treatment. (GLOBAL LEADERS Adjudication Sub-Study [GLASSY]; NCT03231059).
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
peanut完成签到 ,获得积分10
2秒前
深情安青应助标致诗蕾采纳,获得10
2秒前
韩凡发布了新的文献求助10
2秒前
doctorhyh完成签到,获得积分10
4秒前
4秒前
彼方尚有荣光在完成签到 ,获得积分10
5秒前
6秒前
Jyy77完成签到 ,获得积分10
7秒前
碧蓝毛豆完成签到 ,获得积分10
8秒前
10秒前
YOKO发布了新的文献求助10
11秒前
12秒前
13秒前
好学发布了新的文献求助10
15秒前
16秒前
xhy完成签到,获得积分20
16秒前
123发布了新的文献求助10
18秒前
li发布了新的文献求助10
18秒前
tim完成签到,获得积分10
19秒前
YOKO完成签到,获得积分10
19秒前
王越发布了新的文献求助10
21秒前
标致诗蕾完成签到,获得积分10
22秒前
科研通AI5应助xhy采纳,获得10
23秒前
科研通AI5应助bobo采纳,获得10
23秒前
24秒前
标致诗蕾发布了新的文献求助10
28秒前
28秒前
强健的雅绿完成签到,获得积分10
30秒前
三三完成签到 ,获得积分10
33秒前
健康幸福平安完成签到,获得积分10
35秒前
36秒前
37秒前
38秒前
祁郁郁完成签到,获得积分20
38秒前
龙腾岁月发布了新的文献求助20
40秒前
祁郁郁发布了新的文献求助10
41秒前
科研通AI2S应助burrrrr采纳,获得10
42秒前
HD发布了新的文献求助10
43秒前
bobo发布了新的文献求助10
44秒前
今后应助Falling采纳,获得10
45秒前
高分求助中
Technologies supporting mass customization of apparel: A pilot project 600
Introduction to Strong Mixing Conditions Volumes 1-3 500
Tip60 complex regulates eggshell formation and oviposition in the white-backed planthopper, providing effective targets for pest control 400
A Field Guide to the Amphibians and Reptiles of Madagascar - Frank Glaw and Miguel Vences - 3rd Edition 400
China Gadabouts: New Frontiers of Humanitarian Nursing, 1941–51 400
The Healthy Socialist Life in Maoist China, 1949–1980 400
Optical and electric properties of monocrystalline synthetic diamond irradiated by neutrons 320
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 物理 生物化学 纳米技术 计算机科学 化学工程 内科学 复合材料 物理化学 电极 遗传学 量子力学 基因 冶金 催化作用
热门帖子
关注 科研通微信公众号,转发送积分 3800387
求助须知:如何正确求助?哪些是违规求助? 3345653
关于积分的说明 10326311
捐赠科研通 3062106
什么是DOI,文献DOI怎么找? 1680836
邀请新用户注册赠送积分活动 807249
科研通“疑难数据库(出版商)”最低求助积分说明 763572