Long-term ticagrelor for secondary prevention in patients with
prior myocardial infarction and no history of coronary
stenting: insights from PEGASUS-TIMI 54

J 2020

Long-term ticagrelor for secondary prevention in patients with prior myocardial infarction and no history of coronary stenting: insights from PEGASUS-TIMI 54

FURTADO, RHM; JC NICOLAU; G MAGNANI; K IM; DL BHATT et al.

Základní údaje

Originální název

Long-term ticagrelor for secondary prevention in patients with prior myocardial infarction and no history of coronary stenting: insights from PEGASUS-TIMI 54

Autoři

Vydání

European heart journal, Oxford, Oxford University Press, 2020, 0195-668X

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Stát vydavatele

Velká Británie a Severní Irsko

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 29.983

Označené pro přenos do RIV

Organizační jednotka

Lékařská fakulta

DOI

https://doi.org/10.1093/eurheartj/ehz821

UT WoS

000537382900008

Klíčová slova anglicky

Ticagrelor; Myocardial infarction; Antiplatelet drugs; Dual antiplatelet therapy; Medically managed

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 9. 12. 2020 10:59, Mgr. Tereza Miškechová

Anotace

V originále

Aims PEGASUS-TIMI 54 demonstrated that long-term dual antiplatelet therapy (DAPT) with aspirin and ticagrelor reduced the risk of major adverse cardiovascular events (MACE), with an acceptable increase in bleeding, in patients with prior myocardial infarction (MI). While much of the discussion around prolonged DAPT has been focused on stented patients, patients with prior MI without prior coronary stenting comprise a clinically important subgroup. Methods and results This was a pre-specified analysis from PEGASUS-TIMI 54, which randomized 21 162 patients with prior MI (1-3years) and additional high-risk features to ticagrelor 60 mg, 90 mg, or placebo twice daily in addition to aspirin. A total of 4199 patients had no history of coronary stenting at baseline. The primary efficacy outcome (MACE) was the composite of cardiovascular death, MI, or stroke. Patients without history of coronary stenting had higher baseline risk of MACE [13.2% vs. 8.0%, adjusted hazard ratio (HR) 1.41, 95% confidence interval (CI) 1.15-1.73, in the placebo arm]. The relative risk reduction in MACE with ticagrelor (pooled doses) was similar in patients without (HR 0.82, 95% CI 0.68-0.99) and with prior stenting (HR 0.85, 95% CI 0.75-0.96; P for interaction = 0.76). Conclusion Long-term ticagrelor reduces thrombotic events in patients with prior MI regardless of whether they had prior coronary stenting. These data highlight the benefits of DAPT in prevention of spontaneous atherothrombotic events and indicate that long-term ticagrelor may be considered in high-risk patients with prior MI even if they have not been treated with stenting.

Citovat

FURTADO, RHM; JC NICOLAU; G MAGNANI; K IM; DL BHATT; RF STOREY; PG STEG; Jindřich ŠPINAR; A BUDAJ; F KONTNY; R CORBALAN; RG KISS; MT ABOLA; P JOHANSON; EC JENSEN; E BRAUNWALD; MS SABATINE a MP BONACA. Long-term ticagrelor for secondary prevention in patients with prior myocardial infarction and no history of coronary stenting: insights from PEGASUS-TIMI 54. European heart journal. Oxford: Oxford University Press, 2020, roč. 41, č. 17, s. 1625-1632, 9 s. ISSN 0195-668X. Dostupné z: https://doi.org/10.1093/eurheartj/ehz821.

@article{1706296,
   author = {Furtado, RHM and Nicolau, JC and Magnani, G and Im, K and Bhatt, DL and Storey, RF and Steg, PG and Špinar, Jindřich and Budaj, A and Kontny, F and Corbalan, R and Kiss, RG and Abola, MT and Johanson, P and Jensen, EC and Braunwald, E and Sabatine, MS and Bonaca, MP},
   article_location = {Oxford},
   article_number = {17},
   doi = {https://doi.org/10.1093/eurheartj/ehz821},
   keywords = {Ticagrelor; Myocardial infarction; Antiplatelet drugs; Dual antiplatelet therapy; Medically managed},
   language = {eng},
   issn = {0195-668X},
   journal = {European heart journal},
   note = {Bez afiliace k MU.},
   title = {Long-term ticagrelor for secondary prevention in patients with prior myocardial infarction and no history of coronary stenting: insights from PEGASUS-TIMI 54},
   url = {https://watermark.silverchair.com/ehz821.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAsIwggK-BgkqhkiG9w0BBwagggKvMIICqwIBADCCAqQGCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMdcl4NmqS88WwMBZaAgEQgIICdcsl1qdb9sN7Z187Hl1Fq0MLQbIQWiAcme49oxImLNIwXZG},
   volume = {41},
   year = {2020}
}

TY  - JOUR
ID  - 1706296
AU  - Furtado, RHM - Nicolau, JC - Magnani, G - Im, K - Bhatt, DL - Storey, RF - Steg, PG - Špinar, Jindřich - Budaj, A - Kontny, F - Corbalan, R - Kiss, RG - Abola, MT - Johanson, P - Jensen, EC - Braunwald, E - Sabatine, MS - Bonaca, MP
PY  - 2020
TI  - Long-term ticagrelor for secondary prevention in patients with prior myocardial infarction and no history of coronary stenting: insights from PEGASUS-TIMI 54
JF  - European heart journal
VL  - 41
IS  - 17
SP  - 1625-1632
EP  - 1625-1632
PB  - Oxford University Press
SN  - 0195668X
N1  - Bez afiliace k MU.
KW  - Ticagrelor
KW  - Myocardial infarction
KW  - Antiplatelet drugs
KW  - Dual antiplatelet therapy
KW  - Medically managed
UR  - https://watermark.silverchair.com/ehz821.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAsIwggK-BgkqhkiG9w0BBwagggKvMIICqwIBADCCAqQGCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMdcl4NmqS88WwMBZaAgEQgIICdcsl1qdb9sN7Z187Hl1Fq0MLQbIQWiAcme49oxImLNIwXZG
N2  - Aims PEGASUS-TIMI 54 demonstrated that long-term dual antiplatelet therapy (DAPT) with aspirin and ticagrelor reduced the risk of major adverse cardiovascular events (MACE), with an acceptable increase in bleeding, in patients with prior myocardial infarction (MI). While much of the discussion around prolonged DAPT has been focused on stented patients, patients with prior MI without prior coronary stenting comprise a clinically important subgroup. Methods and results This was a pre-specified analysis from PEGASUS-TIMI 54, which randomized 21 162 patients with prior MI (1-3years) and additional high-risk features to ticagrelor 60 mg, 90 mg, or placebo twice daily in addition to aspirin. A total of 4199 patients had no history of coronary stenting at baseline. The primary efficacy outcome (MACE) was the composite of cardiovascular death, MI, or stroke. Patients without history of coronary stenting had higher baseline risk of MACE [13.2% vs. 8.0%, adjusted hazard ratio (HR) 1.41, 95% confidence interval (CI) 1.15-1.73, in the placebo arm]. The relative risk reduction in MACE with ticagrelor (pooled doses) was similar in patients without (HR 0.82, 95% CI 0.68-0.99) and with prior stenting (HR 0.85, 95% CI 0.75-0.96; P for interaction = 0.76). Conclusion Long-term ticagrelor reduces thrombotic events in patients with prior MI regardless of whether they had prior coronary stenting. These data highlight the benefits of DAPT in prevention of spontaneous atherothrombotic events and indicate that long-term ticagrelor may be considered in high-risk patients with prior MI even if they have not been treated with stenting.
ER  -

FURTADO, RHM; JC NICOLAU; G MAGNANI; K IM; DL BHATT; RF STOREY; PG STEG; Jindřich ŠPINAR; A BUDAJ; F KONTNY; R CORBALAN; RG KISS; MT ABOLA; P JOHANSON; EC JENSEN; E BRAUNWALD; MS SABATINE a MP BONACA. Long-term ticagrelor for secondary prevention in patients with prior myocardial infarction and no history of coronary stenting: insights from PEGASUS-TIMI 54. \textit{European heart journal}. Oxford: Oxford University Press, 2020, roč.~41, č.~17, s.~1625-1632, 9 s. ISSN~0195-668X. Dostupné z: https://doi.org/10.1093/eurheartj/ehz821.

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