2021
Stent Selection for Primary Angioplasty and Outcomes in the Era of Potent Antiplatelets. Data from the Multicenter Randomized Prague-18 Trial
HLINOMAZ, Ota, Zuzana MOTOVSKA, Jiri KNOT, Roman MIKLÍK, Mulham SABBAH et. al.Základní údaje
Originální název
Stent Selection for Primary Angioplasty and Outcomes in the Era of Potent Antiplatelets. Data from the Multicenter Randomized Prague-18 Trial
Autoři
HLINOMAZ, Ota (203 Česká republika, domácí), Zuzana MOTOVSKA (203 Česká republika), Jiri KNOT (203 Česká republika), Roman MIKLÍK (203 Česká republika, domácí), Mulham SABBAH (376 Izrael), Milan HROMADKA (203 Česká republika), Ivo VARVAROVSKY (203 Česká republika), Jaroslav DUSEK (203 Česká republika), Michal SVOBODA (203 Česká republika, domácí), Frantisek TOUSEK (203 Česká republika), Bohumil MAJTAN (203 Česká republika), Stanislav SIMEK (203 Česká republika), Marian BRANNY (203 Česká republika) a Jiří JARKOVSKÝ (203 Česká republika, domácí)
Vydání
Journal of Clinical Medicine, Basel, MDPI, 2021, 2077-0383
Další údaje
Jazyk
angličtina
Typ výsledku
Článek v odborném periodiku
Obor
30218 General and internal medicine
Stát vydavatele
Švýcarsko
Utajení
není předmětem státního či obchodního tajemství
Odkazy
Impakt faktor
Impact factor: 4.964
Kód RIV
RIV/00216224:14110/21:00123117
Organizační jednotka
Lékařská fakulta
UT WoS
000718744300001
Klíčová slova anglicky
acute myocardial infarction; primary angioplasty; drug-eluting stent; bare-metal stent; bioresorbable scaffolds; ticagrelor; prasugrel
Příznaky
Mezinárodní význam, Recenzováno
Změněno: 6. 12. 2021 09:22, Mgr. Tereza Miškechová
Anotace
V originále
Drug-eluting stents (DES) are the recommended stents for primary percutaneous coronary intervention (PCI). This study aimed to determine why interventional cardiologists used non-DES and how it influenced patient prognoses. The efficacy and safety outcomes of the different stents were also compared in patients treated with either prasugrel or ticagrelor. Of the PRAGUE-18 study patients, 749 (67.4%) were treated with DES, 296 (26.6%) with bare-metal stents (BMS), and 66 (5.9%) with bioabsorbable vascular scaffold/stents (BVS) between 2013 and 2016. Cardiogenic shock at presentation, left main coronary artery disease, especially as the culprit lesion, and right coronary artery stenosis were the reasons for selecting a BMS. The incidence of the primary composite net-clinical endpoint (EP) (death, nonfatal myocardial infarction, stroke, serious bleeding, or revascularization) at seven days was 2.5% vs. 6.3% and 3.0% in the DES, vs. with BMS and BVS, respectively (HR 2.7; 95% CI 1.419-5.15, p = 0.002 for BMS vs. DES and 1.25 (0.29-5.39) p = 0.76 for BVS vs. DES). Patients with BMS were at higher risk of death at 30 days (HR 2.20; 95% CI 1.01-4.76; for BMS vs. DES, p = 0.045) and at one year (HR 2.1; 95% CI 1.19-3.69; p = 0.01); they also had a higher composite of cardiac death, reinfarction, and stroke (HR 1.66; 95% CI 1.0-2.74; p = 0.047) at one year. BMS were associated with a significantly higher rate of primary EP whether treated with prasugrel or ticagrelor. In conclusion, patients with the highest initial risk profile were preferably treated with BMS over BVS. BMS were associated with a significantly higher rate of cardiovascular events whether treated with prasugrel or ticagrelor.