J 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.