Stent Selection for Primary Angioplasty and Outcomes in the Era
of Potent Antiplatelets. Data from the Multicenter Randomized
Prague-18 Trial

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.

Basic information

Original name

Stent Selection for Primary Angioplasty and Outcomes in the Era of Potent Antiplatelets. Data from the Multicenter Randomized Prague-18 Trial

Authors

HLINOMAZ, Ota (203 Czech Republic, belonging to the institution), Zuzana MOTOVSKA (203 Czech Republic), Jiri KNOT (203 Czech Republic), Roman MIKLÍK (203 Czech Republic, belonging to the institution), Mulham SABBAH (376 Israel), Milan HROMADKA (203 Czech Republic), Ivo VARVAROVSKY (203 Czech Republic), Jaroslav DUSEK (203 Czech Republic), Michal SVOBODA (203 Czech Republic, belonging to the institution), Frantisek TOUSEK (203 Czech Republic), Bohumil MAJTAN (203 Czech Republic), Stanislav SIMEK (203 Czech Republic), Marian BRANNY (203 Czech Republic) and Jiří JARKOVSKÝ (203 Czech Republic, belonging to the institution)

Edition

Journal of Clinical Medicine, Basel, MDPI, 2021, 2077-0383

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30218 General and internal medicine

Country of publisher

Switzerland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 4.964

RIV identification code

RIV/00216224:14110/21:00123117

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.3390/jcm10215103

UT WoS

000718744300001

Keywords in English

acute myocardial infarction; primary angioplasty; drug-eluting stent; bare-metal stent; bioresorbable scaffolds; ticagrelor; prasugrel

Abstract

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.

Citovat

HLINOMAZ, Ota, Zuzana MOTOVSKA, Jiri KNOT, Roman MIKLÍK, Mulham SABBAH, Milan HROMADKA, Ivo VARVAROVSKY, Jaroslav DUSEK, Michal SVOBODA, Frantisek TOUSEK, Bohumil MAJTAN, Stanislav SIMEK, Marian BRANNY and Jiří JARKOVSKÝ. Stent Selection for Primary Angioplasty and Outcomes in the Era of Potent Antiplatelets. Data from the Multicenter Randomized Prague-18 Trial. Journal of Clinical Medicine. Basel: MDPI, 2021, vol. 10, No 21, p. 1-12. ISSN 2077-0383. Available from: https://dx.doi.org/10.3390/jcm10215103.

@article{1807765,
   author = {Hlinomaz, Ota and Motovska, Zuzana and Knot, Jiri and Miklík, Roman and Sabbah, Mulham and Hromadka, Milan and Varvarovsky, Ivo and Dusek, Jaroslav and Svoboda, Michal and Tousek, Frantisek and Majtan, Bohumil and Simek, Stanislav and Branny, Marian and Jarkovský, Jiří},
   article_location = {Basel},
   article_number = {21},
   doi = {http://dx.doi.org/10.3390/jcm10215103},
   keywords = {acute myocardial infarction; primary angioplasty; drug-eluting stent; bare-metal stent; bioresorbable scaffolds; ticagrelor; prasugrel},
   language = {eng},
   issn = {2077-0383},
   journal = {Journal of Clinical Medicine},
   title = {Stent Selection for Primary Angioplasty and Outcomes in the Era of Potent Antiplatelets. Data from the Multicenter Randomized Prague-18 Trial},
   url = {https://www.mdpi.com/2077-0383/10/21/5103},
   volume = {10},
   year = {2021}
}

TY  - JOUR
ID  - 1807765
AU  - Hlinomaz, Ota - Motovska, Zuzana - Knot, Jiri - Miklík, Roman - Sabbah, Mulham - Hromadka, Milan - Varvarovsky, Ivo - Dusek, Jaroslav - Svoboda, Michal - Tousek, Frantisek - Majtan, Bohumil - Simek, Stanislav - Branny, Marian - Jarkovský, Jiří
PY  - 2021
TI  - Stent Selection for Primary Angioplasty and Outcomes in the Era of Potent Antiplatelets. Data from the Multicenter Randomized Prague-18 Trial
JF  - Journal of Clinical Medicine
VL  - 10
IS  - 21
SP  - 1-12
EP  - 1-12
PB  - MDPI
SN  - 20770383
KW  - acute myocardial infarction
KW  - primary angioplasty
KW  - drug-eluting stent
KW  - bare-metal stent
KW  - bioresorbable scaffolds
KW  - ticagrelor
KW  - prasugrel
UR  - https://www.mdpi.com/2077-0383/10/21/5103
N2  - 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.

ER -

HLINOMAZ, Ota, Zuzana MOTOVSKA, Jiri KNOT, Roman MIKLÍK, Mulham SABBAH, Milan HROMADKA, Ivo VARVAROVSKY, Jaroslav DUSEK, Michal SVOBODA, Frantisek TOUSEK, Bohumil MAJTAN, Stanislav SIMEK, Marian BRANNY and Jiří JARKOVSKÝ. Stent Selection for Primary Angioplasty and Outcomes in the Era of Potent Antiplatelets. Data from the Multicenter Randomized Prague-18 Trial. \textit{Journal of Clinical Medicine}. Basel: MDPI, 2021, vol.~10, No~21, p.~1-12. ISSN~2077-0383. Available from: https://dx.doi.org/10.3390/jcm10215103.

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