2022
Impact of Medication Nonadherence in a Clinical Trial of Dual Antiplatelet Therapy
VALGIMIGLI, Marco, Enrico FRIGOLI, Pascal VRANCKX, Yukio OZAKI, Marie-Claude MORICE et. al.Základní údaje
Originální název
Impact of Medication Nonadherence in a Clinical Trial of Dual Antiplatelet Therapy
Autoři
VALGIMIGLI, Marco (garant), Enrico FRIGOLI, Pascal VRANCKX, Yukio OZAKI, Marie-Claude MORICE, Bernard CHEVALIER, Yoshinobu ONUMA, Stephan WINDECKER, Laurent DELORME, Petr KALA (203 Česká republika, domácí), Sasko KEDEV, Rajpal K ABHAICHAND, Vasil VELCHEV, Willem DEWILDE, Jakub PODOLEC, Gregor LEIBUNDGUT, Dragan TOPIC, Carl SCHULTZ, Goran STANKOVIC, Astin LEE, Thomas JOHNSON, Pim A L TONINO, Aneta KLOTZKA, Maciej LESIAK, Renato D LOPES, Pieter C SMITS a Dik HEG
Vydání
Journal of the American College of Cardiology, New York, Elsevier Science INC, 2022, 0735-1097
Další údaje
Jazyk
angličtina
Typ výsledku
Článek v odborném periodiku
Obor
30201 Cardiac and Cardiovascular systems
Stát vydavatele
Spojené státy
Utajení
není předmětem státního či obchodního tajemství
Odkazy
Impakt faktor
Impact factor: 24.000
Kód RIV
RIV/00216224:14110/22:00128437
Organizační jednotka
Lékařská fakulta
UT WoS
000863530300004
Klíčová slova anglicky
drug-eluting stent; dual antiplatelet therapy; high bleeding risk; P2Y12 inhibitor; acetylsalicylic acid
Příznaky
Mezinárodní význam, Recenzováno
Změněno: 31. 1. 2023 12:30, Mgr. Tereza Miškechová
Anotace
V originále
BACKGROUND Nonadherence to antiplatelet therapy after percutaneous coronary intervention (PCI) is common, even in clinical trials. OBJECTIVES The purpose of this study was to investigate the impact of nonadherence to study protocol regimens in the MASTER DAPT (Management of High Bleeding Risk Patients Post Bioresorbable Polymer Coated Stent Implantation With an Abbreviated Versus Prolonged DAPT Regimen) trial. METHODS At 1-month after PCI, 4,579 high bleeding risk patients were randomized to single antiplatelet therapy (SAPT) for 11 months (or 5 months in patients on oral anticoagulation [OAC]) or dual antiplatelet therapy (DAPT) for >= 2 months followed by SAPT. Coprimary outcomes included net adverse clinical events (NACE), major adverse cardiac and cerebral events (MACE), and major or clinically relevant nonmajor bleeding (MCB) at 335 days. Inverse probability-ofcensoring weights were used to correct for nonadherence Academic Research Consortium type 2 or 3. RESULTS In total, 464 (20.2%) patients in the abbreviated-treatment and 214 (9.4%) in the standard-treatment groups incurred nonadherence Academic Research Consortium type 2 or 3. At inverse probability-of-censoring weights analyses, NACE (HR: 1.01; 95% CI: 0.88-1.27) or MACE (HR: 1.07; 95% CI: 0.83-1.40) did not differ, and MCB was lower with abbreviated compared with standard treatment (HR: 0.51; 95% CI: 0.60-0.73) consistently across OAC subgroups; among OAC patients, SAPT discontinuation 6 months after PCI was associated with similar MACE and lower MCB (HR: 0.47; 95% CI: 0.22-0.99) compared with SAPT continuation. CONCLUSIONS In the MASTER DAPT adherent population, 1-month compared with >= 3-month DAPT was associated with similar NACE or MACE and lower MCB. Among OAC patients, SAPT discontinuation after 6 months was associated with similar MACE and lower MCB than SAPT continuation (Management of High Bleeding Risk Patients Post Bioresorbable Polymer Coated Stent Implantation With an Abbreviated Versus Prolonged DAPT Regimen [MASTER DAPT]