Einzeltreffer — DigiBib

Introduction: Among different coronary stents implanted in High Bleeding Risk (HBR) patients with an indication for short antiplatelet therapy, no comparisons in terms of efficacy have been provided.

Methods: A Network Meta Analysis was performed including all randomized controlled trials comparing different coronary stents evaluated in HBR patients. Major Adverse Cardiovascular Events (MACEs) as defined by each included trial were the primary end point, whereas TLR (target lesion revascularization), TVR (target vessel revascularization), stent thrombosis and total and major (BARC3-5) bleedings were the secondary ones.

Results: A total of four studies (ONYX ONE, LEADERS FREE, SENIOR and HBR in BIO-RESORT) including 6637 patients were analyzed with different kind of stents and dual antiplatelet therapy (DAPT) length (1 or 6 months) on 12 months follow-up. About one-third of these patients were defined HBR due to indication for oral anticoagulation. All drug eluting stents (DESs) reduced risk of MACE compared to Bare Metal Stents (BMSs) when followed by a 1-month DAPT. At SUCRA analysis, Orsiro was the device with the highest probability of performing best. Rates of TLR and TVR were significantly lower when using Resolute Onyx, Synergy and BioFreedom stents in comparison to BMS when followed by 1-month DAPT, with Synergy ranking best. Synergy also showed a significantly lower number of stent thrombosis compared to BMS (RR 0.28, 95% CI 0.06-0.93), while Orsiro and Resolute Integrity showed the highest probability of performing best.

Conclusion: In HBRs patients, all DESs were superior to BMSs in terms of efficacy and safety. Among DESs, Orsiro was the one with the highest ranking in terms of MACE, mainly driven by a reduced incidence of repeated revascularization and stent thrombosis.

Titel:	Safety and efficacy of drug-eluting stents for patients at high risk of bleedings: A network meta-analysis.
Autor/in / Beteiligte Person:	Giacobbe, F ; Valente, E ; Morena, A ; Nebiolo, M ; Giannino, G ; De Filippo, O ; Bruno, F ; Isaevska, E ; Richiardi, L ; Iannaccone, M ; Zoccai, GB ; Burzotta, F ; D'Ascenzo, F ; Ferrari, GM
Link:	Full Text Finder (Volltext)
Zeitschrift:	Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions, Jg. 103 (2024-05-01), Heft 6, S. 843-855
Veröffentlichung:	New York, NY : Wiley-Liss, c1999-, 2024
Medientyp:	academicJournal
ISSN:	1522-726X (electronic)
DOI:	10.1002/ccd.31047
Schlagwort:	Humans Coronary Thrombosis etiology Coronary Thrombosis prevention & control Dual Anti-Platelet Therapy Prosthesis Design Randomized Controlled Trials as Topic Risk Factors Time Factors Treatment Outcome Coronary Artery Disease therapy Drug-Eluting Stents Hemorrhage prevention & control Network Meta-Analysis Percutaneous Coronary Intervention adverse effects Percutaneous Coronary Intervention instrumentation Platelet Aggregation Inhibitors adverse effects Platelet Aggregation Inhibitors administration & dosage
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article; Meta-Analysis; Systematic Review Language: English [Catheter Cardiovasc Interv] 2024 May; Vol. 103 (6), pp. 843-855. <i>Date of Electronic Publication: </i>2024 Apr 19. MeSH Terms: Coronary Artery Disease* / therapy ; Drug-Eluting Stents* ; Hemorrhage* / prevention & control ; Network Meta-Analysis* ; Percutaneous Coronary Intervention* / adverse effects ; Percutaneous Coronary Intervention* / instrumentation ; Platelet Aggregation Inhibitors* / adverse effects ; Platelet Aggregation Inhibitors* / administration & dosage ; Humans ; Coronary Thrombosis / etiology ; Coronary Thrombosis / prevention & control ; Dual Anti-Platelet Therapy ; Prosthesis Design ; Randomized Controlled Trials as Topic ; Risk Factors ; Time Factors ; Treatment Outcome References: Canfield J, Totary‐Jain H. 40 years of percutaneous coronary intervention: history and future directions. J Pers Med. 2018;8(4):33. ; Giustino G, Chieffo A, Palmerini T, et al. Efficacy and safety of dual antiplatelet therapy after complex PCI. J Am Coll Cardiol. 2016;68(17):1851‐1864. ; King SB, Smith SC, Hirshfeld JW, et al. 2007 focused update of the ACC/AHA/SCAI 2005 guideline update for percutaneous coronary intervention. Circulation. 2008;117(2):261‐295. ; Iglesias JF, Degrauwe S, Cimci M, et al. Differential effects of newer‐generation ultrathin‐strut versus thicker‐strut drug‐eluting stents in chronic and acute coronary syndromes. JACC. Cardiovas Intervent. 2021;14(22):2461‐2473. ; Valgimigli M, Bueno H, Byrne RA, et al. 2017 ESC focused update on dual antiplatelet therapy in coronary artery disease developed in collaboration with EACTSThe task force for dual antiplatelet therapy in coronary artery disease of the european society of cardiology (ESC) and of the european association for Cardio‐Thoracic surgery (EACTS). Eur Heart J. 2018;39(3):213‐260. ; Thiele H, Barbato E, Barthelemy O, Bauersachs J, Bhatt DL. 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST‐segment elevation. 79. ; Urban P, Mehran R, Colleran R, et al. Defining high bleeding risk in patients undergoing percutaneous coronary intervention: a consensus document from the academic research consortium for high bleeding risk. Eur Heart J. 2019;40(31):2632‐2653. ; D'Ascenzo F, De Filippo O, Gallone G, et al. Machine learning‐based prediction of adverse events following an acute coronary syndrome (PRAISE): a modelling study of pooled datasets. The Lancet. 2021;397(10270):199‐207. ; Escaned J, Cao D, Baber U, et al. Ticagrelor monotherapy in patients at high bleeding risk undergoing percutaneous coronary intervention: TWILIGHT‐HBR. Eur Heart J. 2021;42(45):4624‐4634. ; Valgimigli M, Frigoli E, Heg D, et al. Dual antiplatelet therapy after PCI in patients at high bleeding risk. N Engl J Med. 2021;385(18):1643‐1655. ; Watanabe H, Domei T, Morimoto T, et al. Effect of 1‐Month dual antiplatelet therapy followed by clopidogrel vs 12‐month dual antiplatelet therapy on cardiovascular and bleeding events in patients receiving PCI: the STOPDAPT‐2 randomized clinical trial. JAMA. 2019;321(24):2414‐2427. ; Varenne O, Cook S, Sideris G, et al. Drug‐eluting stents in elderly patients with coronary artery disease (SENIOR): a randomised single‐blind trial. The Lancet. 2018;391(10115):41‐50. ; Urban P, Meredith IT, Abizaid A, et al. Polymer‐free drug‐coated coronary stents in patients at high bleeding risk. N Engl J Med. 2015;373(21):2038‐2047. ; Windecker S, Latib A, Kedhi E, et al. Polymer‐based or polymer‐free stents in patients at high bleeding risk. N Engl J Med. 2020;382(13):1208‐1218. ; Zocca P, Kok MM, van der Heijden LC, et al. High bleeding risk patients treated with very thin‐strut biodegradable polymer or Thin‐Strut durable polymer drug‐eluting stents in the BIO‐RESORT trial. Cardiovasc Drugs Ther. 2018;32(6):567‐576. ; Rissanen TT, Uskela S, Eränen J, et al. Drug‐coated balloon for treatment of de‐novo coronary artery lesions in patients with high bleeding risk (DEBUT): a single‐blind, randomised, non‐inferiority trial. Lancet. 2019;394(10194):230‐239. ; Scheller B, Rissanen TT, Farah A, et al. Drug‐coated balloon for small coronary artery disease in patients with and without High‐Bleeding risk in the BASKET‐SMALL 2 trial. Circ Cardiovas Intervent. 2022;15(4). ; Cao D, Mehran R, Dangas G, et al. Validation of the academic research consortium high bleeding risk definition in contemporary PCI patients. J Am Coll Cardiol. 2020;75(21):2711‐2722. Contributed Indexing: Keywords: High Bleeding Risk; drug eluting stents; meta‐analysis; percutaneous coronary intervention Substance Nomenclature: 0 (Platelet Aggregation Inhibitors) Entry Date(s): Date Created: 20240419 Date Completed: 20240426 Latest Revision: 20240501 Update Code: 20240501

Klicken Sie ein Format an und speichern Sie dann die Daten oder geben Sie eine Empfänger-Adresse ein und lassen Sie sich per Email zusenden.

BibTeX Citavi, JabRef, u.a.
(Literaturverwaltung)

PDF kein Volltext!
(Merkzettel, Notizen)

RIS Endnote, Citavi u.a.
(Literaturverwaltung)

MODS
(XML zur Weiterverarbeitung)

oder

Wählen Sie das für Sie passende Zitationsformat und kopieren Sie es dann in die Zwischenablage, lassen es sich per Mail zusenden oder speichern es als PDF-Datei.

Gewünschter Zitations-Stil:

oder

Bitte prüfen Sie, ob die Zitation formal korrekt ist, bevor Sie sie in einer Arbeit verwenden. Benutzen Sie gegebenenfalls den "Exportieren"-Dialog, wenn Sie ein Literaturverwaltungsprogramm verwenden und die Zitat-Angaben selbst formatieren wollen.

Safety and efficacy of drug-eluting stents for patients at high risk of bleedings: A network meta-analysis.