Ischaemic and bleeding complications with new, compared to standard, ADP-antagonist regimens in acute coronary syndromes: a meta-analysis of randomized trials
dc.contributor.author | Navarese, Eliano Pio | |
dc.contributor.author | Verdoia, M. | |
dc.contributor.author | Schaffer, A. | |
dc.contributor.author | Suriano, P. | |
dc.contributor.author | Koziński, Marek | |
dc.contributor.author | Castriota, Fausto | |
dc.contributor.author | De Servi, Stefano | |
dc.contributor.author | Kubica, Jacek | |
dc.contributor.author | De Luca, G. | |
dc.date.accessioned | 2012-12-19T16:21:13Z | |
dc.date.available | 2012-12-19T16:21:13Z | |
dc.date.issued | 2012-12-19 | |
dc.description.abstract | Background: Platelets play a pivotal role in the pathogenesis of acute coronary syndromes (ACS) and their inhibition remains a mainstay therapy in this setting. We aimed to perform a meta-analysis of randomized trials to evaluate the benefits of new oral antiplatelet regimens to block platelet ADPreceptors compared to standard-dose clopidogrel (300 mg loading dose followed by 75 mg/daily). Methods: We obtained results from all randomized trials enrolling patients with ACS. Primary endpoint was mortality. Secondary endpoints were myocardial infarction and definite in-stent thrombosis. Safety endpoint was the risk of major bleeding complications. We prespecified subanalyses according to new antiplatelet drugs (prasugrel/ticagrelor), high-dose clopidogrel (600 mg) and patients undergoing percutaneous coronary intervention. Results: A total of seven randomized trials were finally included in the meta-analysis (n = 58 591). We observed a significant reduction in mortality (2.9% vs. 3.4%, OR= 0.87, 95% CI 0.79–0.95, P = 0.002), recurrent myocardial infarction (4.2% vs. 5.2%, OR= 0.80, 95% CI 0.74–0.87, P < 0.0001), definite in-stent thrombosis (0.9% vs. 1.7%, OR= 0.52, 95% CI 0.43–0.63, P < 0.0001). The benefits in mortality and reinfarction were driven by the treatment with prasugrel or ticagrelor, without a significant difference in terms of major bleeding complications as compared to standarddose clopidogrel (5% vs. 4.7%, OR= 1.06 95% CI 0.96–1.17, P = 0.25). Conclusions: This meta-analysis showed that new oral antiplatelet regimens are associated with a significant reduction in mortality, reinfarction and in-stent thrombosis in ACS patients without an overall increase of major bleeding when treated with new antiplatelet drugs. | pl |
dc.identifier.uri | http://repozytorium.umk.pl/handle/item/264 | |
dc.language.iso | eng | pl |
dc.rights | info:eu-repo/semantics/openAccess | en |
dc.subject | Ischaemic | pl |
dc.subject | bleeding complications | pl |
dc.subject | ADP-antagonist | pl |
dc.subject | acute coronary syndromes | pl |
dc.title | Ischaemic and bleeding complications with new, compared to standard, ADP-antagonist regimens in acute coronary syndromes: a meta-analysis of randomized trials | pl |
dc.type | info:eu-repo/semantics/article | pl |
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