Harsh B. Golwala, Christopher P. Cannon, P. Gabriel Steg, Gheorghe Doros, Arman Qamar, Stephen G. Ellis, Jonas Oldgren, Jurriën Maria ten Berg, Takeshi Kimura, Stefan H. Hohnloser, Gregory Y. H. Lip, Deepak L. Bhatt
- Aims: Of patients with atrial fibrillation (AF), approximately 10% undergo percutaneous coronary intervention (PCI). We studied the safety and efficacy of dual vs. triple antithrombotic therapy (DAT vs. TAT) in this population.
Methods and results: A systematic review and meta-analysis was conducted using PubMed, Embase, EBSCO, Cochrane database of systematic reviews, Web of Science, and relevant meeting abstracts for Phase 3, randomized trials that compared DAT vs. TAT in patients with AF following PCI. Four trials including 5317 patients were included, of whom 3039 (57%) received DAT. Compared with the TAT arm, Thrombolysis in Myocardial Infarction (TIMI) major or minor bleeding showed a reduction by 47% in the DAT arm [4.3% vs. 9.0%; hazard ratio (HR) 0.53, 95% credible interval (CrI) 0.36–0.85, I2 = 42.9%]. In addition, there was no difference in the trial-defined major adverse cardiac events (MACE) (10.4% vs. 10.0%, HR 0.85, 95% CrI 0.48–1.29, I2 = 58.4%), or in individual outcomes of all-cause mortality, cardiac death, myocardial infarction, stent thrombosis, or stroke between the two arms.
Conclusion: Compared with TAT, DAT shows a reduction in TIMI major or minor bleeding by 47% with comparable outcomes of MACE. Our findings support the concept that DAT may be a better option than TAT in many patients with AF following PCI.
MetadatenAuthor: | Harsh B. Golwala, Christopher P. Cannon, P. Gabriel Steg, Gheorghe Doros, Arman Qamar, Stephen G. Ellis, Jonas Oldgren, Jurriën Maria ten Berg, Takeshi Kimura, Stefan H. HohnloserORCiD, Gregory Y. H. Lip, Deepak L. BhattORCiDGND |
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URN: | urn:nbn:de:hebis:30:3-544672 |
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DOI: | https://doi.org/10.1093/eurheartj/ehy162 |
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ISSN: | 1522-9645 |
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ISSN: | 0195-668X |
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Pubmed Id: | https://pubmed.ncbi.nlm.nih.gov/29668889 |
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Parent Title (English): | European heart journal |
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Publisher: | Oxford University Press |
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Place of publication: | Oxford |
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Document Type: | Article |
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Language: | English |
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Year of Completion: | 2018 |
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Date of first Publication: | 2018/04/13 |
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Publishing Institution: | Universitätsbibliothek Johann Christian Senckenberg |
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Release Date: | 2020/05/04 |
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Tag: | Antithrombotic therapy; Atrial fibrillation; Dual therapy; Percutaneous coronary intervention; Triple therapy |
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Volume: | 39 |
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Issue: | 19 |
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Page Number: | 11 |
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First Page: | 1726 |
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Last Page: | 1735 |
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Note: | This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
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HeBIS-PPN: | 465963986 |
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Institutes: | Medizin / Medizin |
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Dewey Decimal Classification: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
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Sammlungen: | Universitätspublikationen |
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Licence (English): | Creative Commons - Namensnennung-Nicht kommerziell 4.0 |
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