Single antiplatelet therapy directly after percutaneous coronary intervention in non-ST-segment elevation acute coronary syndrome patients: the OPTICA study.

التفاصيل البيبلوغرافية
العنوان:	Single antiplatelet therapy directly after percutaneous coronary intervention in non-ST-segment elevation acute coronary syndrome patients: the OPTICA study.
المؤلفون:	van der Sangen NMR; Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands., Claessen BEPM; Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands., Küçük IT; Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands., den Hartog AW; Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands., Baan J; Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands., Beijk MAM; Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands., Delewi R; Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands., van de Hoef TP; Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands., Knaapen P; Department of Cardiology, Amsterdam UMC, Vrije University (VU), Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands., Lemkes JS; Department of Cardiology, Amsterdam UMC, Vrije University (VU), Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands., Marques KM; Department of Cardiology, Amsterdam UMC, Vrije University (VU), Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands., Nap A; Department of Cardiology, Amsterdam UMC, Vrije University (VU), Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands., Verouden NJW; Department of Cardiology, Amsterdam UMC, Vrije University (VU), Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands., Vis MM; Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands., de Winter RJ; Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands., Kikkert WJ; Department of Cardiology, Amsterdam UMC, Vrije University (VU), Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands., Appelman Y; Department of Cardiology, Amsterdam UMC, Vrije University (VU), Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands., Henriques JPS; Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands.
المصدر:	EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology [EuroIntervention] 2023 May 15; Vol. 19 (1), pp. 63-72.
نوع المنشور:	Journal Article
اللغة:	English
بيانات الدورية:	Publisher: Société Europa édition Country of Publication: France NLM ID: 101251040 Publication Model: Print Cited Medium: Internet ISSN: 1969-6213 (Electronic) Linking ISSN: 1774024X NLM ISO Abbreviation: EuroIntervention Subsets: MEDLINE
أسماء مطبوعة:	Original Publication: Toulouse : Société Europa édition, c2005-
مواضيع طبية MeSH:	Acute Coronary Syndrome/drug therapy , Acute Coronary Syndrome/surgery , Percutaneous Coronary Intervention/adverse effects , Myocardial Infarction/therapy, Humans ; Female ; Middle Aged ; Male ; Platelet Aggregation Inhibitors ; Prasugrel Hydrochloride ; Ticagrelor/therapeutic use ; Pilot Projects ; Hemorrhage/chemically induced ; Treatment Outcome
مستخلص:	Background: Early P2Y 12 inhibitor monotherapy has emerged as a promising alternative to 12 months of dual antiplatelet therapy following percutaneous coronary intervention (PCI). Aims: In this single-arm pilot study, we evaluated the feasibility and safety of ticagrelor or prasugrel monotherapy directly following PCI in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS). Methods: Patients received a loading dose of ticagrelor or prasugrel before undergoing platelet function testing and subsequent PCI using new-generation drug-eluting stents. The stent result was adjudicated with optical coherence tomography in the first 35 patients. Ticagrelor or prasugrel monotherapy was continued for 12 months. The primary ischaemic endpoint was the composite of all-cause mortality, myocardial infarction, definite or probable stent thrombosis or stroke within 6 months. The primary bleeding endpoint was Bleeding Academic Research Consortium type 2, 3 or 5 bleeding within 6 months. Results: From March 2021 to March 2022, 125 patients were enrolled, of whom 75 ultimately met all in- and exclusion criteria (mean age 64.5 years, 29.3% women). Overall, 70 out of 75 (93.3%) patients were treated with ticagrelor or prasugrel monotherapy directly following PCI. The primary ischaemic endpoint occurred in 3 (4.0%) patients within 6 months. No cases of stent thrombosis or spontaneous myocardial infarction occurred. The primary bleeding endpoint occurred in 7 (9.3%) patients within 6 months. Conclusions: This study provides first-in-human evidence that P2Y 12 inhibitor monotherapy directly following PCI for NSTE-ACS is feasible, without any overt safety concerns, and highlights the need for randomised controlled trials comparing direct P2Y 12 inhibitor monotherapy with the current standard of care.
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المشرفين على المادة:	0 (Platelet Aggregation Inhibitors) G89JQ59I13 (Prasugrel Hydrochloride) GLH0314RVC (Ticagrelor)
تواريخ الأحداث:	Date Created: 20230203 Date Completed: 20230515 Latest Revision: 20240516
رمز التحديث:	20240516
مُعرف محوري في PubMed:	PMC10173755
DOI:	10.4244/EIJ-D-22-00886
PMID:	36734020
قاعدة البيانات:	MEDLINE

الوصف
تدمد:	1969-6213
DOI:	10.4244/EIJ-D-22-00886