دورية أكاديمية
أعرض في EDS

Association Between Claims-Defined Frailty and Outcomes Following 30 Versus 12 Months of Dual Antiplatelet Therapy After Percutaneous Coronary Intervention: Findings From the EXTEND-DAPT Study.

التفاصيل البيبلوغرافية
العنوان: Association Between Claims-Defined Frailty and Outcomes Following 30 Versus 12 Months of Dual Antiplatelet Therapy After Percutaneous Coronary Intervention: Findings From the EXTEND-DAPT Study.
المؤلفون: Faridi KF; Section of Cardiovascular Medicine, Department of Medicine Yale School of Medicine New Haven CT USA., Strom JB; Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Division of Cardiovascular Medicine Beth Israel Deaconess Medical Center Boston MA USA., Kundi H; Department of Cardiology Ankara City Hospital Ankara Turkey., Butala NM; Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Division of Cardiovascular Medicine Beth Israel Deaconess Medical Center Boston MA USA.; Cardiology Division, Department of Medicine Massachusetts General Hospital, Harvard Medical School Boston MA USA., Curtis JP; Section of Cardiovascular Medicine, Department of Medicine Yale School of Medicine New Haven CT USA., Gao Q; Baim Institute for Clinical Research Boston MA USA., Song Y; Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Division of Cardiovascular Medicine Beth Israel Deaconess Medical Center Boston MA USA., Zheng L; Baim Institute for Clinical Research Boston MA USA., Tamez H; Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Division of Cardiovascular Medicine Beth Israel Deaconess Medical Center Boston MA USA., Shen C; Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Division of Cardiovascular Medicine Beth Israel Deaconess Medical Center Boston MA USA.; Biogen Cambridge MA USA., Secemsky EA; Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Division of Cardiovascular Medicine Beth Israel Deaconess Medical Center Boston MA USA., Yeh RW; Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Division of Cardiovascular Medicine Beth Israel Deaconess Medical Center Boston MA USA.; Baim Institute for Clinical Research Boston MA USA.
المصدر: Journal of the American Heart Association [J Am Heart Assoc] 2023 Jul 18; Vol. 12 (14), pp. e029588. Date of Electronic Publication: 2023 Jul 14.
نوع المنشور: Clinical Trial; Journal Article; Research Support, N.I.H., Extramural
اللغة: English
بيانات الدورية: Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 101580524 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2047-9980 (Electronic) Linking ISSN: 20479980 NLM ISO Abbreviation: J Am Heart Assoc Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Oxford : Wiley-Blackwell
مواضيع طبية MeSH: Frailty*/diagnosis , Frailty*/epidemiology , Percutaneous Coronary Intervention*/adverse effects, Aged ; Child, Preschool ; Humans ; Aspirin/therapeutic use ; Drug Therapy, Combination ; Hemorrhage/chemically induced ; Hemorrhage/epidemiology ; Medicare ; Platelet Aggregation Inhibitors/adverse effects ; Treatment Outcome ; United States/epidemiology
مستخلص: Background Frailty is rarely assessed in clinical trials of patients who receive dual antiplatelet therapy (DAPT) after percutaneous coronary intervention. This study investigated whether frailty defined using claims data is associated with outcomes following percutaneous coronary intervention, and if there is a differential association in patients receiving standard versus extended duration DAPT. Methods and Results Patients ≥65 years of age in the DAPT (Dual Antiplatelet Therapy) Study, a randomized trial comparing 30 versus 12 months of DAPT following percutaneous coronary intervention, had data linked to Medicare claims (n=1326), and a previously validated claims-based index was used to define frailty. Net adverse clinical events, a composite of all-cause mortality, myocardial infarction, stroke, and major bleeding, were compared between frail and nonfrail patients. Patients defined as frail using claims data (12.0% of the cohort) had higher incidence of net adverse clinical events (23.1%) compared with nonfrail patients (10.7%; P <0.001) at 18-month follow-up and increased risk after multivariable adjustment (adjusted hazard ratio [HR], 2.24 [95% CI, 1.38-3.63]). There were no differences in effects of extended duration DAPT on net adverse clinical events for frail (HR, 1.42 [95% CI, 0.73-2.75]) and nonfrail patients (HR, 1.18 [95% CI, 0.83-1.68]; interaction P =0.61), although analyses were underpowered. Bleeding was highest among frail patients who received extended duration DAPT. Conclusions Among older patients in the DAPT Study, claims-defined frailty was associated with higher net adverse clinical events. Effects of extended duration DAPT were not different for frail patients, although comparisons were underpowered. Further investigation of how frailty influences ischemic and bleeding risks with DAPT are warranted. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT00977938.
References: JAMA Cardiol. 2019 Nov 1;4(11):1084-1091. (PMID: 31553402)
J Am Coll Cardiol. 2022 Feb 8;79(5):482-503. (PMID: 35115105)
Circulation. 2022 Jan 11;145(2):97-106. (PMID: 34743530)
J Gerontol A Biol Sci Med Sci. 2019 Jul 12;74(8):1271-1276. (PMID: 30165612)
Eur Heart J Acute Cardiovasc Care. 2018 Mar;7(2):166-175. (PMID: 29064267)
J Am Med Dir Assoc. 2017 Dec 1;18(12):1097.e1-1097.e10. (PMID: 29079033)
Nat Rev Cardiol. 2011 Feb;8(2):79-90. (PMID: 21139558)
J Gerontol A Biol Sci Med Sci. 2018 Jun 14;73(7):980-987. (PMID: 29244057)
Int J Cardiol. 2016 Nov 1;222:590-593. (PMID: 27513656)
J Am Heart Assoc. 2021 Oct 5;10(19):e022150. (PMID: 34585597)
J Geriatr Cardiol. 2020 May;17(5):270-278. (PMID: 32547610)
JAMA. 2009 Aug 19;302(7):767-73. (PMID: 19690309)
J Geriatr Oncol. 2013 Jan;4(1):26-31. (PMID: 24071489)
Circulation. 2010 Jun 15;121(23):2575-83. (PMID: 20516378)
Can J Cardiol. 2018 Dec;34(12):1648-1654. (PMID: 30527154)
Eur Heart J Qual Care Clin Outcomes. 2021 Mar 15;7(2):189-197. (PMID: 32142106)
J Am Coll Cardiol. 2010 Jun 8;55(23):2556-66. (PMID: 20513595)
J Am Coll Cardiol. 2010 Mar 16;55(11):1080-90. (PMID: 20096533)
Circ Cardiovasc Qual Outcomes. 2012 Jan;5(1):134-40. (PMID: 22253370)
CMAJ. 2005 Aug 30;173(5):489-95. (PMID: 16129869)
Health Serv Res. 2002 Aug;37(4):849-84. (PMID: 12236388)
Circ Cardiovasc Qual Outcomes. 2021 Dec;14(12):e008566. (PMID: 34779656)
J Am Coll Cardiol. 2015 Sep 1;66(9):1036-45. (PMID: 26314532)
N Engl J Med. 2013 Oct 24;369(17):1587-97. (PMID: 23991656)
JACC Cardiovasc Interv. 2018 Mar 12;11(5):435-443. (PMID: 29454730)
Arch Intern Med. 2002 Nov 11;162(20):2333-41. (PMID: 12418947)
N Engl J Med. 1993 Sep 2;329(10):673-82. (PMID: 8204123)
JACC Cardiovasc Interv. 2018 Nov 26;11(22):2287-2296. (PMID: 30466828)
Circulation. 2011 Nov 29;124(22):2397-404. (PMID: 22064593)
Minerva Cardiol Angiol. 2022 Dec 07;:. (PMID: 36475546)
Am Heart J. 2019 Jun;212:64-71. (PMID: 30953936)
Clin Trials. 2019 Aug;16(4):419-430. (PMID: 31081367)
Circ Cardiovasc Qual Outcomes. 2018 Oct;11(10):e005048. (PMID: 30354574)
J Am Coll Cardiol. 2014 Mar 4;63(8):747-62. (PMID: 24291279)
J Am Heart Assoc. 2018 Sep 18;7(18):e009859. (PMID: 30371219)
J Am Coll Cardiol. 2013 May 14;61(19):1964-72. (PMID: 23500222)
J Gerontol A Biol Sci Med Sci. 2007 Jul;62(7):731-7. (PMID: 17634320)
Circulation. 2020 Jul 21;142(3):203-213. (PMID: 32436390)
Circulation. 2018 Mar 20;137(12):e67-e492. (PMID: 29386200)
Med Care. 2017 Jul;55(7):716-722. (PMID: 28437320)
Circ Cardiovasc Qual Outcomes. 2021 Jan;14(1):e006589. (PMID: 33435731)
J Gerontol A Biol Sci Med Sci. 2001 Mar;56(3):M146-56. (PMID: 11253156)
J Am Coll Cardiol. 2014 Oct 14;64(15):1615-28. (PMID: 25301467)
N Engl J Med. 2014 Dec 4;371(23):2155-66. (PMID: 25399658)
JAMA. 2012 Jul 18;308(3):257-64. (PMID: 22797643)
Eur Heart J. 2019 Jul 14;40(27):2231-2239. (PMID: 30977798)
Gerontology. 2018;64(5):422-429. (PMID: 29860244)
Am J Epidemiol. 2017 Sep 15;186(6):745-747. (PMID: 28938711)
Circ Cardiovasc Qual Outcomes. 2011 Sep;4(5):496-502. (PMID: 21878670)
Med Care. 2020 Sep;58(9):815-825. (PMID: 32520767)
JAMA. 2005 Mar 16;293(11):1329-37. (PMID: 15769966)
JACC Cardiovasc Interv. 2020 Aug 10;13(15):1786-1788. (PMID: 32682675)
JAMA. 2016 Apr 26;315(16):1735-49. (PMID: 27022822)
Lancet. 2018 May 5;391(10132):1775-1782. (PMID: 29706364)
Circulation. 2020 Jul 21;142(3):306-308. (PMID: 32687440)
JACC Cardiovasc Interv. 2020 Aug 10;13(15):1777-1785. (PMID: 32682677)
معلومات مُعتمدة: UL1 TR001863 United States TR NCATS NIH HHS; K23 HL161424 United States HL NHLBI NIH HHS; K23 HL150290 United States HL NHLBI NIH HHS; K23 HL144907 United States HL NHLBI NIH HHS; R01 HL136708 United States HL NHLBI NIH HHS
فهرسة مساهمة: Keywords: administrative claims; bleeding; clinical trial; frailty; myocardial infarction; stroke
سلسلة جزيئية: ClinicalTrials.gov NCT00977938
المشرفين على المادة: R16CO5Y76E (Aspirin)
0 (Platelet Aggregation Inhibitors)
تواريخ الأحداث: Date Created: 20230714 Date Completed: 20230725 Latest Revision: 20240725
رمز التحديث: 20240726
مُعرف محوري في PubMed: PMC10382113
DOI: 10.1161/JAHA.123.029588
PMID: 37449567
قاعدة البيانات: MEDLINE
الوصف
تدمد:2047-9980
DOI:10.1161/JAHA.123.029588