Moreover, in this subset of patients with multivessel disease, ticagrelor was associated with significant reductions in event rates. For the composite primary endpoint of MACE (cardiovascular death, MI, and stroke) that difference was 9.37% versus 8.57% (adjusted HR 1.24 95% CI 1.03-1.50) and for coronary events it was 7.67% versus 5.34% (adjusted HR 1.49 95% CI 1.19-1.87). That benefit was seen at the expense of more major bleeding.įor this prespecified analysis of the trial, published in the February 6, 2018, issue of the Journal of the American College of Cardiology, Bonaca along with Sameer Bansilal, MD, MS (Icahn School of Medicine at Mount Sinai, New York), and colleagues found that risk of ischemic events was significantly higher among patients with multivessel disease (59.4% of the cohort) than among those without. The original PEGASUS-TIMI 54 trial demonstrated that in patients who are stable 1 year post-MI, adding ticagrelor (Brilinta AstraZeneca) to aspirin reduces their 3-year risk of cardiovascular death, MI, or stroke. “Most clinicians know that just simply knowing when a patient has their MI if they've had multivessel disease can be an important in terms of determining the optimal intensity and duration of. “We know that atherosclerosis is a systemic disease, and one important observation from this paper is that patients with multivessel disease, even if they've been stented, are still at very high risk,” Bonaca continued. Indeed, he told TCTMD, “it was interesting to characterize how high” the risk for patients with multivessel disease actually was. While that observation may be “intuitive,” study author Marc Bonaca, MD, MPH (Brigham and Women’s Hospital, Boston, MA), acknowledged, understanding the magnitude of risk is important. The presence of multivessel disease should prompt clinicians to consider longer-term ticagrelor in their post-MI patients, a new subanalysis of the PEGASUS-TIMI 54 trial suggests.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |