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Prospective application of a bleeding and ischemic risks-adjusted antithrombotic protocol in elderly patients revascularized with everolimus-eluting stents:EPIC05-Sierra75 study
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作者 Jose M de la Torre Hernandez Ramon Lopez Palop +28 位作者 Jesus M Jimenez Mazuecos Pilar Carrillo Sáez Alejandro Gutierez-Barrios Eduardo Pinar Belen Cid Luis Fernandez Tamara Garcia Camarero Cristóbal Urbano-Carrillo juan F Oteo Dominguez Victor A Jimenez Diaz Antonio EGomez Menchero Eladio Galindo Fernández juan GCórdoba Soriano Raymundo Ocaranza Eduardo ArroyoÚcar Koldobika Garcia San Roman Silvio Leal Ginés Martínez Cáceres Jose A Linares Vicente Georgina Fuertes Ferre Xavier Carrillo juan crama merchán Catia Costa juan Sanchis Renato Fernandes Alberto Rodrigues Jose M Vegas Valle Hélder Pereira Armando Perez de Prado 《Journal of Geriatric Cardiology》 SCIE CAS CSCD 2022年第5期354-366,共13页
OBJECTIVES Elderly patients show a higher incidence of ischemic and bleeding events after percutaneous transluminal coron-ary intervention(PCI).We sought to investigate outcomes in elderly patients treated with antith... OBJECTIVES Elderly patients show a higher incidence of ischemic and bleeding events after percutaneous transluminal coron-ary intervention(PCI).We sought to investigate outcomes in elderly patients treated with antithrombotic strategy guided by bleeding and ischemic risks after revascularization with last generation everolimus-eluting stent(EES).METHODS Prospective multicenter registry including patients over 75 years revascularized with EES and antithrombotic ther-apy guided by clinical presentation,PCI complexity and PRECISE DAPT score.Co-primary safety endpoints were:(1)composite of cardiac death,myocardial infarction and stent thrombosis and;(2)bleeding(BARC 2-5).Primary efficacy endpoint was target lesion revascularization.A matched group of patients revascularized with current drug-eluting stents and no such tailored antith-rombotic therapy was used as control.RESULTS Finally,1064 patients were included in SIERRA-75 cohort,80.8±4.2 years,36.6%women,71%acute coronary syn-dromes(ACS)and 53.6%complex PCI.Co-primary safety endpoint of major adverse cardiovascular events was met in 6.2%,co-primary safety endpoint of bleeding in 7.8%and primary efficacy endpoint of TKLR in 1.5%.The multivariable adjusted model showed no significant association of the prescribed short/long dual antiplatelet therapy(DAPT)durations with any endpoint suggesting a well tailored therapy.No stent thrombosis reported in the subgroup with 1-3 months DAPT duration.As compared to control group,bleeding BARC 2-5 was significantly lower in SIERRA-75 group(7.4%vs.10.2%,P=0.04)as well as the net safety-efficacy endpoint(14.3%vs.18.5%,P=0.02).CONCLUSIONS In elderly population,the application of this risks-adjusted antithrombotic protocol after revascularization with last generation EES seems to be associated with an improved prognosis in terms of ischemic and bleeding outcomes. 展开更多
关键词 patients BLEEDING ANTITHROMBOTIC
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