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Bleeding and Ischemic Outcomes With Ticagrelor Monotherapy According to Body Mass Index.
Kunadian, Vijay; Baber, Usman; Pivato, Carlo A; Cao, Davide; Dangas, George; Sartori, Samantha; Zhang, Zhongjie; Angiolillo, Dominick J; Briguori, Carlo; Cohen, David J; Collier, Timothy; Dudek, Dariusz; Gibson, Michael; Gil, Robert; Huber, Kurt; Kaul, Upendra; Kornowski, Ran; Krucoff, Mitchell W; Dehghani, Payam; Mehta, Shamir; Moliterno, David J; Ohman, E Magnus; Escaned, Javier; Sardella, Gennaro; Sharma, Samin K; Shlofmitz, Richard; Weisz, Giora; Witzenbichler, Bernhard; Dzavík, Vladimír; Gurbel, Paul; Hamm, Christian W; Henry, Timothy; Kastrati, Adnan; Marx, Steven O; Oldroyd, Keith; Steg, P Gabriel; Pocock, Stuart; Mehran, Roxana.
Afiliación
  • Kunadian V; Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University and Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom.
  • Baber U; Department of Cardiology, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
  • Pivato CA; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA; IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
  • Cao D; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy.
  • Dangas G; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Sartori S; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Zhang Z; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Angiolillo DJ; Division of Cardiology, University of Florida College of Medicine, Jacksonville, Florida, USA.
  • Briguori C; Mediterranea Cardiocentro, Naples, Italy.
  • Cohen DJ; Cardiovascular Research Foundation, New York, New York, USA; St. Francis Hospital, Roslyn, Roslyn, New York, USA.
  • Collier T; Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom.
  • Dudek D; Jagiellonian University Medical College, Krakow, Poland.
  • Gibson M; Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
  • Gil R; Center of Postgraduate Medical Education, Central Clinical Hospital of the Ministry of Interior and Administration, Warsaw, Poland.
  • Huber K; 3rd Department Medicine, Cardiology and Intensive Care Medicine, Wilhelminen Hospital, and Sigmund Freud University, Medical Faculty, Vienna, Austria.
  • Kaul U; Batra Hospital and Medical Research Centre, New Delhi, India.
  • Kornowski R; Rabin Medical Center, Petach Tikva, Israel.
  • Krucoff MW; Duke University Medical Center-Duke Clinical Research Institute, Durham, North Carolina, USA.
  • Dehghani P; Prairie Vascular Research, Regina, Saskatchewan, Canada.
  • Mehta S; Hamilton Health Sciences, Hamilton, Ontario, Canada.
  • Moliterno DJ; University of Kentucky, Lexington, Kentucky, USA.
  • Ohman EM; Duke University Medical Center-Duke Clinical Research Institute, Durham, North Carolina, USA.
  • Escaned J; Hospital Clínico San Carlos IDISCC, Complutense University of Madrid, Madrid, Spain.
  • Sardella G; Policlinico Umberto I University, Rome, Italy.
  • Sharma SK; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Shlofmitz R; St. Francis Hospital, Roslyn, Roslyn, New York, USA.
  • Weisz G; NewYork-Presbyterian Hospital, Columbia University Medical Center, New York, New York, USA.
  • Witzenbichler B; Helios Amper-Klinikum, Dachau, Germany.
  • Dzavík V; Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada.
  • Gurbel P; Sinai Hospital of Baltimore System, Baltimore, Maryland, USA.
  • Hamm CW; Kerckhoff Clinic, Bad Nauheim, Germany.
  • Henry T; The Carl and Edyth Lindner Center for Research and Education at the Christ Hospital, Cincinnati, Ohio, USA.
  • Kastrati A; Deutsches Herzzentrum München, Munich, Germany.
  • Marx SO; Columbia University Medical Center, New York, New York, USA.
  • Oldroyd K; The West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Glasgow, United Kingdom.
  • Steg PG; Université de Paris and Assistance Publique-Hôpitaux de Paris, Paris, France.
  • Pocock S; Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom.
  • Mehran R; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA. Electronic address: roxana.mehran@mountsinai.org.
JACC Cardiovasc Interv ; 15(19): 1948-1960, 2022 10 10.
Article en En | MEDLINE | ID: mdl-36202563
BACKGROUND: There is a paucity of data regarding the safety and efficacy of different antiplatelet regimens according to standardized body mass index (BMI) categories. OBJECTIVES: The aim of this study was to investigate bleeding and ischemic outcomes according to BMI in the TWILIGHT (Ticagrelor With Aspirin or Alone in High-Risk Patients After Coronary Intervention) trial. METHODS: The TWILIGHT trial randomized high-risk patients to ticagrelor plus aspirin or ticagrelor plus placebo at 3 months after percutaneous coronary intervention. In this secondary analysis, patients were stratified by standard BMI categories, as recommended by the European Society of Cardiology Working Group on Thrombosis (normal weight [BMI 18.5-24.99 kg/m2], overweight [BMI 25-29.99 kg/m2], and obese [BMI ≥30 kg/m2]) and by median BMI, as prespecified in the protocol. RESULTS: Among 7,038 patients randomized and with available BMI, 1,807 (25.7%) were normal weight, 2,927 (41.6%) were overweight, and 2,304 (32.7%) were obese. In normal-weight, overweight, and obese patients, ticagrelor monotherapy, compared with ticagrelor plus aspirin, reduced the primary endpoint of Bleeding Academic Research Consortium type 2, 3, or 5 bleeding (normal weight: HR: 0.48 [95% CI: 0.32-0.73]; overweight: HR: 0.57 [95% CI: 0.41-0.78]; obese: HR: 0.63 [95% CI: 0.44-0.91]; P for interaction = 0.627), without any increase in the composite ischemic endpoint of all-cause death, myocardial infarction, or stroke (normal weight: HR: 1.36 [95% CI: 0.84-2.19]; overweight: HR: 0.92 [95% CI: 0.63-1.35]; obese: HR: 0.84 [95% CI: 0.56-1.25]; P for interaction = 0.290). These findings were consistent with the prespecified analysis by median BMI. CONCLUSIONS: Among high-risk patients undergoing percutaneous coronary intervention, ticagrelor monotherapy, compared with ticagrelor plus aspirin, reduced bleeding events without any increase in ischemic risk across different BMI categories.
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Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Inhibidores de Agregación Plaquetaria / Intervención Coronaria Percutánea Tipo de estudio: Clinical_trials / Diagnostic_studies Límite: Humans Idioma: En Revista: JACC Cardiovasc Interv Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Reino Unido
Texto completo
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Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Inhibidores de Agregación Plaquetaria / Intervención Coronaria Percutánea Tipo de estudio: Clinical_trials / Diagnostic_studies Límite: Humans Idioma: En Revista: JACC Cardiovasc Interv Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Reino Unido