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Impact of the antiplatelet strategy following patent foramen ovale percutaneous closure.
Guedeney, Paul; Farjat-Pasos, Julio I; Asslo, Gabriel; Roule, Vincent; Beygui, Farzin; Hermida, Alexis; Gabrion, Paul; Leborgne, Laurent; Houde, Christine; Huang, Florent; Lattuca, Benoit; Leclercq, Florence; Mesnier, Jules; Abtan, Jérémie; Rouanet, Stéphanie; Hammoudi, Nadjib; Collet, Jean-Philippe; Zeitouni, Michel; Silvain, Johanne; Montalescot, Gilles; Rodés-Cabau, Josep.
Afiliación
  • Guedeney P; Sorbonne Université, ACTION Study Group, INSERM UMRS_1166 Institut de cardiologie (AP-HP), Paris, France.
  • Farjat-Pasos JI; Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada.
  • Asslo G; Sorbonne Université, ACTION Study Group, INSERM UMRS_1166 Institut de cardiologie (AP-HP), Paris, France.
  • Roule V; Service de Cardiologie, ACTION Study Group, Centre Hospitalier Universitaire (CHU) de Caen Normandie, Normandie Univ, INSERM UMRS 1237, GIP Cyceron, Caen, France.
  • Beygui F; Service de Cardiologie, ACTION Study Group, Centre Hospitalier Universitaire (CHU) de Caen Normandie, Normandie Univ, INSERM UMRS 1237, GIP Cyceron, Caen, France.
  • Hermida A; Cardiac Arrhythmia Service, Amiens-Picardie University Hospital, Amiens, France.
  • Gabrion P; Cardiac Arrhythmia Service, Amiens-Picardie University Hospital, Amiens, France.
  • Leborgne L; Cardiac Arrhythmia Service, Amiens-Picardie University Hospital, Amiens, France.
  • Houde C; Centre Hospitalier Universitaire de Québec, Quebec City, Quebec, Canada.
  • Huang F; Service de Cardiologie, Hôpital Foch, Suresnes, France.
  • Lattuca B; ACTION Study Group, Cardiology Department, Nîmes University Hospital, Montpellier University, Nîmes, France.
  • Leclercq F; Department of Cardiology, Arnaud de Villeneuve University Hospital, Montpellier, France.
  • Mesnier J; Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada.
  • Abtan J; FACT (French Alliance for Cardiovascular Clinical Trials), Université de Paris, INSERM U-1148, Hôpital Bichat (Assistance Publique-Hôpitaux de Paris), Paris, France.
  • Rouanet S; FACT (French Alliance for Cardiovascular Clinical Trials), Université de Paris, INSERM U-1148, Hôpital Bichat (Assistance Publique-Hôpitaux de Paris), Paris, France.
  • Hammoudi N; Statistician Unit, StatEthic, ACTION Study Group, Levallois-Perret, France.
  • Collet JP; Sorbonne Université, ACTION Study Group, INSERM UMRS_1166 Institut de cardiologie (AP-HP), Paris, France.
  • Zeitouni M; Sorbonne Université, ACTION Study Group, INSERM UMRS_1166 Institut de cardiologie (AP-HP), Paris, France.
  • Silvain J; Sorbonne Université, ACTION Study Group, INSERM UMRS_1166 Institut de cardiologie (AP-HP), Paris, France.
  • Montalescot G; Sorbonne Université, ACTION Study Group, INSERM UMRS_1166 Institut de cardiologie (AP-HP), Paris, France.
  • Rodés-Cabau J; Sorbonne Université, ACTION Study Group, INSERM UMRS_1166 Institut de cardiologie (AP-HP), Paris, France.
Eur Heart J Cardiovasc Pharmacother ; 9(7): 601-607, 2023 11 02.
Article en En | MEDLINE | ID: mdl-36963773
AIMS: Temporary dual antiplatelet therapy (DAPT) is recommended following patent foramen ovale (PFO) percutaneous closure although its benefit, compared to single antiplatelet therapy (SAPT), has not been demonstrated in this setting. We aimed at assessing outcomes following PFO closure according to the antiplatelet strategy at discharge. METHODS AND RESULTS: The ambispective AIR-FORCE cohort included consecutive patients from seven centres in France and Canada undergoing PFO closure and discharged without anticoagulation. Patients treated in French and Canadian centres were mostly discharged with DAPT and SAPT, respectively. The primary endpoint was the composite of death, stroke, transient ischaemic attack, peripheral embolism, myocardial infarction, or BARC type ≥2 bleeding with up to 5 years of follow-up. The impact of the antiplatelet strategy on outcomes was evaluated with a marginal Cox model (cluster analyses per country) with inverse probability weighting according to propensity score. A total of 1532 patients (42.2% female, median age: 49 [40-57] years) were included from 2001 to 2022, of whom 599 (39.1%) were discharged with SAPT and 933 (60.9%) with DAPT, for ≤3 months in 894/923 (96.9%) cases. After a median follow-up of 2.4 [1.1-4.4] years, a total of 58 events were observed. In the weighted analysis, the rate of the primary endpoint up to 5 years was 7.8% in the SAPT strategy and 7.3% in the DAPT strategy (weighted hazard ratio 1.04, 95% confidence interval 0.59-1.83). CONCLUSION: The antiplatelet strategy following PFO closure did not seem to impact clinical outcomes, thus challenging the current recommendations of temporary DAPT.
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Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Inhibidores de Agregación Plaquetaria / Foramen Oval Permeable Tipo de estudio: Guideline / Prognostic_studies Límite: Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Eur Heart J Cardiovasc Pharmacother Año: 2023 Tipo del documento: Article País de afiliación: Francia

Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Inhibidores de Agregación Plaquetaria / Foramen Oval Permeable Tipo de estudio: Guideline / Prognostic_studies Límite: Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Eur Heart J Cardiovasc Pharmacother Año: 2023 Tipo del documento: Article País de afiliación: Francia