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Incidencia anual de trombosis del stent confirmadas y factores clínicos predictores en pacientes con SCA tratados con ticagrelor o prasugrel

Published on Apr 1, 2019in Revista Espanola De Cardiologia 5.13
· DOI :10.1016/j.recesp.2018.02.024
Sergio Raposeiras-Roubín13
Estimated H-index: 13
,
Emad Abu Assi16
Estimated H-index: 16
+ 35 AuthorsAndrés Íñiguez-Romo5
Estimated H-index: 5
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Abstract
Resumen Introduccion y objetivos Hay muy poca evidencia sobre las tasas de trombosis del stent (TS) en pacientes que reciben tratamiento antiagregante plaquetario doble (TAPD) con ticagrelor o prasugrel. El objetivo de este estudio es analizar la incidencia y predictores de la TS tras un sindrome coronario agudo en pacientes que reciben TAPD con ticagrelor frente a prasugrel. Metodos Se utilizaron datos del registro RENAMI (REgistry of New Antiplatelet therapy in patients with acute Myocardial Infarction) , y se analizo en total a 4.123 pacientes con sindrome coronario agudo dados de alta con TAPD con ticagrelor o prasugrel en 11 centros de 6 paises europeos. Se considero como evento la TS confirmada en el primer ano. Se realizo un analisis de riesgos competitivos mediante un modelo de regresion de Fine y Gray, siendo la muerte el evento competitivo. Resultados Recibieron TAPD con ticagrelor 2.604 pacientes y con prasugrel, 1.519; 41 pacientes (1,10%) presentaron TS, con incidencias acumuladas similares entre ticagrelor (1,21%) y prasugrel (0,90%). Los predictores independientes de la TS fueron: la edad (sHR = 1,03; IC95%, 1,01-1,06), la elevacion del segmento ST (sHR = 2,24; IC95%, 1,22-4,14), el antecedente de infarto de miocardio (sHR = 2,56; IC95%, 1,19-5,49) y la creatinina serica (sHR = 1,29; IC95%, 1,08-1,54). Conclusiones La TS es infrecuente en pacientes que reciben TAPD con ticagrelor y prasugrel. La edad avanzada, la elevacion del segmento ST, el antecedente de infarto y la creatinina serica son las variables que se asocian con mayor riesgo de TS.
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References39
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Published on Dec 1, 2017in Revista Espanola De Cardiologia 5.13
Javier Cuesta15
Estimated H-index: 15
,
Fernando Rivero12
Estimated H-index: 12
+ 6 AuthorsFernando Alfonso63
Estimated H-index: 63
Abstract Introduction and objectives Stent thrombosis (ST) is a rare but potentially serious complication. Optical coherence tomography (OCT) provides high-resolution images and additional information to angiography in the study of this event. Methods Prospective study of patients with ST undergoing reintervention with OCT imaging. Results The study included a total of 40 consecutive patients with ST. Mean age was 69 ± 13 years and 83% were male. Early ST (≤ 30 days) was observed in 16 patients ...
Published on Dec 1, 2017in Revista Espanola De Cardiologia 5.13
Javier Cuesta15
Estimated H-index: 15
,
Fernando Rivero12
Estimated H-index: 12
+ 6 AuthorsFernando Alfonso63
Estimated H-index: 63
Resumen Introduccion y objetivos La trombosis del stent (TS) es una complicacion infrecuente pero potencialmente grave. La tomografia de coherencia optica (OCT) ofrece imagenes de alta resolucion e informacion adicional a la angiografia en el estudio de esta enfermedad. Metodos Estudio prospectivo en el que se incluyo a todos los pacientes con una TS a los que se realizo una OCT durante el procedimiento. Resultados Se incluyo a un total de 40 pacientes con TS consecutivos, con una media de edad ...
Published on Nov 1, 2017in Revista Espanola De Cardiologia 5.13
Manuel Almendro-Delia7
Estimated H-index: 7
,
A García-Alcántara5
Estimated H-index: 5
+ 7 AuthorsJuan C. García-Rubira17
Estimated H-index: 17
Abstract Introduction and objectives The incorporation of the new antiplatelet agents (NAA) prasugrel and ticagrelor into routine clinical practice is irregular and data from the “real world” remain scarce. We aimed to assess the time trend of NAA use and the clinical safety and efficacy of these drugs compared with those of clopidogrel in a contemporary cohort of patients with acute coronary syndromes (ACS). Methods A multicenter retrospective observational study was conducted in patients with ...
Published on Jun 1, 2017in Jacc-cardiovascular Interventions 9.54
Jens Wiebe6
Estimated H-index: 6
(TUM: Technische Universität München),
Petra Hoppmann20
Estimated H-index: 20
(TUM: Technische Universität München)
+ 9 AuthorsKarl-Ludwig Laugwitz42
Estimated H-index: 42
(TUM: Technische Universität München)
Abstract Objectives The aim of this study was to report clinical outcomes in patients treated in routine practice 2 years after everolimus-eluting bioresorbable stent (BRS) implantation. Background Long-term results in patients undergoing BRS implantation in routine clinical practice are sparse, and existing evidence from randomized trials considers mostly selected patients. Methods The ISAR-ABSORB registry enrolled consecutive patients undergoing BRS implantation in routine clinical practice at...
Published on Jun 1, 2017in Stata Journal 1.80
Sarwar Islam Mozumder1
Estimated H-index: 1
(University of Leicester),
Mark J. Rutherford10
Estimated H-index: 10
(University of Leicester),
Paul C. Lambert41
Estimated H-index: 41
(KI: Karolinska Institutet)
In competing-risks analysis, the cause-specific cumulative incidence function (CIF) is usually obtained in a modeling framework by either 1) transform- ing on all cause-specific hazards or 2) transforming by using a direct relationship with the subdistribution hazard function. We expand on current competing-risks methodology from within the flexible parametric survival modeling framework and focus on the second approach. This approach models all cause-specific CIFs si- multaneously and is more u...
Published on May 4, 2017in Current Medical Research and Opinion 2.35
Nikesh Malik1
Estimated H-index: 1
(St George’s University Hospitals NHS Foundation Trust),
Amerjeet Banning5
Estimated H-index: 5
(University of Leicester)
+ 10 AuthorsThierry Lefèvre60
Estimated H-index: 60
AbstractObjective: Stent thrombosis (ST) is a potentially life-threatening complication of percutaneous coronary intervention (PCI). We aimed to develop a scoring system to predict the risk of ST following PCI.Research design and methods: Odds ratios (ORs) for risk factors associated with ST were identified from a meta-analysis based on a systematic literature review, and through consensus expert opinion (Delphi–RAND method). The combined ORs were used to calculate risk scores for acute (within ...
Published on Jan 1, 2017in The Cardiology 1.56
Junhua Ge3
Estimated H-index: 3
,
Haichu Yu2
Estimated H-index: 2
,
Jian Li3
Estimated H-index: 3
Acute stent thrombosis (AST) is a rare but life-threatening complication of coronary artery stenting. AST remains a challenging task for cardiologists, despite the application of modern procedural tec
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