1. Impact of established cardiovascular disease on outcomes in the randomized global leaders trial
- Author
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Yoshinobu Onuma, Stephan Windecker, Marco Valgimigli, Stephen P. Hoole, Keith G. Oldroyd, Rodney H. Stables, Philippe Gabriel Steg, Neville Kukreja, Chun-Chin Chang, Richard Anderson, Ply Chichareon, Gavin Galasko, Kuniaki Takahashi, Patrick W. Serruys, Mariusz Tomaniak, Norihiro Kogame, Scot Garg, Farzin Fath-Ordoubadi, Azfar Zaman, Rodrigo Modolo, Christian W. Hamm, Peter Jüni, Saqib Chowdhary, University of Zurich, Serruys, Patrick W, Graduate School, ACS - Atherosclerosis & ischemic syndromes, ACS - Microcirculation, ACS - Heart failure & arrhythmias, and Cardiology
- Subjects
Male ,Ticagrelor ,Time Factors ,medicine.medical_treatment ,Myocardial Ischemia ,030204 cardiovascular system & hematology ,antiplatelet ,poly-vascular disease ,Coronary artery disease ,0302 clinical medicine ,cardiovascular disease ,Recurrence ,Clinical endpoint ,030212 general & internal medicine ,Myocardial infarction ,Prospective Studies ,610 Medicine & health ,Aspirin ,Dual Anti-Platelet Therapy ,Hazard ratio ,Drug-Eluting Stents ,General Medicine ,Middle Aged ,Treatment Outcome ,Female ,Cardiology and Cardiovascular Medicine ,coronary artery disease ,medicine.drug ,medicine.medical_specialty ,Risk Assessment ,11171 Cardiocentro Ticino ,2705 Cardiology and Cardiovascular Medicine ,Drug Administration Schedule ,03 medical and health sciences ,Percutaneous Coronary Intervention ,SDG 3 - Good Health and Well-being ,Internal medicine ,medicine ,2741 Radiology, Nuclear Medicine and Imaging ,Humans ,Radiology, Nuclear Medicine and imaging ,Aged ,Sirolimus ,business.industry ,Percutaneous coronary intervention ,medicine.disease ,Heart Disease Risk Factors ,Conventional PCI ,Purinergic P2Y Receptor Antagonists ,business ,Platelet Aggregation Inhibitors - Abstract
Objective: To investigate the impact of different anti-platelet strategies on outcomes after percutaneous coronary intervention (PCI) in patients with established cardiovascular disease (CVD). Methods: GLOBAL LEADERS was a randomized, superiority, all-comers trial comparing one-month dual anti-platelet therapy (DAPT) with ticagrelor and aspirin followed by 23-month ticagrelor monotherapy (experimental treatment) with standard 12-month DAPT followed by 12-month aspirin monotherapy (reference treatment) in patients treated with a biolimus A9-eluting stent. Established CVD was defined as ≥1 prior myocardial infarction, PCI, coronary artery bypass operation, stroke, or established peripheral vascular disease. The primary endpoint was a composite of all-cause death or new Q-wave MI at 2-years. The secondary safety endpoint was BARC 3 or 5 bleeding. Exploratory secondary endpoints were the patient-orientated composite endpoint and net adverse clinical events. Results: Among the 15,761 patients in this cohort were 6,693 patients (42.5%) with established CVD. Compared to those without established CVD, these patients had significantly higher rates of the primary (5.1 vs. 3.3%, HR1.59[1.36–1.86], p
- Published
- 2019