Biolimus-A9 polymer-free coated stent in high bleeding risk patients with acute coronary syndrome: a Leaders Free ACS sub-study
Eur. heart j
; 38(13): 961-969, 2017. tab, graf
Artigo
em Inglês
| Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP
| ID: biblio-1062641
Biblioteca responsável:
BR79.1
Localização: BR79.1
ABSTRACT
Aims Although a true clinical challenge, high bleeding risk patients with an acute coronary syndrome (ACS) undergoing per cutaneous coronary intervention (PCI) have never been specifically studied. Leaders Free ACS, a pre-specified Leaders Free sub-study, determined efficacy, and safety of a combination of 1-month dual anti-platelet therapy (DAPT) with im plantation of either a polymer-free Biolimus-A9-coated stent (BA9-DCS) or a bare-metal stent (BMS) in these patients. Methods and results Leaders Free included 2466 patients undergoing PCI who had at least 1 of 13 pre-defined factors for an increased bleed ing risk. Of these, 659 ACS patients were included in this analysis (BA9-DCS 330, BMS 329). At 12-month follow-up, treatment with the BA9-DCS was more effective (clinically driven target-lesion revascularization 3.9 vs. 9.0%, P » 0.009) and safer (cumulative incidence of cardiac death, myocardial infarction, or definite or probable stent thrombosis 9.3 vs. 18.5%, P » 0.001), driven by significantly lower rates of cardiac mortality (3.4 vs. 6.9%, P » 0.049) and myocardial infarction (6.9 vs. 13.8%, P » 0.005). Conclusion We believe that the results of this sub-analysis from the Leaders Free trial are likely to significantly impact clinical practice for high bleeding risk patients presenting with an ACS the use of a BMS can, in our view, no longer be recommended, and, given the paucity of available data for second-generation DES with shortened DAPT in these patients, the BA9- DCS should currently be considered as the device with the strongest evidence to support its use for this indication.
Texto completo:
Disponível
Coleções:
Bases de dados nacionais
/
Brasil
Base de dados:
Sec. Est. Saúde SP
/
SESSP-IDPCPROD
Assunto principal:
Síndrome Coronariana Aguda
/
Intervenção Coronária Percutânea
Tipo de estudo:
Estudo de etiologia
/
Fatores de risco
Idioma:
Inglês
Revista:
Eur. heart j
Ano de publicação:
2017
Tipo de documento:
Artigo
Instituição/País de afiliação:
Biosensors Europe/CH
/
Cardiovascular European Research Center (CERC)/FR
/
Centro Cardiologico Monzino/IT
/
Contilia Heart and Vascular Centre/DE
/
Department of Cardiovascular Medicine/BE
/
Hospital Universitario Virgen de la Arrixaca/ES
/
Hôspital de la Tour/CH
/
Instituto Dante Pazzanese de Cardiologia/BR
/
London School of Hygiene and Tropical Medicine/US
/
Tan Tock Seng Hospital/SG