Ischaemic risk and efficacy of ticagrelor in relation to time from P2Y12 inhibitor withdrawal in patients with prior myocardial infarction: insights from PEGASUS-TIMI 54.
Identifieur interne : 002060 ( PubMed/Curation ); précédent : 002059; suivant : 002061Ischaemic risk and efficacy of ticagrelor in relation to time from P2Y12 inhibitor withdrawal in patients with prior myocardial infarction: insights from PEGASUS-TIMI 54.
Auteurs : Marc P. Bonaca [Serbie] ; Deepak L. Bhatt [États-Unis] ; P Gabriel Steg [France] ; Robert F. Storey [Royaume-Uni] ; Marc Cohen [États-Unis] ; Kyungah Im [États-Unis] ; Ton Oude Ophuis [Pays-Bas] ; Andrej Budaj [Pologne] ; Shinya Goto [Japon] ; José L Pez-Send N [Espagne] ; Rafael Diaz [Argentine] ; Anthony Dalby [Afrique du Sud] ; Frans Van De Werf [Belgique] ; Diego Ardissino [Italie] ; Gilles Montalescot [France] ; Philip Aylward [Australie] ; Giulia Magnani [États-Unis] ; Eva C. Jensen [Suède] ; Peter Held [Suède] ; Eugene Braunwald [États-Unis] ; Marc S. Sabatine [États-Unis]Source :
- European heart journal [ 1522-9645 ] ; 2016.
Descripteurs français
- KwdFr :
- Adulte d'âge moyen, Adénosine (administration et posologie), Adénosine (analogues et dérivés), Adénosine (effets indésirables), Antagonistes des récepteurs purinergiques P2Y (administration et posologie), Antagonistes des récepteurs purinergiques P2Y (effets indésirables), Calendrier d'administration des médicaments, Facteurs de risque, Femelle, Humains, Hémorragie (), Infarctus du myocarde (mortalité), Infarctus du myocarde (traitement médicamenteux), Ischémie myocardique (), Ischémie myocardique (mortalité), Mâle, Prévention secondaire, Résultat thérapeutique, Sujet âgé.
- MESH :
- administration et posologie : Adénosine, Antagonistes des récepteurs purinergiques P2Y.
- analogues et dérivés : Adénosine.
- effets indésirables : Adénosine, Antagonistes des récepteurs purinergiques P2Y.
- mortalité : Infarctus du myocarde, Ischémie myocardique.
- traitement médicamenteux : Infarctus du myocarde.
- Adulte d'âge moyen, Calendrier d'administration des médicaments, Facteurs de risque, Femelle, Humains, Hémorragie, Ischémie myocardique, Mâle, Prévention secondaire, Résultat thérapeutique, Sujet âgé.
English descriptors
- KwdEn :
- Adenosine (administration & dosage), Adenosine (adverse effects), Adenosine (analogs & derivatives), Aged, Drug Administration Schedule, Female, Hemorrhage (chemically induced), Humans, Male, Middle Aged, Myocardial Infarction (drug therapy), Myocardial Infarction (mortality), Myocardial Ischemia (mortality), Myocardial Ischemia (prevention & control), Purinergic P2Y Receptor Antagonists (administration & dosage), Purinergic P2Y Receptor Antagonists (adverse effects), Risk Factors, Secondary Prevention, Treatment Outcome.
- MESH :
- chemical , administration & dosage : Adenosine, Purinergic P2Y Receptor Antagonists.
- chemical , adverse effects : Adenosine, Purinergic P2Y Receptor Antagonists.
- chemical , analogs & derivatives : Adenosine.
- chemically induced : Hemorrhage.
- drug therapy : Myocardial Infarction.
- mortality : Myocardial Infarction, Myocardial Ischemia.
- prevention & control : Myocardial Ischemia.
- Aged, Drug Administration Schedule, Female, Humans, Male, Middle Aged, Risk Factors, Secondary Prevention, Treatment Outcome.
Abstract
Ticagrelor reduced major adverse cardiovascular event (MACE) by 15-16% in patients with prior myocardial infarction (MI) in PEGASUS-TIMI 54. We hypothesized that patients who recently discontinued P2Y12 inhibition, even years after MI, may be at particular risk of MACE and may derive particular benefit from continuation or reinitiation of therapy.
DOI: 10.1093/eurheartj/ehv531
PubMed: 26491109
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pubmed:26491109Le document en format XML
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</affiliation>
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<author><name sortKey="Storey, Robert F" sort="Storey, Robert F" uniqKey="Storey R" first="Robert F" last="Storey">Robert F. Storey</name>
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<country xml:lang="fr">Royaume-Uni</country>
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</affiliation>
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<author><name sortKey="Cohen, Marc" sort="Cohen, Marc" uniqKey="Cohen M" first="Marc" last="Cohen">Marc Cohen</name>
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<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Cardiovascular Division, Newark Beth Israel Medical Center, Mount Sinai School of Medicine, New York</wicri:regionArea>
</affiliation>
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<author><name sortKey="Im, Kyungah" sort="Im, Kyungah" uniqKey="Im K" first="Kyungah" last="Im">Kyungah Im</name>
<affiliation wicri:level="1"><nlm:affiliation>TIMI Study Group, Brigham and Women's Hospital, Heart & Vascular Center, 75 Francis Street, Boston, MA 02115, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>TIMI Study Group, Brigham and Women's Hospital, Heart & Vascular Center, 75 Francis Street, Boston, MA 02115</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Oude Ophuis, Ton" sort="Oude Ophuis, Ton" uniqKey="Oude Ophuis T" first="Ton" last="Oude Ophuis">Ton Oude Ophuis</name>
<affiliation wicri:level="1"><nlm:affiliation>CWZ Hospital, Nijmegen, The Netherlands.</nlm:affiliation>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>CWZ Hospital, Nijmegen</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Budaj, Andrej" sort="Budaj, Andrej" uniqKey="Budaj A" first="Andrej" last="Budaj">Andrej Budaj</name>
<affiliation wicri:level="1"><nlm:affiliation>Postgraduate Medical School, Grochowski Hospital, Warsaw, Poland.</nlm:affiliation>
<country xml:lang="fr">Pologne</country>
<wicri:regionArea>Postgraduate Medical School, Grochowski Hospital, Warsaw</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Goto, Shinya" sort="Goto, Shinya" uniqKey="Goto S" first="Shinya" last="Goto">Shinya Goto</name>
<affiliation wicri:level="1"><nlm:affiliation>Tokai University School of Medicine, Institute of Medical Science, Tokyo, Japan.</nlm:affiliation>
<country xml:lang="fr">Japon</country>
<wicri:regionArea>Tokai University School of Medicine, Institute of Medical Science, Tokyo</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="L Pez Send N, Jose" sort="L Pez Send N, Jose" uniqKey="L Pez Send N J" first="José" last="L Pez-Send N">José L Pez-Send N</name>
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<country xml:lang="fr">Espagne</country>
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</affiliation>
</author>
<author><name sortKey="Diaz, Rafael" sort="Diaz, Rafael" uniqKey="Diaz R" first="Rafael" last="Diaz">Rafael Diaz</name>
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<country xml:lang="fr">Argentine</country>
<wicri:regionArea>ECLA (Estudios Clínicos Latino América), Rosario</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Dalby, Anthony" sort="Dalby, Anthony" uniqKey="Dalby A" first="Anthony" last="Dalby">Anthony Dalby</name>
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<country xml:lang="fr">Afrique du Sud</country>
<wicri:regionArea>Milpark Hospital, Johannesburg</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Van De Werf, Frans" sort="Van De Werf, Frans" uniqKey="Van De Werf F" first="Frans" last="Van De Werf">Frans Van De Werf</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium.</nlm:affiliation>
<country xml:lang="fr">Belgique</country>
<wicri:regionArea>Department of Cardiovascular Sciences, University of Leuven, Leuven</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Ardissino, Diego" sort="Ardissino, Diego" uniqKey="Ardissino D" first="Diego" last="Ardissino">Diego Ardissino</name>
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<country xml:lang="fr">Italie</country>
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</affiliation>
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<author><name sortKey="Montalescot, Gilles" sort="Montalescot, Gilles" uniqKey="Montalescot G" first="Gilles" last="Montalescot">Gilles Montalescot</name>
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<country xml:lang="fr">France</country>
<wicri:regionArea>Institut de Cardiologie, Pitié-Salpêtrière Hospital, 47 boul de l'Hôpital, Paris</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Aylward, Philip" sort="Aylward, Philip" uniqKey="Aylward P" first="Philip" last="Aylward">Philip Aylward</name>
<affiliation wicri:level="1"><nlm:affiliation>Division of Medicine, Cardiac & Critical Care Services, Flinders Medical Centre, Adelaide, South Australia, Australia.</nlm:affiliation>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>Division of Medicine, Cardiac & Critical Care Services, Flinders Medical Centre, Adelaide, South Australia</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Magnani, Giulia" sort="Magnani, Giulia" uniqKey="Magnani G" first="Giulia" last="Magnani">Giulia Magnani</name>
<affiliation wicri:level="1"><nlm:affiliation>TIMI Study Group, Brigham and Women's Hospital, Heart & Vascular Center, 75 Francis Street, Boston, MA 02115, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>TIMI Study Group, Brigham and Women's Hospital, Heart & Vascular Center, 75 Francis Street, Boston, MA 02115</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Jensen, Eva C" sort="Jensen, Eva C" uniqKey="Jensen E" first="Eva C" last="Jensen">Eva C. Jensen</name>
<affiliation wicri:level="1"><nlm:affiliation>AstraZenecaAZ R&D, Molndal, Sweden.</nlm:affiliation>
<country xml:lang="fr">Suède</country>
<wicri:regionArea>AstraZenecaAZ R&D, Molndal</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Held, Peter" sort="Held, Peter" uniqKey="Held P" first="Peter" last="Held">Peter Held</name>
<affiliation wicri:level="1"><nlm:affiliation>AstraZenecaAZ R&D, Molndal, Sweden.</nlm:affiliation>
<country xml:lang="fr">Suède</country>
<wicri:regionArea>AstraZenecaAZ R&D, Molndal</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Braunwald, Eugene" sort="Braunwald, Eugene" uniqKey="Braunwald E" first="Eugene" last="Braunwald">Eugene Braunwald</name>
<affiliation wicri:level="1"><nlm:affiliation>TIMI Study Group, Brigham and Women's Hospital, Heart & Vascular Center, 75 Francis Street, Boston, MA 02115, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>TIMI Study Group, Brigham and Women's Hospital, Heart & Vascular Center, 75 Francis Street, Boston, MA 02115</wicri:regionArea>
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<front><div type="abstract" xml:lang="en">Ticagrelor reduced major adverse cardiovascular event (MACE) by 15-16% in patients with prior myocardial infarction (MI) in PEGASUS-TIMI 54. We hypothesized that patients who recently discontinued P2Y12 inhibition, even years after MI, may be at particular risk of MACE and may derive particular benefit from continuation or reinitiation of therapy.</div>
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<Month>04</Month>
<Day>08</Day>
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<DateCompleted><Year>2017</Year>
<Month>01</Month>
<Day>17</Day>
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<DateRevised><Year>2017</Year>
<Month>01</Month>
<Day>17</Day>
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<Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1522-9645</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>37</Volume>
<Issue>14</Issue>
<PubDate><Year>2016</Year>
<Month>Apr</Month>
<Day>07</Day>
</PubDate>
</JournalIssue>
<Title>European heart journal</Title>
<ISOAbbreviation>Eur. Heart J.</ISOAbbreviation>
</Journal>
<ArticleTitle>Ischaemic risk and efficacy of ticagrelor in relation to time from P2Y12 inhibitor withdrawal in patients with prior myocardial infarction: insights from PEGASUS-TIMI 54.</ArticleTitle>
<Pagination><MedlinePgn>1133-42</MedlinePgn>
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<ELocationID EIdType="doi" ValidYN="Y">10.1093/eurheartj/ehv531</ELocationID>
<Abstract><AbstractText Label="AIMS" NlmCategory="OBJECTIVE">Ticagrelor reduced major adverse cardiovascular event (MACE) by 15-16% in patients with prior myocardial infarction (MI) in PEGASUS-TIMI 54. We hypothesized that patients who recently discontinued P2Y12 inhibition, even years after MI, may be at particular risk of MACE and may derive particular benefit from continuation or reinitiation of therapy.</AbstractText>
<AbstractText Label="METHODS AND RESULTS" NlmCategory="RESULTS">Patients in PEGASUS-TIMI 54 were categorized by time from last P2Y12 inhibitor (days: ≤30, >30-360, >360). The risk of MACE and the efficacy of ticagrelor were compared across categories. In the placebo arm, patients who more recently stopped P2Y12 inhibitor therapy had a greater number of risk factors but still had a higher risk of MACE after multivariable adjustment [≤30 days, hazard ratio (HR)adj 1.47, 95% confidence interval (CI) 1.12-1.93, P = 0.0051; 30 days-1 year, HRadj 1.28, 95% CI 0.98-1.67, P = 0.073] compared with those who stopped >1 year prior (P-trend = 0.0097). The benefit of ticagrelor depended on the time from last dose, with HRs (95% CI) for ticagrelor (pooled doses) vs. placebo of 0.73 (0.61-0.87), 0.86 (0.71-1.04), and 1.01 (0.80-1.27), respectively, by category (P-trend for interaction < 0.001). The benefit in those ≤30 days of stopping was similar regardless of time from MI (<2 years, HR 0.73, 95% CI 0.60-0.89 vs. ≥2 years, HR 0.71, 95% CI 0.50-1.00).</AbstractText>
<AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">The benefit of ticagrelor for long-term secondary prevention in patients with prior MI and at least one additional risk factor appeared more marked in patients continuing on or re-starting after only a brief interruption of P2Y12 inhibition, when compared with patients who had proved themselves stable more than 2 years from their MI and off P2Y12 inhibitor therapy for more than a year. The increase in bleeding events with ticagrelor was similar regardless of this time interval. For clinicians considering a strategy of prolonged P2Y12 inhibitor therapy in high-risk patients, these data suggest greater benefit in the continuation of such therapy without interruption after MI, rather than re-initiating such therapy in patients who have remained stable for an extended period. Future analyses may help to clarify further the profile of post-MI patients most likely to benefit from uninterrupted dual antiplatelet therapy.</AbstractText>
<AbstractText Label="CLINICAL TRIAL REGISTRATION INFORMATION" NlmCategory="BACKGROUND">http://www.clinicaltrials.gov NCT01225562.</AbstractText>
<CopyrightInformation>Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.</CopyrightInformation>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Bonaca</LastName>
<ForeName>Marc P</ForeName>
<Initials>MP</Initials>
<AffiliationInfo><Affiliation>TIMI Study Group, Brigham and Women's Hospital, Heart & Vascular Center, 75 Francis Street, Boston, MA 02115, USA mbonaca@partners.org.</Affiliation>
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<Author ValidYN="Y"><LastName>Bhatt</LastName>
<ForeName>Deepak L</ForeName>
<Initials>DL</Initials>
<AffiliationInfo><Affiliation>TIMI Study Group, Brigham and Women's Hospital, Heart & Vascular Center, 75 Francis Street, Boston, MA 02115, USA.</Affiliation>
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<ForeName>P Gabriel</ForeName>
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<AffiliationInfo><Affiliation>Département de Cardiologie, Hôpital Bichat, Assistance Publique, Paris, France.</Affiliation>
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<Author ValidYN="Y"><LastName>Storey</LastName>
<ForeName>Robert F</ForeName>
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<AffiliationInfo><Affiliation>University of Sheffield, Sheffield, UK.</Affiliation>
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</Author>
<Author ValidYN="Y"><LastName>Cohen</LastName>
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<Initials>M</Initials>
<AffiliationInfo><Affiliation>Cardiovascular Division, Newark Beth Israel Medical Center, Mount Sinai School of Medicine, New York, USA.</Affiliation>
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<ForeName>Kyungah</ForeName>
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<Initials>A</Initials>
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<ForeName>Shinya</ForeName>
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<Initials>F</Initials>
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<ForeName>Diego</ForeName>
<Initials>D</Initials>
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<ForeName>Gilles</ForeName>
<Initials>G</Initials>
<AffiliationInfo><Affiliation>Institut de Cardiologie, Pitié-Salpêtrière Hospital, 47 boul de l'Hôpital, Paris, France.</Affiliation>
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<Initials>P</Initials>
<AffiliationInfo><Affiliation>Division of Medicine, Cardiac & Critical Care Services, Flinders Medical Centre, Adelaide, South Australia, Australia.</Affiliation>
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<Author ValidYN="Y"><LastName>Magnani</LastName>
<ForeName>Giulia</ForeName>
<Initials>G</Initials>
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<ForeName>Eva C</ForeName>
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<AffiliationInfo><Affiliation>TIMI Study Group, Brigham and Women's Hospital, Heart & Vascular Center, 75 Francis Street, Boston, MA 02115, USA.</Affiliation>
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