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Meta-analysis of randomized controlled trials and adjusted observational results of use of clopidogrel, aspirin, and oral anticoagulants in patients undergoing percutaneous coronary intervention

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Harvard

D'Ascenzo, F, Taha, S, Moretti, C, Omedè, P, Grossomarra, W, Persson, J, Lamberts, M, Dewilde, W, Rubboli, A, Fernández, S, Cerrato, E, Meynet, I, Ballocca, F, Barbero, U, Quadri, G, Giordana, F, Conrotto, F, Capodanno, D, DiNicolantonio, J, Bangalore, S, Reed, M, Meier, P, Zoccai, G & Gaita, F 2015, 'Meta-analysis of randomized controlled trials and adjusted observational results of use of clopidogrel, aspirin, and oral anticoagulants in patients undergoing percutaneous coronary intervention', The American journal of cardiology, bind 115, nr. 9, s. 1185-93. https://doi.org/10.1016/j.amjcard.2015.02.003

APA

D'Ascenzo, F., Taha, S., Moretti, C., Omedè, P., Grossomarra, W., Persson, J., Lamberts, M., Dewilde, W., Rubboli, A., Fernández, S., Cerrato, E., Meynet, I., Ballocca, F., Barbero, U., Quadri, G., Giordana, F., Conrotto, F., Capodanno, D., DiNicolantonio, J., ... Gaita, F. (2015). Meta-analysis of randomized controlled trials and adjusted observational results of use of clopidogrel, aspirin, and oral anticoagulants in patients undergoing percutaneous coronary intervention. The American journal of cardiology, 115(9), 1185-93. https://doi.org/10.1016/j.amjcard.2015.02.003

CBE

D'Ascenzo F, Taha S, Moretti C, Omedè P, Grossomarra W, Persson J, Lamberts M, Dewilde W, Rubboli A, Fernández S, Cerrato E, Meynet I, Ballocca F, Barbero U, Quadri G, Giordana F, Conrotto F, Capodanno D, DiNicolantonio J, Bangalore S, Reed M, Meier P, Zoccai G, Gaita F. 2015. Meta-analysis of randomized controlled trials and adjusted observational results of use of clopidogrel, aspirin, and oral anticoagulants in patients undergoing percutaneous coronary intervention. The American journal of cardiology. 115(9):1185-93. https://doi.org/10.1016/j.amjcard.2015.02.003

MLA

Vancouver

Author

D'Ascenzo, Fabrizio ; Taha, Salma ; Moretti, Claudio ; Omedè, Pierluigi ; Grossomarra, Walter ; Persson, Jonas ; Lamberts, Morten ; Dewilde, Willem ; Rubboli, Andrea ; Fernández, Sergio ; Cerrato, Enrico ; Meynet, Ilaria ; Ballocca, Flavia ; Barbero, Umberto ; Quadri, Giorgio ; Giordana, Francesca ; Conrotto, Federico ; Capodanno, Davide ; DiNicolantonio, James ; Bangalore, Sripal ; Reed, Matthew ; Meier, Pascal ; Zoccai, Giuseppe ; Gaita, Fiorenzo. / Meta-analysis of randomized controlled trials and adjusted observational results of use of clopidogrel, aspirin, and oral anticoagulants in patients undergoing percutaneous coronary intervention. I: The American journal of cardiology. 2015 ; Bind 115, Nr. 9. s. 1185-93.

Bibtex

@article{a990c4de9ba04612bbb944e50c3919b7,
title = "Meta-analysis of randomized controlled trials and adjusted observational results of use of clopidogrel, aspirin, and oral anticoagulants in patients undergoing percutaneous coronary intervention",
abstract = "The optimal antiaggregant therapy after coronary stenting in patients receiving oral anticoagulants (OACs) is currently debated. MEDLINE and Cochrane Library were searched for studies reporting outcomes of patients who underwent PCI and who were on triple therapy (TT) or dual-antiplatelet therapy (DAPT) with aspirin and clopidogrel or dual therapy (DT) with OAC and clopidogrel. Major bleeding was the primary end point, whereas all-cause death, myocardial infarction (MI), stent thrombosis, and stroke were secondary ones. Results were reported for all studies and separately for those deriving from randomized controlled trials or multivariate analysis. In 9 studies, 1,317 patients were treated with DAPT and 1,547 with TT. DAPT offered a significant reduction of major bleeding at 1 year for overall studies and for the subset of observational works providing adjusted data (odds ratio [OR] 0.51, 95% confidence interval [CI] 0.39 to 0.68, I2 60% and OR 0.36, 95% CI 0.28 to 0.46) compared to TT. No increased risk of major adverse cardiac events (MACE: death, MI, stroke, and stent thrombosis) was reported (OR 0.71, 95% CI 0.46 to 1.08), although not deriving from randomized controlled trials or multivariate analysis. Six studies tested OAC and clopidogrel (1,263 patients) versus OAC, aspirin, and clopidogrel (3,055 patients) with a significant reduction of bleeding (OR 0.79, 95% CI 0.64 to 0.98), without affecting rates of death, MI, stroke, and stent thrombosis (OR 0.90, 95% CI 0.69 to 1.23) also when including clinical data from randomized controlled trials or multivariate analysis. In conclusion, compared to TT, both aspirin and clopidogrel and clopidogrel and OAC reduce bleeding. No difference in major adverse cardiac events is present for clopidogrel and OAC, whereas only low-grade evidence is present for aspirin and clopidogrel.",
keywords = "Administration, Oral, Anticoagulants, Aspirin, Drug Therapy, Combination, Hemorrhage, Humans, Myocardial Ischemia, Percutaneous Coronary Intervention, Platelet Aggregation Inhibitors, Randomized Controlled Trials as Topic, Stents, Ticlopidine, Treatment Outcome",
author = "Fabrizio D'Ascenzo and Salma Taha and Claudio Moretti and Pierluigi Omed{\`e} and Walter Grossomarra and Jonas Persson and Morten Lamberts and Willem Dewilde and Andrea Rubboli and Sergio Fern{\'a}ndez and Enrico Cerrato and Ilaria Meynet and Flavia Ballocca and Umberto Barbero and Giorgio Quadri and Francesca Giordana and Federico Conrotto and Davide Capodanno and James DiNicolantonio and Sripal Bangalore and Matthew Reed and Pascal Meier and Giuseppe Zoccai and Fiorenzo Gaita",
note = "Copyright {\textcopyright} 2015 Elsevier Inc. All rights reserved.",
year = "2015",
month = may,
day = "1",
doi = "10.1016/j.amjcard.2015.02.003",
language = "English",
volume = "115",
pages = "1185--93",
journal = "American Journal of Cardiology",
issn = "0002-9149",
publisher = "Excerpta Medica, Inc",
number = "9",

}

RIS

TY - JOUR

T1 - Meta-analysis of randomized controlled trials and adjusted observational results of use of clopidogrel, aspirin, and oral anticoagulants in patients undergoing percutaneous coronary intervention

AU - D'Ascenzo, Fabrizio

AU - Taha, Salma

AU - Moretti, Claudio

AU - Omedè, Pierluigi

AU - Grossomarra, Walter

AU - Persson, Jonas

AU - Lamberts, Morten

AU - Dewilde, Willem

AU - Rubboli, Andrea

AU - Fernández, Sergio

AU - Cerrato, Enrico

AU - Meynet, Ilaria

AU - Ballocca, Flavia

AU - Barbero, Umberto

AU - Quadri, Giorgio

AU - Giordana, Francesca

AU - Conrotto, Federico

AU - Capodanno, Davide

AU - DiNicolantonio, James

AU - Bangalore, Sripal

AU - Reed, Matthew

AU - Meier, Pascal

AU - Zoccai, Giuseppe

AU - Gaita, Fiorenzo

N1 - Copyright © 2015 Elsevier Inc. All rights reserved.

PY - 2015/5/1

Y1 - 2015/5/1

N2 - The optimal antiaggregant therapy after coronary stenting in patients receiving oral anticoagulants (OACs) is currently debated. MEDLINE and Cochrane Library were searched for studies reporting outcomes of patients who underwent PCI and who were on triple therapy (TT) or dual-antiplatelet therapy (DAPT) with aspirin and clopidogrel or dual therapy (DT) with OAC and clopidogrel. Major bleeding was the primary end point, whereas all-cause death, myocardial infarction (MI), stent thrombosis, and stroke were secondary ones. Results were reported for all studies and separately for those deriving from randomized controlled trials or multivariate analysis. In 9 studies, 1,317 patients were treated with DAPT and 1,547 with TT. DAPT offered a significant reduction of major bleeding at 1 year for overall studies and for the subset of observational works providing adjusted data (odds ratio [OR] 0.51, 95% confidence interval [CI] 0.39 to 0.68, I2 60% and OR 0.36, 95% CI 0.28 to 0.46) compared to TT. No increased risk of major adverse cardiac events (MACE: death, MI, stroke, and stent thrombosis) was reported (OR 0.71, 95% CI 0.46 to 1.08), although not deriving from randomized controlled trials or multivariate analysis. Six studies tested OAC and clopidogrel (1,263 patients) versus OAC, aspirin, and clopidogrel (3,055 patients) with a significant reduction of bleeding (OR 0.79, 95% CI 0.64 to 0.98), without affecting rates of death, MI, stroke, and stent thrombosis (OR 0.90, 95% CI 0.69 to 1.23) also when including clinical data from randomized controlled trials or multivariate analysis. In conclusion, compared to TT, both aspirin and clopidogrel and clopidogrel and OAC reduce bleeding. No difference in major adverse cardiac events is present for clopidogrel and OAC, whereas only low-grade evidence is present for aspirin and clopidogrel.

AB - The optimal antiaggregant therapy after coronary stenting in patients receiving oral anticoagulants (OACs) is currently debated. MEDLINE and Cochrane Library were searched for studies reporting outcomes of patients who underwent PCI and who were on triple therapy (TT) or dual-antiplatelet therapy (DAPT) with aspirin and clopidogrel or dual therapy (DT) with OAC and clopidogrel. Major bleeding was the primary end point, whereas all-cause death, myocardial infarction (MI), stent thrombosis, and stroke were secondary ones. Results were reported for all studies and separately for those deriving from randomized controlled trials or multivariate analysis. In 9 studies, 1,317 patients were treated with DAPT and 1,547 with TT. DAPT offered a significant reduction of major bleeding at 1 year for overall studies and for the subset of observational works providing adjusted data (odds ratio [OR] 0.51, 95% confidence interval [CI] 0.39 to 0.68, I2 60% and OR 0.36, 95% CI 0.28 to 0.46) compared to TT. No increased risk of major adverse cardiac events (MACE: death, MI, stroke, and stent thrombosis) was reported (OR 0.71, 95% CI 0.46 to 1.08), although not deriving from randomized controlled trials or multivariate analysis. Six studies tested OAC and clopidogrel (1,263 patients) versus OAC, aspirin, and clopidogrel (3,055 patients) with a significant reduction of bleeding (OR 0.79, 95% CI 0.64 to 0.98), without affecting rates of death, MI, stroke, and stent thrombosis (OR 0.90, 95% CI 0.69 to 1.23) also when including clinical data from randomized controlled trials or multivariate analysis. In conclusion, compared to TT, both aspirin and clopidogrel and clopidogrel and OAC reduce bleeding. No difference in major adverse cardiac events is present for clopidogrel and OAC, whereas only low-grade evidence is present for aspirin and clopidogrel.

KW - Administration, Oral

KW - Anticoagulants

KW - Aspirin

KW - Drug Therapy, Combination

KW - Hemorrhage

KW - Humans

KW - Myocardial Ischemia

KW - Percutaneous Coronary Intervention

KW - Platelet Aggregation Inhibitors

KW - Randomized Controlled Trials as Topic

KW - Stents

KW - Ticlopidine

KW - Treatment Outcome

U2 - 10.1016/j.amjcard.2015.02.003

DO - 10.1016/j.amjcard.2015.02.003

M3 - Journal article

C2 - 25799015

VL - 115

SP - 1185

EP - 1193

JO - American Journal of Cardiology

JF - American Journal of Cardiology

SN - 0002-9149

IS - 9

ER -

ID: 45925186