Please use this identifier to cite or link to this item: http://repositorio.unicamp.br/jspui/handle/REPOSIP/336275
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dc.contributor.CRUESPUNIVERSIDADE ESTADUAL DE CAMPINASpt_BR
dc.contributor.authorunicampModolo, Rodrigo Gimenez Pissutti-
dc.typeArtigopt_BR
dc.titleBenefit and risks of aspirin in addition to ticagrelor in acute coronary syndromes: a post hoc analysis of the randomized global leaders trialpt_BR
dc.contributor.authorTomaniak, Mariusz-
dc.contributor.authorChichareon, Ply-
dc.contributor.authorOnuma, Yoshinobu-
dc.contributor.authorDeliargyris, Efthymios N.-
dc.contributor.authorTakahashi, Kuniaki-
dc.contributor.authorKogame, Norihiro-
dc.contributor.authorModolo, Rodrigo-
dc.contributor.authorChang, Chun Ching-
dc.contributor.authorRademaker-Havinga, Tessa-
dc.contributor.authorStorey, Robert F.-
dc.contributor.authorDangas, George D.-
dc.contributor.authorHernndez Antolin, Rosa Ana-
dc.contributor.authorGoicolea, Javier-
dc.contributor.authorRibeiro, Vasco Gama-
dc.contributor.authorda Silva, Pedro Canas-
dc.contributor.authorFerreira, Rui Cruz-
dc.contributor.authorAlmeida, Manuel-
dc.contributor.authorUngi, Imre-
dc.contributor.authorMerkely, Bela-
dc.contributor.authorFontos, Geza-
dc.contributor.authorHorvath, Ivan-
dc.contributor.authorWalsh, Simon-
dc.contributor.authorKoszegi, Zsolt-
dc.contributor.authorJambrik, Zoltan-
dc.contributor.authorEdes, Istvan-
dc.contributor.authorJozsef, Falukozy-
dc.contributor.authorColombo, Antonio-
dc.contributor.authorBolognese, Leonardo-
dc.contributor.authorFerrario, Maurizio-
dc.contributor.authorTumscitz, Carlo-
dc.contributor.authorDominici, Marcello-
dc.contributor.authorCurello, Salvatore-
dc.contributor.authorAdlam, David-
dc.contributor.authorRoffi, Marco-
dc.contributor.authorEeckhout, Eric-
dc.contributor.authorMoccetti, Tiziano-
dc.contributor.authorMoschovitis, Aris-
dc.contributor.authorLeibundgut, Gregor-
dc.contributor.authorHuber, Kurt-
dc.contributor.authorFrey, Bernhard-
dc.contributor.authorDelle Karth, Georg-
dc.contributor.authorFriedrich, Guy-
dc.contributor.authorSteinwender, Clemens-
dc.contributor.authorCotton, James-
dc.contributor.authorZweiker, Robert-
dc.contributor.authorStables, Rod H.-
dc.contributor.authorAnderson, Richard-
dc.contributor.authorChowdhary, Saqib-
dc.contributor.authorGarg, Scot-
dc.contributor.authorHildick-Smith, David-
dc.contributor.authorFath-Ordoubadi, Farzin-
dc.contributor.authorOldroyd, Keith G.-
dc.contributor.authorGalasko, Gavin-
dc.contributor.authorKukreja, Neville-
dc.contributor.authorHolmvang, Lene-
dc.contributor.authorZaman, Azfar-
dc.contributor.authorSubkovas, Eduardas-
dc.contributor.authorCurzen, Nick-
dc.contributor.authorHoole, Stephen-
dc.contributor.authorTalwar, Suneel-
dc.contributor.authorOttesen, Michael Munndt-
dc.contributor.authorBuszman, Pawel-
dc.contributor.authorZurakowski, Aleksander-
dc.contributor.authorGaluszka, Grzegorz-
dc.contributor.authorProkopczuk, Janusz-
dc.contributor.authorZmudka, Krzysztof-
dc.contributor.authorBhatt, Deepak L.-
dc.contributor.authorJasionowicz, Pawel-
dc.contributor.authorMlodziankowski, Adam-
dc.contributor.authorLiebetrau, Christoph-
dc.contributor.authorNaber, Christoph Kurt-
dc.contributor.authorNeumann, Franz-Josef-
dc.contributor.authorSchchinger, Volker-
dc.contributor.authorSeidler, Tim-
dc.contributor.authorIbrahim, Karim-
dc.contributor.authorZrenner, Bernhard-
dc.contributor.authorGori, Tommaso-
dc.contributor.authorAngiolillo, Dominick J.-
dc.contributor.authorWerner, Nikos-
dc.contributor.authorAkin, Ibrahim-
dc.contributor.authorGeisler, Tobias-
dc.contributor.authorvom Dahl, Juergen-
dc.contributor.authorHaude, Michael-
dc.contributor.authorEitel, Ingo-
dc.contributor.authorKrackhardt, Florian-
dc.contributor.authorJung, Werner-
dc.contributor.authorLemos Neto, Pedro Alves-
dc.contributor.authorSousa, Amanda-
dc.contributor.authorHamm, Christian-
dc.contributor.authorQuintella, Edgard Freitas-
dc.contributor.authorLeandro, Sergio-
dc.contributor.authorBotelho, Roberto-
dc.contributor.authorRaffel, Christopher-
dc.contributor.authorBarlis, Peter-
dc.contributor.authorHai, Koh Tian-
dc.contributor.authorOng, Paul-
dc.contributor.authorPetrov, Ivo-
dc.contributor.authorKonteva, Mariana-
dc.contributor.authorVelchev, Vasil-
dc.contributor.authorValgimigli, Marco-
dc.contributor.authorGelev, Valeri-
dc.contributor.authorTonev, Gincho-
dc.contributor.authorValkov, Veselin-
dc.contributor.authorVassilev, Dobrin-
dc.contributor.authorTrendafilova-Lazarova, Diana-
dc.contributor.authorWindecker, Stephan-
dc.contributor.authorSteg, Philippe Gabriel-
dc.contributor.authorVranckx, Pascal-
dc.contributor.authorSerruys, Patrick W.-
dc.contributor.authorBertrand, Olivier F.-
dc.contributor.authorPlante, Sylvain-
dc.contributor.authorVan Geuns, Robert-Jan-
dc.contributor.authorHofma, Sjoerd H.-
dc.contributor.authorRoyaards, Kees-Jan-
dc.contributor.authorSlagboom, Ton-
dc.contributor.authorSuryapranata, Harry-
dc.contributor.authorUmans, Victor A. W. M.-
dc.contributor.authorRensing, Benno-
dc.contributor.authorvan der Harst, Pim-
dc.contributor.authorMagro, Michael-
dc.contributor.authorBarbato, Emanuel-
dc.contributor.authorAminian, Adel-
dc.contributor.authorBenit, Edouard-
dc.contributor.authorJanssens, Luc-
dc.contributor.authorVrolix, Mathias-
dc.contributor.authorBuysschaert, Ian-
dc.contributor.authorCarrie, Didier-
dc.contributor.authorBarraud, Pascal-
dc.contributor.authorTeiger, Emmanuel-
dc.contributor.authorKoning, Ren-
dc.contributor.authorFarzin, Beygui-
dc.contributor.authorMorelle, Jean-francois-
dc.contributor.authorIsaaz, Karl-
dc.contributor.authorMaillard, Luc-
dc.contributor.authorAbdellaoui, Mohamed-
dc.contributor.authorBrunel, Philippe-
dc.contributor.authorAngioi, Michael-
dc.contributor.authorLantelme, Pierre-
dc.contributor.authorSabate, Manel-
dc.contributor.authorAlbarran Gonzalez-Trevilla, Agustin-
dc.contributor.authorCequier, Angel-
dc.contributor.authorIiguez, Andres-
dc.contributor.authorSerra Penaranda, Antonio-
dc.contributor.authorMacaya Miguel, Carlos-
dc.contributor.authorFrancisco Diaz, Jose-
dc.subjectClopidogrelpt_BR
dc.subject.otherlanguageClopidogrelpt_BR
dc.description.abstractWhat are the benefits and risks of continuing aspirin in addition to P2Y12 receptor inhibition with ticagrelor among patients with acute coronary syndrome between 1 month and 12 months after percutaneous coronary intervention? FindingsIn this nonprespecified, post hoc analysis of the GLOBAL LEADERS randomized clinical trial, beyond 1 month after percutaneous coronary intervention in acute coronary syndrome, aspirin was associated with increased bleeding risk and appeared not to add to the benefit of ticagrelor on ischemic events. MeaningThe findings of this hypothesis-generating analysis pave the way for further trials evaluating aspirin-free antiplatelet strategies after percutaneous coronary intervention. ImportanceThe role of aspirin as part of antiplatelet regimens in acute coronary syndromes (ACS) needs to be clarified in the context of newer potent P2Y12 antagonists. ObjectiveTo evaluate the benefit and risks of aspirin in addition to ticagrelor among patients with ACS beyond 1 month after percutaneous coronary intervention (PCI). Design, Setting, and ParticipantsThis is a nonprespecified, post hoc analysis of GLOBAL LEADERS, a randomized, open-label superiority trial comparing 2 antiplatelet treatment strategies after PCI. The trial included 130 secondary/tertiary care hospitals in different countries, with 15991 unselected patients with stable coronary artery disease or ACS undergoing PCI. Patients had outpatient visits at 1, 3, 6, 12, 18, and 24 months after index procedure. InterventionsThe experimental group received aspirin plus ticagrelor for 1 month followed by 23-month ticagrelor monotherapy; the reference group received aspirin plus either clopidogrel (stable coronary artery disease) or ticagrelor (ACS) for 12 months, followed by 12-month aspirin monotherapy. In this analysis, we examined the clinical outcomes occurring between 31 days and 365 days after randomization, specifically in patients with ACS who, within this time frame, were assigned to receive either ticagrelor alone or ticagrelor and aspirin. Main Outcomes and MeasuresThe primary outcome was the composite of all-cause death or new Q-wave myocardial infarction. ResultsOf 15968 participants, there were 7487 patients with ACS enrolled; 3750 patients were assigned to the experimental group and 3737 patients to the reference group. Between 31 and 365 days after randomization, the primary outcome occurred in 55 patients (1.5%) in the experimental group and in 75 patients (2.0%) in the reference group (hazard ratio [HR], 0.73; 95% CI, 0.51-1.03; P=.07); investigator-reported Bleeding Academic Research Consortium-defined bleeding type 3 or 5 occurred in 28 patients (0.8%) in the experimental group and in 54 patients (1.5%) in the reference arm (HR, 0.52; 95% CI, 0.33-0.81; P=.004). Conclusions and RelevanceBetween 1 month and 12 months after PCI in ACS, aspirin was associated with increased bleeding risk and appeared not to add to the benefit of ticagrelor on ischemic events. These findings should be interpreted as exploratory and hypothesis generating; however, they pave the way for further trials evaluating aspirin-free antiplatelet strategies after PCI. Trial RegistrationClinicalTrials.gov identifier: NCT01813435. This secondary analysis of the GLOBAL LEADERS randomized clinical trial evaluates the benefit and risks of aspirin in addition to ticagrelor among patients with acute coronary syndrome beyond 1 month after percutaneous coronary intervention.pt_BR
dc.relation.ispartofJAMA cardiologypt_BR
dc.relation.ispartofabbreviationJAMA cardiol.pt_BR
dc.publisher.cityChicago, ILpt_BR
dc.publisher.countryEstados Unidospt_BR
dc.publisherAmerican Medical Associationpt_BR
dc.date.issued2019-
dc.date.monthofcirculationSept.pt_BR
dc.language.isoengpt_BR
dc.description.volume4pt_BR
dc.description.issuenumber11pt_BR
dc.description.firstpage1092pt_BR
dc.description.lastpage1101pt_BR
dc.rightsFechadopt_BR
dc.sourceWOSpt_BR
dc.identifier.issn2380-6583pt_BR
dc.identifier.eissn2380-6591pt_BR
dc.identifier.doi10.1001/jamacardio.2019.3355pt_BR
dc.identifier.urlhttps://jamanetwork.com/journals/jamacardiology/article-abstract/2752077pt_BR
dc.date.available2020-03-10T14:58:39Z-
dc.date.accessioned2020-03-10T14:58:39Z-
dc.description.provenanceSubmitted by Bruna Maria Campos da Cunha (bcampos@unicamp.br) on 2020-03-10T14:58:39Z No. of bitstreams: 0. Added 1 bitstream(s) on 2020-11-11T13:13:44Z : No. of bitstreams: 1 000501300400007.pdf: 510195 bytes, checksum: 7d36e917de8065bb5314e9b07b5dac04 (MD5)en
dc.description.provenanceMade available in DSpace on 2020-03-10T14:58:39Z (GMT). No. of bitstreams: 0 Previous issue date: 2019en
dc.identifier.urihttp://repositorio.unicamp.br/jspui/handle/REPOSIP/336275-
dc.contributor.departmentSem informaçãopt_BR
dc.contributor.unidadeFaculdade de Ciências Médicaspt_BR
dc.subject.keywordDual antiplatelet therapypt_BR
dc.subject.keywordIn-vitropt_BR
dc.subject.keywordInterventionpt_BR
dc.subject.keywordReceptorpt_BR
dc.subject.keywordPlatopt_BR
dc.identifier.source000501300400007pt_BR
dc.creator.orcidSem informaçãopt_BR
dc.type.formArtigo originalpt_BR
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