Impact of renal function on clinical outcomes after PCI in ACS and stable CAD patients treated with ticagrelor: a prespecified analysis of the GLOBAL LEADERS randomized clinical trial

Background Impaired renal function (IRF) is associated with increased risks of both ischemic and bleeding events. Ticagrelor has been shown to provide greater absolute reduction in ischemic risk following acute coronary syndrome (ACS) in those with versus without IRF. Methods A pre-specified sub-ana...

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Published in:Clinical research in cardiology 2020-07, Vol.109 (7), p.930-943
Main Authors: Tomaniak, Mariusz, Chichareon, Ply, Klimczak-Tomaniak, Dominika, Takahashi, Kuniaki, Kogame, Norihiro, Modolo, Rodrigo, Wang, Rutao, Ono, Masafumi, Hara, Hironori, Gao, Chao, Kawashima, Hideyuki, Rademaker-Havinga, Tessa, Garg, Scot, Curzen, Nick, Haude, Michael, Kochman, Janusz, Gori, Tommaso, Montalescot, Gilles, Angiolillo, Dominick J., Capodanno, Davide, Storey, Robert F., Hamm, Christian, Vranckx, Pascal, Valgimigli, Marco, Windecker, Stephan, Onuma, Yoshinobu, Serruys, Patrick W., Anderson, Richard
Format: Article
Language:English
Subjects:
Acute Coronary Syndrome - complications
Acute Coronary Syndrome - physiopathology
Acute Coronary Syndrome - therapy
Acute coronary syndromes
Aged
Antiplatelet therapy
Aspirin
Bleeding
Cardiology
Cardiovascular disease
Cerebral infarction
Clinical outcomes
Clinical trials
Confidence intervals
Coronary artery
Coronary artery disease
Coronary Artery Disease - complications
Coronary Artery Disease - physiopathology
Coronary Artery Disease - therapy
Death
Drug-Eluting Stents
Dual Anti-Platelet Therapy
Female
Glomerular Filtration Rate
Health services
Heart diseases
Humans
Ischemia
Life Sciences
Male
Medicine
Medicine & Public Health
Middle Aged
Mortality
Myocardial infarction
Original Paper
Patients
Percutaneous Coronary Intervention
Platelet Aggregation Inhibitors - therapeutic use
Renal function
Renal Insufficiency - complications
Ticagrelor - therapeutic use
Treatment Outcome
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Summary:Background Impaired renal function (IRF) is associated with increased risks of both ischemic and bleeding events. Ticagrelor has been shown to provide greater absolute reduction in ischemic risk following acute coronary syndrome (ACS) in those with versus without IRF. Methods A pre-specified sub-analysis of the randomized GLOBAL LEADERS trial ( n  = 15,991) comparing the experimental strategy of 23-month ticagrelor monotherapy (after 1-month ticagrelor and aspirin dual anti-platelet therapy [DAPT]) with 12-month DAPT followed by 12-month aspirin after percutaneous coronary intervention (PCI) in ACS and stable coronary artery disease (CAD) patients stratified according to IRF (glomerular filtration rate 
ISSN:1861-0684
1861-0692
DOI:10.1007/s00392-019-01586-9