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Your search keyword '"Ruifrok WT"' showing total 2 results
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2 results on '"Ruifrok WT"'

1. Duration of antiplatelet therapy after complex percutaneous coronary intervention in patients at high bleeding risk: a MASTER DAPT trial sub-analysis

Author

Valgimigli, Marco, Smits, Pieter C, Frigoli, Enrico, Bongiovanni, Dario, Tijssen, Jan, Hovasse, Thomas, Mafragi, Al, Ruifrok, Willem Theodoor, Karageorgiev, Dimitar, Aminian, Adel, Garducci, Stefano, Merkely, Bela, Routledge, Helen, Ando, Kenji, Diaz Fernandez, Josè Francisco, Cuisset, Thomas, Nesa Malik, Fazila Tun, Halabi, Majdi, Belle, Loic, Din, Jehangir, Beygui, Farzin, Abhyankar, Atul, Reczuch, Krzysztof, Pedrazzini, Giovanni, Heg, Dik, Vranckx, Pascal, MASTER DAPT Investigators, Cardiology, ACS - Heart failure & arrhythmias, Valgimigli, M, Smits, PC, Frigoli, E, Bongiovanni, D, Tijssen, J, Hovasse, T, Mafragi, A, Ruifrok, WT, Karageorgiev, D, Aminian, A, Garducci, S, Merkely, B, Routledge, H, Ando, K, Fernandez, JFD, Cuisset, T, Malik, FTN, Halabi, M, Belle, L, Din, J, Beygui, F, Abhyankar, A, Reczuch, K, Pedrazzini, G, Heg, D, and VRANCKX, Pascal

Subjects
animal structures, Aspirin, Myocardial Infarction, Hemorrhage, Percutaneous coronary intervention, Stroke, Treatment Outcome, Complex intervention, Dual antiplatelet therapy, Humans, Drug Therapy, Combination, Acute Coronary Syndrome, High bleeding risk, 610 Medizin und Gesundheit, Cardiology and Cardiovascular Medicine, Platelet Aggregation Inhibitors
Abstract

Aim To assess the effects of 1- or ≥3-month dual antiplatelet therapy (DAPT) in high bleeding risk (HBR) patients who received biodegradable-polymer sirolimus-eluting stents for complex percutaneous coronary intervention (PCI) and/or acute coronary syndrome (ACS). Methods and results In the MASTER DAPT trial, 3383 patients underwent non-complex (abbreviated DAPT, n = 1707; standard DAPT, n = 1676) and 1196 complex (abbreviated DAPT, n = 588; standard DAPT, n = 608) PCI. Co-primary outcomes at 335 days were net adverse clinical events [NACE; composite of all-cause death, myocardial infarction, stroke, and bleeding academic research consortium (BARC) 3 or 5 bleeding events]; major adverse cardiac or cerebral events (MACCE; all-cause death, myocardial infarction, and stroke); and Types 2, 3, or 5 BARC bleeding. Net adverse clinical events and MACCE did not differ with abbreviated vs. standard DAPT among patients with complex [hazard ratio (HR): 1.03, 95% confidence interval (CI): 0.69–1.52, and HR: 1.24, 95% CI: 0.79–1.92, respectively] and non-complex PCI (HR: 0.90, 95% CI: 0.71–1.15, and HR: 0.91, 95% CI: 0.69–1.21; Pinteraction = 0.60 and 0.26, respectively). BARC 2, 3, or 5 was reduced with abbreviated DAPT in patients with and without complex PCI (HR: 0.64; 95% CI: 0.42–0.98, and HR: 0.70; 95% CI: 0.55–0.89; Pinteraction = 0.72). Among the 2816 patients with complex PCI and/or ACS, NACE and MACCE did not differ and BARC 2, 3, or 5 was lower with abbreviated DAPT. Conclusion In HBR patients free from recurrent ischaemic events at 1 month, DAPT discontinuation was associated with similar NACE and MACCE and lower bleeding rates compared with standard DAPT, regardless of PCI or patient complexity. Clinical Trial Registration This trial is registered with ClinicalTrials.gov, number NCT03023020, and is closed to new participants, with follow-up completed.

Published
2022

2. Temporary omission of oral anticoagulation in atrial fibrillation patients undergoing percutaneous coronary intervention: rationale and design of the WOEST-3 randomised trial.

Author

Verburg A, Bor WL, Küçük IT, Henriques JPS, Vink MA, Ruifrok WT, Plomp J, Heestermans TACM, Schotborgh CE, Vlaar PJ, Magro M, Rikken SAOF, van den Broek WWA, van Mieghem CAG, Cornelis K, Rosseel L, Dujardin KS, Vandeloo B, Vandendriessche T, Ferdinande B, van 't Hof AWJ, Tijssen JGP, Limbruno U, De Caterina R, Rubboli A, Angiolillo DJ, Adriaenssens T, Dewilde W, and Ten Berg JM

Subjects
Aged, Female, Humans, Male, Middle Aged, Administration, Oral, Aspirin therapeutic use, Aspirin administration & dosage, Aspirin adverse effects, Dual Anti-Platelet Therapy methods, Purinergic P2Y Receptor Antagonists administration & dosage, Purinergic P2Y Receptor Antagonists adverse effects, Purinergic P2Y Receptor Antagonists therapeutic use, Treatment Outcome, Anticoagulants administration & dosage, Anticoagulants therapeutic use, Anticoagulants adverse effects, Atrial Fibrillation complications, Atrial Fibrillation drug therapy, Hemorrhage chemically induced, Percutaneous Coronary Intervention adverse effects, Percutaneous Coronary Intervention methods, Platelet Aggregation Inhibitors administration & dosage, Platelet Aggregation Inhibitors therapeutic use, Platelet Aggregation Inhibitors adverse effects
Abstract

The optimal antithrombotic management of atrial fibrillation (AF) patients who require oral anticoagulation (OAC) undergoing percutaneous coronary intervention (PCI) remains unclear. Current guidelines recommend dual antithrombotic therapy (DAT; OAC plus P2Y 12 inhibitor - preferably clopidogrel) after a short course of triple antithrombotic therapy (TAT; DAT plus aspirin). Although DAT reduces bleeding risk compared to TAT, this is counterbalanced by an increase in ischaemic events. Aspirin provides early ischaemic benefit, but TAT is associated with an increased haemorrhagic burden; therefore, we propose a 30-day dual antiplatelet therapy (DAPT; aspirin plus P2Y 12 inhibitor) strategy post-PCI, temporarily omitting OAC. The study aims to compare bleeding and ischaemic risk between a 30-day DAPT strategy following PCI and a guideline-directed therapy in AF patients requiring OAC. WOEST-3 (ClinicalTrials.gov: NCT04436978) is an investigator-initiated, international, open-label, randomised controlled trial (RCT). AF patients requiring OAC who have undergone successful PCI will be randomised within 72 hours after PCI to guideline-directed therapy (edoxaban plus P2Y 12 inhibitor plus limited duration of aspirin) or a 30-day DAPT strategy (P2Y 12 inhibitor plus aspirin, immediately discontinuing OAC) followed by DAT (edoxaban plus P2Y 12 inhibitor). With a sample size of 2,000 patients, this trial is powered to assess both superiority for major or clinically relevant non-major bleeding and non-inferiority for a composite of all-cause death, myocardial infarction, stroke, systemic embolism or stent thrombosis. In summary, the WOEST-3 trial is the first RCT temporarily omitting OAC in AF patients, comparing a 30-day DAPT strategy with guideline-directed therapy post-PCI to reduce bleeding events without hampering efficacy.

Published
2024
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