Jacobshagen, Claudius

[["dc.bibliographiccitation.firstpage","427"],["dc.bibliographiccitation.issue","3"],["dc.bibliographiccitation.journal","Journal of Thrombosis and Thrombolysis"],["dc.bibliographiccitation.lastpage","435"],["dc.bibliographiccitation.volume","47"],["dc.contributor.author","Koltowski, Lukasz"],["dc.contributor.author","Tomaniak, Mariusz"],["dc.contributor.author","Gross, Lisa"],["dc.contributor.author","Rymuza, Bartosz"],["dc.contributor.author","Kowara, Michal"],["dc.contributor.author","Parma, Radoslaw"],["dc.contributor.author","Komosa, Anna"],["dc.contributor.author","Klopotowski, Mariusz"],["dc.contributor.author","Jacobshagen, Claudius"],["dc.contributor.author","Gori, Tommaso"],["dc.contributor.author","Aradi, Daniel"],["dc.contributor.author","Huber, Kurt"],["dc.contributor.author","Hadamitzky, Martin"],["dc.contributor.author","Massberg, Steffen"],["dc.contributor.author","Lesiak, Maciej"],["dc.contributor.author","Filipiak, Krzysztof J."],["dc.contributor.author","Witkowski, Adam"],["dc.contributor.author","Opolski, Grzegorz"],["dc.contributor.author","Huczek, Zenon"],["dc.contributor.author","Sibbing, Dirk"],["dc.date.accessioned","2019-07-09T11:51:05Z"],["dc.date.available","2019-07-09T11:51:05Z"],["dc.date.issued","2019"],["dc.description.abstract","To investigate the safety and efficacy of an early platelet function testing (PFT)-guided de-escalation of dual antiplatelet treatment (DAPT) in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI) with bioresorbable vascular scaffolds (BVS). Early DAPT de-escalation is a new non-inferior alternative to 12-months DAPT in patients with biomarker positive ACS treated with stent implantation. In this post-hoc analysis of the TROPICAL-ACS trial, which randomized 2610 ACS patients to a PFT-guided DAPT de-escalation (switch from prasugrel to clopidogrel) or to control group (uniform prasugrel), we compared clinical outcomes of patients (n = 151) who received a BVS during the index PCI. The frequency of the primary endpoint (cardiovascular death, myocardial infarction, stroke or BARC ≥ 2 bleeding) was 8.8% (n = 6) in the de-escalation group vs. 12.0% (n = 10) in the control group (HR 0.72, 95% CI 0.26-1.98, p = 0.52) at 12 months. One early definite stent thrombosis (ST) occurred in the control group (day 19) and 1 possible ST (sudden cardiovascular death) in the de-escalation group (day 86), both despite prasugrel treatment and in a background of high on-treatment platelet reactivity assessed at day 14 after randomization (ADP-induced platelet aggregation values of 108 U and 59 U, respectively). A PFT-guided DAPT de-escalation strategy could potentially be a safe and effective strategy in ACS patients with BVS implantation but the level of platelet inhibition may be of particular importance. This hypothesis-generating post-hoc analysis requires verification in larger studies with upcoming BVS platforms."],["dc.identifier.doi","10.1007/s11239-019-01811-2"],["dc.identifier.pmid","30739305"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/16046"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/59873"],["dc.language.iso","en"],["dc.notes.intern","Merged from goescholar"],["dc.notes.status","final"],["dc.rights","CC BY 4.0"],["dc.rights.uri","https://creativecommons.org/licenses/by/4.0"],["dc.subject.ddc","610"],["dc.title","Guided de-escalation of DAPT in acute coronary syndrome patients undergoing percutaneous coronary intervention with BVS implantation: a post-hoc analysis from the randomized TROPICAL-ACS trial"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]