Evidence map›Paper›PMID 30793734›Full record

Trial reportEuropean heart journal2019

Dabigatran dual therapy with ticagrelor or clopidogrel after percutaneous coronary intervention in atrial fibrillation patients with or without acute coronary syndrome: a subgroup analysis from the RE-DUAL PCI trial.

Jonas Oldgren, Philippe Gabriel Steg, Stefan H Hohnloser, Gregory Y H Lip, Takeshi Kimura, Matias Nordaby, Martina Brueckmann, Eva Kleine, Jurrien M Ten Berg, Deepak L Bhatt and 1 more

Open access · bronzeAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in European heart journal, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
33citing papers in PubMed, 4 pooled it
9.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

33 citing papers in PubMed, 4 syntheses or guidelines pooled it, 78 citations in OpenAlex.

  1. Pooled it
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  5. Trial
  6. Trial
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  12. Observational
  13. Article
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  15. Review
  16. Therapeutic uncertainties: first finding of atrial fibrillation in acute coronary syndrome.European heart journal supplements : journal of the European Society of Cardiology · 2022
    Article
  17. A novel risk score to identify the need for triple antithrombotic therapy in patients with atrial fibrillation undergoing percutaneous coronary intervention: a post hoc analysis of the RE-DUAL PCI trial.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2022
    Article
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 10 institutions in 8 countries.

Jonas OldgrenUppsala Clinical Research Center and Department of Medical Sciences, Uppsala University, Dag Hammarskjölds väg 38, SE-751 85 Uppsala, Sweden.
Philippe Gabriel StegFACT, an F-CRIN Network, Université Paris Diderot, INSERM U_1148 and Hôpital Bichat Assistance Publique, Paris, France.
Stefan H HohnloserDepartment of Medicine, Division of Cardiology, Johann Wolfgang Goethe University, Theodor Stern-Kai 7, DE-60590 Frankfurt/Main, Germany.
Gregory Y H LipInstitute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK.
Takeshi KimuraDepartment of Cardiovascular Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, Japan.
Matias NordabyBoehringer Ingelheim International GmbH, TA CardioMetabolism, Binger Str. 173, Ingelheim, Germany.
Martina BrueckmannBoehringer Ingelheim International GmbH, TA CardioMetabolism, Binger Str. 173, Ingelheim, Germany.
Eva KleineBoehringer Ingelheim International GmbH, TA CardioMetabolism, Binger Str. 173, Ingelheim, Germany.
Jurrien M Ten BergDepartment of Cardiology, St. Antonius Ziekenhuis, Koekoekslaan 1, Nieuwegein 3435 CM, The Netherlands.
Deepak L BhattBrigham and Women's Hospital, Heart and Vascular Center and Harvard Medical School, 75 Francis Street, Boston, MA, USA.
Christopher P CannonBrigham and Women's Hospital, Heart and Vascular Center and Harvard Medical School, 75 Francis Street, Boston, MA, USA.
Boehringer Ingelheim (Germany) · DEAalborg University · DKBrigham and Women's Hospital · USGoethe University Frankfurt · DEHarvard University · USHeidelberg University · DEKyoto University · JPSt. Antonius Ziekenhuis · NLUniversité Paris Cité · FRUppsala University · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsAfter percutaneous coronary intervention (PCI) in patients with atrial fibrillation, safety and efficacy with dabigatran dual therapy were evaluated in pre-specified subgroups of patients undergoing PCI due to acute coronary syndrome (ACS) or elective PCI, and those receiving ticagrelor or clopidogrel treatment. METHODS AND

resultsIn the RE-DUAL PCI trial, 2725 patients were randomized to dabigatran 110 mg or 150 mg with P2Y12 inhibitor, or warfarin with P2Y12 inhibitor and aspirin. Mean follow-up was 14 months, 50.5% had ACS, and 12% received ticagrelor. The risk of the primary endpoint, major or clinically relevant non-major bleeding event, was reduced with both dabigatran dual therapies vs. warfarin triple therapy in patients with ACS [hazard ratio (95% confidence interval), 0.47 (0.35-0.63) for 110 mg and 0.67 (0.50-0.90) for 150 mg]; elective PCI [0.57 (0.43-0.76) for 110 mg and 0.76 (0.56-1.03) for 150 mg]; receiving ticagrelor [0.46 (0.28-0.76) for 110 mg and 0.59 (0.34-1.04) for 150 mg]; or clopidogrel [0.51 (0.41-0.64) for 110 mg and 0.73 (0.58-0.91) for 150 mg], all interaction P-values >0.10. Overall, dabigatran dual therapy was comparable to warfarin triple therapy for the composite endpoint of death, myocardial infarction, stroke, systemic embolism, or unplanned revascularization, with minor variations across the subgroups, all interaction P-values >0.10.

conclusionThe benefits of both dabigatran 110 mg and 150 mg dual therapy compared with warfarin triple therapy in reducing bleeding risks were consistent across subgroups of patients with or without ACS, and patients treated with ticagrelor or clopidogrel.

Indexed as

Percutaneous Coronary InterventionAcute Coronary SyndromeAgedAged, 80 and overAnticoagulantsAntithrombinsAspirinAtrial FibrillationCase-Control StudiesClopidogrelCoronary Artery DiseaseDabigatranDrug Therapy, CombinationDual Anti-Platelet TherapyElective Surgical ProceduresFemaleAnticoagulantsAntithrombinsAspirinClopidogrelDabigatranPlatelet Aggregation InhibitorsTicagrelorWarfarinAcute coronary syndromeAtrial fibrillationCoronary artery diseaseOral anticoagulantsP2Y12 inhibitorsPercutaneous coronary intervention

Identifiers

PMID30793734
PMCPMC6514838
OpenAlexW2917582759

What OpenQuestion holds

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LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.