Evidence map›Paper›PMID 34712935›Full record

ArticleCJC open2021

De-escalation of P2Y12 Inhibitor Use After Percutaneous Coronary Intervention and Acute Coronary Syndromes.

Quinton Barry, Angel Fu, Rene Boudreau, Alyssa Chow, Cole Clifford, Trevor Simard, Aun Yeong Chong, Alexander Dick, Michael Froeschl, Christopher Glover and 6 more

Open access · goldAbstract read
In one paragraph

Article in CJC open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.2field-weighted citation impact, top 50% 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

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 1 institution in 1 country.

Quinton BarryDepartment of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
Angel FuDepartment of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
Rene BoudreauDepartment of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
Alyssa ChowDepartment of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
Cole CliffordDepartment of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
Trevor SimardDepartment of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
Aun Yeong ChongDepartment of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
Alexander DickDepartment of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
Michael FroeschlDepartment of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
Christopher GloverDepartment of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
Benjamin HibbertDepartment of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
Marino LabinazDepartment of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
Michel Le MayDepartment of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
Juan RussoDepartment of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
Derek SoDepartment of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
CAPITAL Investigators
University of Ottawa · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDe-escalation from potent platelet P2Y12 inhibitors to clopidogrel is common. Despite having a clinical rationale, non-bleeding-related de-escalation when a lateral change between potent agents is an option may put patients at increased ischemic risk. We set out to define the scope of P2Y12 inhibitor de-escalation in a large clinical registry and evaluate the potential impact of non-bleeding-related de-escalation on clinical outcomes.

methods

resultsOf 1854 patients, 209 (11.3%) underwent de-escalation: 24.9% of cases were bleeding-related, 37.8% were non-bleeding-related, and 37.3% were for unknown reasons. All patients with non-bleeding-related de-escalation were switched from ticagrelor to clopidogrel. The primary outcome occurred in 14 (6.7%) patients, of which 50% underwent non-bleeding-related de-escalation (

conclusionsDe-escalation, particularly non-bleeding-related de-escalation, of P2Y12 inhibitors is common. A substantial proportion of such de-escalation may be avoidable. Given the potential risk of ischemic complications, strategies should be considered to encourage both the upfront use of potent P2Y12 inhibitors and alternative strategies to de-escalation.

Identifiers

PMID34712935
PMCPMC8531228
OpenAlexW3158832301

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.