Evidence map›Paper›PMID 36991321›Full record

ArticleBMC cardiovascular disorders2023

Effectiveness of dual antiplatelet de-escalation therapy on the prognosis of patients with ST segment elevation myocardial infarction undergoing percutaneous coronary intervention.

Zhigang Zhao, Jingyao Wang, Mengjie Lei, Yachao Li, Yanli Yang, Lei An, Xue Sun, Cairong Li, Zengming Xue

Open access · goldAbstract read
In one paragraph

Article in BMC cardiovascular disorders, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.4field-weighted citation impact, top 36% 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

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 2 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. 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

9 authors at 2 institutions in 1 country.

Zhigang ZhaoDepartment of Cardiology, Langfang Core Laboratory of Precision Treatment of CAD, Langfang People's Hospital, Hebei Medical University, Langfang, No. 37, Xinhua Road, 065000, Langfang, China.
Jingyao WangDepartment of Cardiology, Langfang Core Laboratory of Precision Treatment of CAD, Langfang People's Hospital, Hebei Medical University, Langfang, No. 37, Xinhua Road, 065000, Langfang, China.
Mengjie LeiDepartment of Cardiology, Langfang Core Laboratory of Precision Treatment of CAD, Langfang People's Hospital, Hebei Medical University, Langfang, No. 37, Xinhua Road, 065000, Langfang, China.
Yachao LiDepartment of Cardiology, Langfang Core Laboratory of Precision Treatment of CAD, Langfang People's Hospital, Hebei Medical University, Langfang, No. 37, Xinhua Road, 065000, Langfang, China.
Yanli YangDepartment of Cardiology, Langfang Core Laboratory of Precision Treatment of CAD, Langfang People's Hospital, Hebei Medical University, Langfang, No. 37, Xinhua Road, 065000, Langfang, China.
Lei AnDepartment of Cardiology, Langfang Core Laboratory of Precision Treatment of CAD, Langfang People's Hospital, Hebei Medical University, Langfang, No. 37, Xinhua Road, 065000, Langfang, China.
Xue SunDepartment of Cardiology, Langfang Core Laboratory of Precision Treatment of CAD, Langfang People's Hospital, Hebei Medical University, Langfang, No. 37, Xinhua Road, 065000, Langfang, China.
Cairong LiDepartment of Cardiology, Langfang Core Laboratory of Precision Treatment of CAD, Langfang People's Hospital, Hebei Medical University, Langfang, No. 37, Xinhua Road, 065000, Langfang, China.
Zengming XueDepartment of Cardiology, Langfang Core Laboratory of Precision Treatment of CAD, Langfang People's Hospital, Hebei Medical University, Langfang, No. 37, Xinhua Road, 065000, Langfang, China. xuezengming@163.com.
Langfang Normal University · CNHebei Medical University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimTo investigate the effectiveness of de-escalation of ticagrelor (from ticagrelor 90 mg to clopidogrel 75 mg or ticagrelor 60 mg) on the prognosis of patients with ST segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI) after 3 months of oral dual antiplatelet therapy (DAPT).

methodsFrom March 2017 to August 2021, 1056 patients with STEMI in a single centre, through retrospective investigation and analysis, were divided into intensive (ticagrelor 90 mg), standard (clopidogrel 75 mg after PCI) and de-escalation groups (clopidogrel 75 mg or ticagrelor 60 mg after 3 months of treatment with 90 mg ticagrelor) based on the type and dose of P2Y

resultsThe results showed that during the follow-up period, there was no statistically significant difference in the incidence of MACCEs between the intensive and de-escalation groups (P > 0.05). The incidence of MACCEs in the standard treatment group was higher than that in the intensive treatment group (P = 0.014), but the incidence of bleeding events in the de-escalation group was significantly lower than that in the standard group (9.3% vs. 18.4%, χ²=7.191, P = 0.027). The Cox regression analysis showed that increases in haemoglobin (HGB) (HR = 0.986) and estimated glomerular filtration rate (eGFR) (HR = 0.983) could reduce the incidence of MACCEs, while old myocardial infarction (OMI) (P = 0.023) and hypertension (P = 0.013) were independent predictors of MACCEs.

conclusionFor STEMI patients undergoing PCI, the de-escalation scheme of ticagrelor to clopidogrel 75 mg or ticagrelor 60 mg at 3 months after PCI was related to the reduction of bleeding events, especially minor bleeding events, without an increase in ischaemic events.

Indexed as

Myocardial InfarctionPercutaneous Coronary InterventionST Elevation Myocardial InfarctionClopidogrelHemorrhageHumansPlatelet Aggregation InhibitorsPrognosisRetrospective StudiesTicagrelorTreatment OutcomeClopidogrelPlatelet Aggregation InhibitorsTicagrelorBleedingDe-escalationDual antiplateletMajor adverse cardiovascular and cerebrovascular eventsMyocardial infarction

Identifiers

PMID36991321
PMCPMC10061818
OpenAlexW4361200005

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.