BC 063 – Dé-escalade de la thérapie antiplaquettaire double avec ticagrélor seul post-syndrome coronarien aigu (étude ULTIMATE-DAPT)

Épisode de BaladoCritique - club de lecture médical par Dr Luc Lanthier et collaborateurs · 19 juin 2024

Dans cette 63e baladodiffusion, les Dr Luc Lanthier et Étienne Couture discutent de l’utilisation de la thérapie antiplaquettaire post-syndrome coronarien aigu, en plus de réviser la littérature médicale de mai 2024.

Quiz clinique (3 min 25), présentation principale (3 min 57), critique (27 min 00), autres articles (35 min 41), réponse au quiz clinique (38 min 12)

Référence principale :

Ge Z, Kan J, Gao X, Raza A, Zhang JJ, Mohydin BS, et al; ULTIMATE-DAPT investigators. Ticagrelor alone versus ticagrelor plus aspirin from month 1 to month 12 after percutaneous coronary intervention in patients with acute coronary syndromes (ULTIMATE-DAPT): a randomised, placebo-controlled, double-blind clinical trial. Lancet. 2024;403(10439):1866-1878. PubMed PMID: 38599220.

Articles associés :

Li X, Ge Z, Kan J, Anjum M, Xie P, Chen X, et al. Intravascular ultrasound-guided versus angiography-guided percutaneous coronary intervention in acute coronary syndromes (IVUS-ACS): a two-stage, multicentre, randomised trial. Lancet. 2024;403(10439):1855-65. PubMed PMID: 38604212.

GBD 2021 Causes of Death Collaborators. Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet. 2024;403(10440):2100-32. PubMed PMID: 38582094.

Urban P, Mehran R, Colleran R, Angiolillo DJ, Byrne RA, Capodanno D, et al. Defining High Bleeding Risk in Patients Undergoing Percutaneous Coronary Intervention. Circulation. 2019;140(3):240-61. PubMed PMID: 31116032.

Bainey KR, Marquis-Gravel G, Belley-Cote E, Turgeon RD, Ackman ML, et al. Canadian Cardiovascular Society/Canadian Association of Interventional Cardiology 2023 Focused Update of the Guidelines for the Use of Antiplatelet Therapy. Can J Cardiol. 2024;40(2):160-81. PubMed PMID: 38104631.

Byrne RA, Rossello X, Coughlan JJ, Barbato E, Berry C, Chieffo A, et al. 2023 ESC Guidelines for the management of acute coronary syndromes. Eur Heart J. 2023;44(38):3720-826. PubMed PMID: 37622654.

Lawton JS, Tamis-Holland JE, Bangalore S, Bates ER, Beckie TM, Bischoff JM, et al. 2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2022;145(3):e18-e114. PubMed PMID: 34882435.

Yusuf S, Zhao F, Mehta SR, et al; Clopidogrel in Unstable Angina to Prevent Recurrent Events Trial Investigators. Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation. N Engl J Med. 2001;345(7):494-502. PubMed PMID: 11519503.

Wallentin L, Becker RC, Budaj A, Cannon CP, Emanuelsson H, Held C, et al; PLATO Investigators; Freij A, Thorsén M. Ticagrelor versus clopidogrel in patients with acute coronary syndromes. N Engl J Med. 2009;361(11):1045-57. PubMed PMID: 19717846.

Mehran R, Baber U, Sharma SK, Cohen DJ, Angiolillo DJ, Briguori C, et al. Ticagrelor with or without Aspirin in High-Risk Patients after PCI. N Engl J Med. 2019;381(21):2032-42. PubMed PMID: 31556978.

Kim BK, Hong SJ, Cho YH, Yun KH, Kim YH, Suh Y, et al. Effect of Ticagrelor Monotherapy vs Ticagrelor With Aspirin on Major Bleeding and Cardiovascular Events in Patients With Acute Coronary Syndrome: The TICO Randomized Clinical Trial. JAMA. 2020;323(23):2407-16. PubMed PMID: 32543684.

Kim CJ, Park MW, Kim MC, Choo EH, Hwang BH, Lee KY, et al. Unguided de-escalation from ticagrelor to clopidogrel in stabilised patients with acute myocardial infarction undergoing percutaneous coronary intervention (TALOS-AMI): an investigator-initiated, open-label, multicentre, non-inferiority, randomised trial. Lancet. 2021;398(10308):1305-16. PubMed PMID: 34627490.

Hong SJ, Lee SJ, Suh Y, Yun KH, Kang TS, Shin S, et al. Stopping Aspirin Within 1 Month After Stenting for Ticagrelor Monotherapy in Acute Coronary Syndrome: The T-PASS Randomized Noninferiority Trial. Circulation. 2024;149(8):562-73. PubMed PMID: 37878786.

Natsuaki M, Watanabe H, Morimoto T, Yamamoto K, Obayashi Y, Nishikawa R, et al. An Aspirin-Free Versus Dual Antiplatelet Strategy for Coronary Stenting: STOPDAPT-3 Randomized Trial. Circulation. 2024;149(8):585-600. PubMed PMID: 37994553.

Steiner-Gager GM, Siller-Matula JM. Abbreviated dual antiplatelet therapy after acute coronary syndrome. Lancet. 2024;403(10439):1823-5. PubMed PMID: 38599219.

Autres articles d’intérêt récent :

Connolly SJ, Sharma M, Cohen AT, Demchuk AM, Czlonkowska A, Lindgren AG, et al. Andexanet for Factor Xa Inhibitor-Associated Acute Intracerebral Hemorrhage. N Engl J Med. 2024;390(19):1745-55. PubMed PMID: 38749032.

Blankenberg S, Seiffert M, Vonthein R, Baumgartner H, Bleiziffer S, Borger MA et al; DEDICATE-DZHK6 Trial Investigators. Transcatheter or Surgical Treatment of Aortic-Valve Stenosis. N Engl J Med. 2024;390(17):1572-1583. PubMed PMID: 38588025.

Costalat V, Jovin TG, Albucher JF, Cognard C, Henon H, Nouri N, et al. Trial of Thrombectomy for Stroke with a Large Infarct of Unrestricted Size. N Engl J Med. 2024;390(18):1677-89. PubMed PMID: 38718358.

Frangoul H, Locatelli F, Sharma A, Bhatia M, Mapara M, Molinari L, et al. Exagamglogene Autotemcel for Severe Sickle Cell Disease. N Engl J Med. 2024;390(18):1649-62. PubMed PMID: 38661449.

Locatelli F, Lang P, Wall D, Meisel R, Corbacioglu S, Li AM, et al. Exagamglogene Autotemcel for Transfusion-Dependent beta-Thalassemia. N Engl J Med. 2024;390(18):1663-76. PubMed PMID: 38657265.

Maron MS, Masri A, Nassif ME, Barriales-Villa R, Arad M, Cardim N, et al. Aficamten for Symptomatic Obstructive Hypertrophic Cardiomyopathy. N Engl J Med. 2024;390(20):1849-61. PubMed PMID: 38739079.

Guides de pratique :

Kaplan DE, Ripoll C, Thiele M, Fortune BE, Simonetto DA, Garcia-Tsao G, et al. AASLD Practice Guidance on risk stratification and management of portal hypertension and varices in cirrhosis. Hepatology. 2024;79(5):1180-211. PubMed PMID: 37870298.

Rubio-Tapia A, McCallum R, Camilleri M. AGA Clinical Practice Update on Diagnosis and Management of Cannabinoid Hyperemesis Syndrome: Commentary. Gastroenterology. 2024;166(5):930-4. PubMed PMID: 38456869.

Tjoumakaris SI, Hanel R, Mocco J, Ali-Aziz Sultan M, Froehler M, Lieber BB, et al. ARISE I Consensus Review on the Management of Intracranial Aneurysms. Stroke. 2024;55(5):1428-37. PubMed PMID: 38648283.

Kan P, Fiorella D, Dabus G, Samaniego EA, Lanzino G, Siddiqui AH, et al. ARISE I Consensus Statement on the Management of Chronic Subdural Hematoma. Stroke. 2024;55(5):1438-48. PubMed PMID: 38648281.

Référence du quiz clinique :

Kotani Y, Turi S, Ortalda A, Baiardo Redaelli M, Marchetti C, Landoni G, Bellomo R. Positive single-center randomized trials and subsequent multicenter randomized trials in critically ill patients: a systematic review. Crit Care. 2023;27(1):465. PubMed PMID: 38017475.

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