학술논문
Guided de-escalation of antiplatelet treatment in patients with acute coronary syndrome undergoing percutaneous coronary intervention (TROPICAL-ACS): a randomised, open-label, multicentre trial
Document Type
Article
Author
Sibbing, Dirk; Aradi, Dániel; Jacobshagen, Claudius; Gross, Lisa; Trenk, Dietmar; Geisler, Tobias; Orban, Martin; Hadamitzky, Martin; Merkely, Béla; Kiss, Róbert Gábor; Komócsi, András; Dézsi, Csaba A; Holdt, Lesca; Felix, Stephan B; Parma, Radoslaw; Klopotowski, Mariusz; Schwinger, Robert H G; Rieber, Johannes; Huber, Kurt; Neumann, Franz-Josef; Koltowski, Lukasz; Mehilli, Julinda; Huczek, Zenon; Massberg, Steffen; Parma, Radoslaw; Parma, Zofia; Lesiak, Maciej; Komosa, Anna; Huczek, Zenon; Koltowski, Lukasz; Kowara, Michal; Rymuza, Bartosz; Klopotowski, Mariusz; Malek, Lukasz; Aradi, Daniel; Veress, Gábor; Dézsi, András Döme; Merkely, Béla; Lux, Árpád; Kiss, Róbert Gábor; Papp, Judit; Kovács, Andrea; Dézsi, Csaba András; Amer, Sayour; Ruzsa, Zoltán; Róna, Szilárd; Komócsi, András; Ili, Renáta; Ungi, Imre; Nagy, Ferenc; Zweiker, Robert; Tóth-Gayor, Gábor; Huber, Kurt; Haller, Paul; von Scheidt, Wolfgang; Blüthgen, Andreas; Neumann, Franz-Josef; Trenk, Dietmar; Leggewie, Stefan; Kreider-Stempfle, Hans Ulrich; Remp, Thomas; Kara, Kaffer; Mügge, Andreas; Wutzler, Alexander; Fichtlscherer, Stephan; Zeiher, Andreas M.; Seeger, Florian; Hinterseer, Martin; König, Andreas; Lederle, Susanne; Jacobshagen, Claudius; Czepluch, Frauke; Maier, Lars; Schillinger, Wolfgang; Sossalla, Samuel; Hummel, Astrid; Felix, Stephan; Karakas, Mahir; Sydow, Karsten; Rudolph, Tanja; Halbach, Marcel; Gori, Tommaso; Münzel, Thomas; May, Andreas; Gerstenberg, Carsten-Manuel; Pilecky, David; Rieber, Johannes; Deichstetter, Markus; Sibbing, Dirk; Mehilli, Julinda; Gross, Lisa; Kääb, Stefan; Löw, Anja; Orban, Martin; Orban, Matthias; Sattler, Stefan; Deuschl, Sabine; Teupser, Daniel; Holdt, Lesca; Mudra, Harald; Räder, Thomas; Schütz, Torsten; Vahldiek, Felix; Divchev, Dimitar; Ince, Hüseyin; Nienaber, Christoph A; Radunski, Henning; Boekstegers, Peter; Horstkotte, Jan; Mueller, Ralf; Geisler, Tobias; Müller, Karin; Schwinger, Robert; Rasp, Oliver
Source
The Lancet; October 2017, Vol. 390 Issue: 10104 p1747-1757, 11p
Subject
Language
ISSN
01406736; 1474547X
Abstract
Current guidelines recommend potent platelet inhibition with prasugrel or ticagrelor for 12 months after an acute coronary syndrome managed with percutaneous coronary intervention (PCI). However, the greatest anti-ischaemic benefit of potent antiplatelet drugs over the less potent clopidogrel occurs early, while most excess bleeding events arise during chronic treatment. Hence, a stage-adapted treatment with potent platelet inhibition in the acute phase and de-escalation to clopidogrel in the maintenance phase could be an alternative approach. We aimed to investigate the safety and efficacy of early de-escalation of antiplatelet treatment from prasugrel to clopidogrel guided by platelet function testing (PFT).