Interventional Cardiology, Sandro Pertini Hospital, Rome.
Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II.
J Cardiovasc Med (Hagerstown). 2022 Nov 1;23(11):738-743. doi: 10.2459/JCM.0000000000001372. Epub 2022 Sep 7.
Percutaneous coronary intervention with stent implantation (PCI-S) in patients requiring chronic oral anticoagulant therapy (OAC) is associated with an increased risk of bleeding and ischemic complications. Different randomized studies showed a significant advantage of a double antithrombotic therapy and superiority of direct oral anticoagulant (DOAC) compared with warfarin, but real-world data are limited. Aim is to evaluate the antithrombotic management and clinical outcome of patients with an indication for OAC who undergo PCI-S in a 'real-world' setting.
The multicentre prospective observational PERSEO (PERcutaneouS coronary intErventions in patients treated with Oral anticoagulant therapy) Registry (ClinicalTrials.gov Identifier: NCT03392948) has been designed to enrol patients requiring OAC treated by PCI-S in 25 Italian centres. A target of at least 1080 patients will be followed for 1 year and data on thromboembolic and bleeding events and changes in antithrombotic therapy will be registered. The primary end point is a combined measure of efficacy and safety outcome (NACE), including major bleeding events and major adverse cardiac and cerebral events at 1-year follow-up in patients treated with DOAC (and dual or triple antiplatelet therapy) compared with the corresponding strategies with vitamin K antagonists. A secondary prespecified analysis has been defined to evaluate NACE in dual versus triple antithrombotic therapy after hospital discharge at 1-year follow-up.
The PERSEO Registry will investigate in a 'real world' setting the safety and efficacy of DOAC versus warfarin and dual versus triple antithrombotic therapy in patients with indication for oral anticoagulant therapy who undergo PCI-S.
需要长期口服抗凝治疗(OAC)的患者行经皮冠状动脉介入治疗(PCI-S)与出血和缺血性并发症风险增加相关。不同的随机研究表明,双联抗血栓治疗具有显著优势,且直接口服抗凝剂(DOAC)优于华法林,但真实世界数据有限。本研究旨在评估在真实世界环境下,行 PCI-S 的 OAC 适应证患者的抗栓管理和临床结局。
多中心前瞻性观察性 PERSEO(接受口服抗凝治疗的经皮冠状动脉介入治疗患者)登记研究(ClinicalTrials.gov 标识符:NCT03392948)旨在纳入 25 家意大利中心行 PCI-S 的 OAC 治疗患者。将至少随访 1080 例患者 1 年,登记血栓栓塞和出血事件以及抗栓治疗变化的数据。主要终点是 DOAC(双联或三联抗血小板治疗)与维生素 K 拮抗剂治疗患者的 1 年随访时的有效性和安全性复合终点(NACE),包括大出血事件和主要心脏和脑不良事件。还定义了次要预设分析,以评估 1 年随访时出院后双联与三联抗栓治疗的 NACE。
PERSEO 登记研究将在真实世界环境下评估 DOAC 与华法林以及双联与三联抗栓治疗在需要 OAC 治疗而行 PCI-S 的患者中的安全性和有效性。