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Anti-thrombotic and glucose lowering therapy in patients with diabetes and Coronary Artery disease undergoing PCI. Final report on two-year outcomes of the ARTHEMIS Study
Session:
SESSÃO DE POSTERS 37 - DOENÇAS CARDIOVASCULARES - TERAPÊUTICA ANTITROMBÓTICA
Speaker:
Luís Raposo
Congress:
CPC 2025
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
12. Coronary Artery Disease (Chronic)
Subtheme:
12.4 Coronary Artery Disease – Treatment
Session Type:
Cartazes
FP Number:
---
Authors:
Luis Raposo; Gustavo Pires Morais; Luis Almeida Morais; João Costa; Hugo Vinhas; Gustavo Campos; Pedro Carrilho Ferreira; Filipe Seixo; Cristina Martins; Diogo Rodrigues Brás; André Alexandre; Sérgio Bravo Baptista
Abstract
<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:10.0pt"><span style="font-family:"Avenir Book""><strong>Background and aims.</strong><strong><span style="font-size:10.0pt"><span style="font-family:"Avenir Book""> </span></span></strong>In a nationwide prospective registry, anti-platelet and glucose-lowering prescription regimens, treatment compliance and clinical outcomes were evaluated in unselected patients with type-2 diabetes (DM) undergoing PCI with stent implantation. Current analysis reports on the final 2—year results.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:10.0pt"><span style="font-family:"Avenir Book"">Population and Methods. </span></span></strong><span style="font-size:10.0pt"><span style="font-family:"Avenir Book"">Patients (N=1000, 68±13 yo, 55.5% ACS) were recruited between January and November 2021 in 12 centres. Information on recommended therapy (namely anti-thrombotic strategy), compliance, vital status, as well as ischemic, heat failure and bleeding events was captured at 6, 12, 18 and 24-months at each participating centre, and summarized at 12 and 24-months as appropriate.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:10.0pt"><span style="font-family:"Avenir Book"">Results. </span></span></strong><span style="font-size:10.0pt"><span style="font-family:"Avenir Book"">Data on vital status was available for 98.2% and 96.6% of pts at 12 and 24-months, respectively. Total and cardiovascular mortality rates were 7.4% and 2.3% at 2-years. Ischemic MACE (death+MI+revasc) occurred in 17,7% of pts (mostly repeat revascularizations [9.7%]) and the rate of admission for heart failure was 3.9%. Baseline ischemic DAPT-Score (<u>></u>2) was not associated with MACE (17.6% vs 18.5% in High vs Low risk; p=0.75). Haemorrhagic events were reported in 11.4% of pts (15.6% vs 9.3% in High vs. Low baseline PRECISE-DAPT bleeding risk; p=0.007), being mostly BARC-1 (n=41/99), and one fatal bleeding (0.1%). At the 12-months landmark, anti-platelet regimens were consistent with baseline strategy in 71.6% of cases. In the remaining, 5.8% were on (or changed to) a less aggressive regimen; conversely, 19.2% changed in the opposite direction (more aggressive treatment), a proportion that rose to 40.9% at 2-years. Change was mostly driven by medical decision (66% of cases). Use of SGT2 and GLP-1 inhibitors (but not other glucose-lowering drugs), increased steadily over time. As compared to baseline, metabolic control consistently improved over the observation period (HbA1c 7.6% at inclusion vs 7.1% at 1 and 2-years; p=0.002 Related-Samples Friedman's Ranked Two-Way ANOVA).</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:10.0pt"><span style="font-family:"Avenir Book"">Conclusions. </span></span></strong><span style="font-size:10.0pt"><span style="font-family:"Avenir Book"">In this cross-sectional study of a representative population of patients with DM and CAD warranting stent implantation, both ischemic and bleeding event rates were significant. Maintenance of potent anti-platelet regimens remained frequent over time, likely as a consequence of recurrent ischemic events. Prescription of prognosis-modifying drugs for diabetes increased steadily, and metabolic control improved significantly over the study period. </span></span></span></span></p>
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