Evidence map›Paper›PMID 26880570›Full record

Trial reportClinical cardiology2016

Clinical Outcome of First- vs Second-Generation DES According to DAPT Duration: Results of ARCTIC-Generation.

Jean-Philippe Collet, Johanne Silvain, Mathieu Kerneis, Thomas Cuisset, Nicolas Meneveau, Ziad Boueri, Olivier Barthélémy, Grégoire Rangé, Guillaume Cayla, Eric Van Belle and 14 more

Abstract readComparative StudyMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Clinical cardiology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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. Article
  2. Observational
  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

24 authors.

Jean-Philippe ColletUniv Paris 06 (UPMC), ACTION Study Group, Institut de Cardiologie, Hôpital Pitié-Salpêtrière (APHP), Paris, France.
Johanne SilvainUniv Paris 06 (UPMC), ACTION Study Group, Institut de Cardiologie, Hôpital Pitié-Salpêtrière (APHP), Paris, France.
Mathieu KerneisUniv Paris 06 (UPMC), ACTION Study Group, Institut de Cardiologie, Hôpital Pitié-Salpêtrière (APHP), Paris, France.
Thomas CuissetDepartment of Cardiology, CHU La Timone, Marseille, France.
Nicolas MeneveauDepartment of Cardiology, CHU Jean Minjoz, Besançon, France.
Ziad BoueriDepartment of Cardiology, CH de Bastia, France.
Olivier BarthélémyUniv Paris 06 (UPMC), ACTION Study Group, Institut de Cardiologie, Hôpital Pitié-Salpêtrière (APHP), Paris, France.
Grégoire RangéDepartment of Cardiology, Les Hôpitaux de Chartres, Le Coudray, France.
Guillaume CaylaACTION Study Group, Department of Cardiology, CHU Carémeau, Nîmes, France.
Eric Van BelleDepartment of Cardiology, Lille University Hospital, Lille, France.
Simon ElhadadDepartment of Cardiology, CH de Lagny-Marne la Vallée, Lagny-sur-Marne, France.
Didier CarriéDepartment of Cardiology, CHU Rangueil, Toulouse, France.
Christophe CaussinDepartment of Cardiology, Institut Mutualiste Montsouris, Paris, France.
Hélène RousseauACTION Study Group, Unité de Recherche Clinique-Hôpital Lariboisière (APHP), Paris, France.
Pierre AubryDepartment of Cardiology, Centre Hospitalier Bichat (APHP), Paris, France.
Jacques MonséguDepartment of cardiology, Groupe Hospitalier Mutualiste, Grenoble, France.
Pierre SabouretUniv Paris 06 (UPMC), ACTION Study Group, Institut de Cardiologie, Hôpital Pitié-Salpêtrière (APHP), Paris, France.
Stephen A O'ConnorUniv Paris 06 (UPMC), ACTION Study Group, Institut de Cardiologie, Hôpital Pitié-Salpêtrière (APHP), Paris, France.
Jérémie AbtanUniv Paris 06 (UPMC), ACTION Study Group, Institut de Cardiologie, Hôpital Pitié-Salpêtrière (APHP), Paris, France.
Christophe Saint-EtienneDepartment of Cardiology, CHU Trousseau, Tours, France.
Farzin BeyguiACTION Study Group, CHU Côte de Nacre, Caen, France.
Eric VicautACTION Study Group, Unité de Recherche Clinique-Hôpital Lariboisière (APHP), Paris, France.
Gilles MontalescotUniv Paris 06 (UPMC), ACTION Study Group, Institut de Cardiologie, Hôpital Pitié-Salpêtrière (APHP), Paris, France.
ARCTIC Investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

There is an apparent benefit with extension of dual antiplatelet therapy (DAPT) beyond 1 year after implantation of drug-eluting stents (DES). Assessment by a Double Randomization of a Conventional Antiplatelet Strategy vs a Monitoring-Guided Strategy for Drug-Eluting Stent Implantation, and of Treatment Interruption vs Continuation One Year After Stenting (ARCTIC)-Generation assessed whether there is a difference of outcome between first- vs second-generation DES and if there is an interaction with DAPT duration in the ARCTIC-Interruption study. ARCTIC-Interruption randomly allocated 1259 patients 1 year after stent implantation to a strategy of interruption of DAPT (n = 624), in which aspirin antiplatelet treatment only was maintained, or DAPT continuation (n = 635) for 6 to 18 additional months. The primary endpoint was the composite of death, myocardial infarction, stent thrombosis, stroke, or urgent revascularization. A total of 520 and 722 patients received a first- and a second-generation DES, respectively. After a median follow-up of 17 months (interquartile range, 15-18 months) after randomization, the primary endpoint occurred in 32 (6.2%) and 19 (2.6%) patients with first- and second-generation DES, respectively (hazard ratio: 2.31, 95% confidence interval: 1.31-4.07, P = 0.004). This was observed irrespective of the strategy of interruption or continuation of DAPT and timing of study recruitment. Major bleeding events occurred in 4 (0.8%) and 3 patients (0.4%) with first- and second-generation DES, respectively (hazard ratio: 1.79, 95% confidence interval: 0.40-8.02, P = 0.44). Results did not change after multiple adjustments for potential confounding variables. ARCTIC-Generation showed worse clinical outcome with first- vs second-generation DES, a difference that appeared to persist even with prolonged DAPT.

Indexed as

Drug-Eluting StentsAgedCoronary Artery DiseaseCoronary ThrombosisDrug Administration ScheduleDrug Therapy, CombinationFemaleFranceHemorrhageHumansKaplan-Meier EstimateMaleMiddle AgedMyocardial InfarctionPercutaneous Coronary InterventionPlatelet Aggregation InhibitorsPlatelet Aggregation Inhibitors

Identifiers

PMID26880570
PMCPMC6490771

What Socratic holds

Textmetadata
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 Socratic graph.