ARCTIC Trial Shows No Benefits to Adjusting Antiplatelet Therapy and Platelet Monitoring for Coronary Stenting
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The ARCTIC trial found that there were no significant improvements in clinical outcomes with platelet function monitoring and treatment adjustment for coronary stenting, when compared to standard antiplatelet therapy without monitoring. |
These findings were presented as part of AHA 2012 in Los Angeles, Ca. and simultaneously published in The New England Journal of Medicine. The trial looked at 2,440 randomly assigned patients at 38 centers, found the primary endpoint of the composite of death, myocardial infarction, stent thrombosis, stroke or urgent revascularization occurred in 34.6 percent of the patients in the monitoring group one year after stent implantation, compared to 31.1 percent of those in the conventional-treatment group (hazard ratio, 1.13, 95 percent confidence internal [CI], 0.98 to 1.29, P=0.10). In addition, the main secondary endpoint, stent thrombosis or any urgent revascularization, occurred in 4.9 percent of the patients in the monitoring group and 4.6 percent of those in the conventional treatment group (hazard ratio, 1.06; 95 percent CI, 0.74 to 1.52; P=0.77). |
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The authors suggest that given patients' responses to oral antiplatelet therapy vary, bedside monitoring offers the opportunity to improve outcomes after coronary stenting by individualizing therapy. However, they note that there are "no significant improvements in clinical outcomes with platelet-function monitoring and treatment adjustment for coronary stenting."
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