{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:18:20Z","timestamp":1787008700187,"version":"build-2736575974"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2019,12,9]],"date-time":"2019-12-09T00:00:00Z","timestamp":1575849600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"European Clinical Research Institute"},{"name":"Biosensors International, AstraZeneca, and the Medicines Company"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To evaluate long-term safety and efficacy of ticagrelor monotherapy in patients undergoing percutaneous coronary interventions (PCIs) in relation to chronic obstructive pulmonary disease (COPD) at baseline and the occurrence of dyspnoea reported as adverse event (AE) that may lead to treatment non-adherence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>This is a non-prespecified, post hoc analysis of the randomized GLOBAL LEADERS trial (n\u2009=\u200915\u00a0991), comparing the experimental strategy of 23-month ticagrelor monotherapy following 1-month dual antiplatelet therapy (DAPT) after PCI with the reference strategy of 12-month DAPT followed by 12-month aspirin monotherapy. Impact of COPD and dyspnoea AE (as a time-dependent covariate) on clinical outcomes was evaluated up to 2 years. The primary endpoint was a 2-year all-cause mortality or non-fatal, centrally adjudicated, new Q-wave myocardial infarction. The presence of COPD (n\u2009=\u2009832) was the strongest clinical predictor of 2-year all-cause mortality after PCI [hazard ratio (HR) 2.84; 95% confidence interval (CI) 2.21\u20133.66; P adjusted\u2009=\u20090.001] in this cohort (n\u2009=\u200915\u00a0991). No differential treatment effects on 2-year clinical outcomes were found in patients with and without COPD (primary endpoint: HR 0.88; 95% CI 0.58\u20131.35; P\u2009=\u20090.562; P int\u2009=\u20090.952). Overall, at 2 years dyspnoea was reported as an AE in 2101 patients, more frequently among COPD patients, irrespective of treatment allocation (27.2% in experimental arm vs. 14.5% in reference arm, P\u2009=\u20090.001). Its occurrence was not associated with a higher rate of the primary endpoint (P adjusted\u2009=\u20090.640) in the experimental vs. the reference arm.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this exploratory analysis, COPD negatively impacted long-term prognosis after PCI. Despite higher incidence of dyspnoea in the experimental arm, in particular among COPD patients, the safety of the experimental treatment strategy appeared not to be affected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial registration unique identifier<\/jats:title>\n                    <jats:p>NCT01813435.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjcvp\/pvz052","type":"journal-article","created":{"date-parts":[[2019,12,5]],"date-time":"2019-12-05T07:11:49Z","timestamp":1575529909000},"page":"222-230","source":"Crossref","is-referenced-by-count":10,"title":["Impact of chronic obstructive pulmonary disease and dyspnoea on clinical outcomes in ticagrelor treated patients undergoing percutaneous coronary intervention in the randomized GLOBAL LEADERS trial"],"prefix":"10.1093","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8289-1393","authenticated-orcid":false,"given":"Mariusz","family":"Tomaniak","sequence":"first","affiliation":[{"name":"Department of Cardiology, Erasmus Medical Centre, Erasmus University, Rotterdam, The Netherlands"},{"name":"First Department of Cardiology, Medical University of Warsaw, Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ply","family":"Chichareon","sequence":"first","affiliation":[{"name":"Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands"},{"name":"Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5748-7700","authenticated-orcid":false,"given":"Kuniaki","family":"Takahashi","sequence":"first","affiliation":[{"name":"Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5724-9243","authenticated-orcid":false,"given":"Norihiro","family":"Kogame","sequence":"first","affiliation":[{"name":"Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0047-7859","authenticated-orcid":false,"given":"Rodrigo","family":"Modolo","sequence":"first","affiliation":[{"name":"Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands"},{"name":"Department of Internal Medicine, Cardiology Division, University of Campinas (UNICAMP), Campinas, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun Chin","family":"Chang","sequence":"first","affiliation":[{"name":"Department of Cardiology, Erasmus Medical Centre, Erasmus University, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernest","family":"Spitzer","sequence":"first","affiliation":[{"name":"Department of Cardiology, Erasmus Medical Centre, Erasmus University, Rotterdam, The Netherlands"},{"name":"Cardialysis Core Laboratories and Clinical Trial Management, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franz-Josef","family":"Neumann","sequence":"first","affiliation":[{"name":"Universit\u00e4ts-Herzzentrum Freiburg Bad Krozingen, Bad Krozingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvain","family":"Plante","sequence":"first","affiliation":[{"name":"Southlake Regional Health Centre, Newmarket, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosana","family":"Hern\u00e1ndez Antolin","sequence":"first","affiliation":[{"name":"Hospital Ram\u00f3n y Cajal, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoltan","family":"Jambrik","sequence":"first","affiliation":[{"name":"B\u00e9k\u00e9s Megyei P\u00e1ndy K\u00e1lm\u00e1n K\u00f3rh\u00e1z County Hospital, Gyula, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeri","family":"Gelev","sequence":"first","affiliation":[{"name":"Tokuda Hospital, Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Brunel","sequence":"first","affiliation":[{"name":"Cardiologie Clinique Valmy Hopital Prive Dijon Bourgogne HPDB Dijon, Dijon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana","family":"Konteva","sequence":"first","affiliation":[{"name":"Heart Centre \u201cPontica\u201d, Burgas, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farzin","family":"Beygui","sequence":"first","affiliation":[{"name":"CHU de Caen, Caen, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Francois","family":"Morelle","sequence":"first","affiliation":[{"name":"Clinique St. Martin, Caen, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krzysztof J","family":"Filipiak","sequence":"first","affiliation":[{"name":"First Department of Cardiology, Medical University of Warsaw, Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert-Jan","family":"van Geuns","sequence":"first","affiliation":[{"name":"Department of Cardiology, Erasmus Medical Centre, Erasmus University, Rotterdam, The Netherlands"},{"name":"Department of Cardiology, Radboud UMC, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0758-3539","authenticated-orcid":false,"given":"Osama","family":"Soliman","sequence":"first","affiliation":[{"name":"Department of Cardiology, National University of Ireland Galway, Galway, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Tijssen","sequence":"first","affiliation":[{"name":"Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands"},{"name":"Cardialysis Core Laboratories and Clinical Trial Management, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tessa","family":"Rademaker-Havinga","sequence":"first","affiliation":[{"name":"Cardialysis Core Laboratories and Clinical Trial Management, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert F","family":"Storey","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Science, University of Sheffield, Sheffield, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Hamm","sequence":"first","affiliation":[{"name":"University of Giessen, Giessen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe Gabriel","family":"Steg","sequence":"first","affiliation":[{"name":"FACT (French Alliance for Cardiovascular Trials), Universit\u00e9 Paris Diderot, H\u00f4pital Bichat, Assistance Publique\u2014H\u00f4pitaux de Paris, INSERM U-1148, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Windecker","sequence":"first","affiliation":[{"name":"Department of Cardiology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshinobu","family":"Onuma","sequence":"first","affiliation":[{"name":"Department of Cardiology, National University of Ireland Galway, Galway, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Valgimigli","sequence":"first","affiliation":[{"name":"Department of Cardiology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9636-1104","authenticated-orcid":false,"given":"Patrick W","family":"Serruys","sequence":"first","affiliation":[{"name":"Department of Cardiology, National University of Ireland Galway, Galway, Ireland"},{"name":"NHLI, Imperial College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the GLOBAL LEADERS Study Investigators","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,12,9]]},"reference":[{"key":"2020071511224088300_pvz052-B1","doi-asserted-by":"crossref","first-page":"191.","DOI":"10.1186\/s12872-017-0622-2","article-title":"Major adverse cardiac events and mortality in chronic obstructive pulmonary disease following percutaneous coronary intervention: a systematic review and 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