3 research outputs found
Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
- Author
- Abad-Motos Ane
- Abbas Ahmed M.
- Abbas Mostafa
- Abbasi Mujeeb
- Abbott Tom
- Abd Karim Muhammad Fairuz Shah
- Abdalaal Ibrahim
- Abdel-Galil Khalid
- Abdelemam Rania
- Abdelgawad Abdalrahman
- Abdelkarim Maryam
- Abdelkhalek Mohamed
- Abdelmageed Abdelfatah
- Abdelmawgoud Sherif
- Abdelmohsen Sarah
- Abdelrahman Ahmed Saber
- Abdelrahman Mostafa
- Abdelwahab Khaled
- Abdou Hossam
- Abdulai Darling Ramatu
- Abdulkhaleq Marwa
- Abdullah Bahiyah
- Abdulsalam Khalifa
- Abdulsalam Shuaib
- Abdur-Rahman Lukman
- Abdus-Salam Rukiyat
- Abdussalam Hameedat Opeyemi
- Abebrese John Tabiri
- Abeldaño Ariel
- Abou-Khalil Jad
- Abou-Taleb Hisham
- Abozid Anwaar
- Abozied Hesham
- Abrate Alberto
- Abu-Zaid Ahmed
- Abubakar Mohammed Kabir
- Abud Burçin
- Abuzaid Mohammed
- Adam Albushra Altayeb
- Adamina Michel
- Adamou Harissou
- Adamu Auwal
- Adamu Kabir Musa
- Adanu Kekeli
- Adebara Idowu
- Adebola Oluwaseyi
- Ademuyiwa Adesoji
- Adeniran Abiodun
- Adepiti Akinfolarin
- Aderogba Adeleke Akeem
- Adesunkanmi Abdulhafiz
- Adeyeye Ademola
- Adisa Adewale
- Adjeso Theophilus Justus Kofi
- Ads Adel Mohamed
- Ads Alaa Mohamed
- Adu-Aryee Nii Armah
- Adumah Collins
- Afzal Irrum
- Agapov Mikhail
- Agarwal Gaurav
- Agarwal Ravi
- Agbeko Anita Eseenam
- Agbeno Evans Kofi
- Agbonrofo Peter
- Agboola Oluseyi
- Aggarwal Gaurav
- Aghadi Ifeanyi
- Aghtarafi Natasha
- Agrawal Amit
- Agresta Ferdinando
- Aguado Héctor J.
- Aguilera-Arevalo Maria-Lorena
- Aherne Thomas
- Ahmad Aline
- Ahmad Maleeha
- Ahmad Misbahu
- Ahmad Sarwat
- Ahmad Shahzaib
- Ahmad Shoaib
- Ahmed Hayat Tarig Abdelhafiz
- Ahmed Khalid
- Ahmed Sharwany
- Ahmed Shima
- Ahmed Usama
- Aisuodionoe-Shadrach Oseremen
- Aitken Sarah
- Ajenifuja Kayode
- Ajiya Abdulrazak
- Akeel Nouf
- Akin Emrah
- Akinajo Opeyemi
- Akinyemi Tosin
- Akrida Ioanna
- Aktokmakyan Talar Vartanoglu
- Akwaisah Ayoub
- Al Bettar Osama
- Al-Badawi Ismail A.
- Al-Juaifari Maytham
- Al-Khyatt Waleed
- Al-Mallah Abdullah
- Al-Nusairi Ahmed
- Al-Saadi Nina
- Al-Sayaghi Khaled
- Al-Shaiji Tariq
- Al-Shehari Mohammed
- Al-Touny Aiman
- Al-Touny Shimaa A.
- Aladawi Omar
- Aladna Abdallah
- Alali Mahmoud
- Alam Mahmood
- Alam Mohammed Shadrul
- Alarabi Rehab
- Alawneh Yazan
- Alayande Barnabas
- Albanese Erminia
- Albayadi Eslam
- Albdour Maram
- Alconchel Felipe
- Alderazi Amer
- Alegbeleye Bamidele
- Alekberli Tural
- Alemu Misganaw Alemu Adimass
- Alexander Philip
- Alfieri Alex
- Algahtany Khaled
- Algarni Kamal
- Alhamad Ameen
- Alhamid Mohammad
- Alharmi Rawan A. Rahman
- Alharthi Mohammed
- Alhazmi Barrag
- Ali Mohamed Shafi Mahboob
- Ali Stephen
- Alibrahim Hidar
- Aljaaly Hattan
- Aljaiuossi Anas
- Aljanadi Firas
- Aljiffry Murad
- Aljirdabi Noof
- Alkahlan Mohammed
- Alkhalifa Elmustafa
- Alkhatib Sondos
- Alkhatieb Maram
- Allan Anna
- Almarshad Felwa
- Almgla Naser
- Almhimid Ali
- Almiqlash Bushray
- Almoshantaf Mohammad Badr
- Almutairi Abdulmjeed
- Alnsour Abed Alfattah Mahmoud
- Alobied Majd
- Alomar Osama
- Alonso Jesús Aarón Martínez
- Alonso Manuel Diez
- Alonso Nestor Fabian Pedraza
- Alonso Veronica
- Alqallaf Abdullah
- Alqaseer Asma
- Alrayes Bourhan
- Alsefri Maryam
- Alser Osaid
- Alsharif Mohammed
- Alsori Mohamed
- Altaf Abdulmalik
- Altinel Yuksel
- Altiner Saygin
- Altouny Ahmad
- Altun Demet
- Alvarez Natalia
- Alvarez-Lozada Luis Adrian
- Alvi Abdul
- Alwael Athari
- Alwash Mohammed
- Alyami Ziyad
- Alyousef Mohammed
- Alzahrani Saud
- Alzerwi Nasser
- Amin Shivang
- Amir Mohammed
- Ammar Ahmed Siddique
- Ammendola Michele
- Amores Remedios Revilla
- Amrayev Sultan
- Anastasiadou Sofia
- Ancans Guntis
- Anderson Caroline
- Andreani Lorenzo
- Andreotti Dario
- Andreuccetti Jacopo
- Andrianakis Alexandros
- Andro Christophe
- Anesi Alexandre
- Angamuthu Stephen
- Angeles Martina Aida
- Angelico Roberta
- Angelis Fragkiskos
- Angelou Dimitrios
- Angelou Kyveli
- Angulo Victor Pinto
- Anjum Arfa
- Anjum Muhammad Ayyub
- Annicchiarico Alfredo
- Anoldo Pietro
- Ansaloni Luca
- Anthoulakis Christos
- Antonelli Amedeo
- Anwar Mohamed
- Anwar Sumadi Lukman
- Anwer Mariyah
- Anyanwu Lofty-John
- Apostolou Christos
- Apostolou Konstantinos
- Appiah-Kubi Adu
- Aprea Giovanni
- Arbab Hana
- Archer James
- Ardura Francisco
- Aremu Muyiwa
- Arif Tahera
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- Armatura Giulia
- Armijos Daniel
- Arnaout Ali
- Arnaoutoglou Eleni
- Arnaud Alexis P.
- Arneja Jugpal
- Arrangoiz Rodrigo
- Arshad Muhammad
- Arthur Joshua
- Ashcroft James
- Ashford Bruce
- Ashraf Fariha
- Asiimwe Daniel
- Asirifi Samuel Amoako
- Asla Amir
- Aslam Ramisha
- Aspide Raffaele
- Ataya Karim
- Ateca Ibabe Villalabeitia
- Atici Semra Demirli
- Atis Gokhan
- Atkins William
- Atkinson Kate
- Attwood Joseph
- Auerkari Aino
- Augestad Knut Magne
- Augustin Goran
- Aujayeb Avinash
- Avella Pasquale
- Awad Ahmed K.
- Awad Hadeel
- Awad Rabih
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- Aydin Yener
- Ayeni Funbi
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- Balla Andrea
- Balogh Zsolt J.
- Balogun James A.
- Balogun Simon
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- Saleh Ma'Moun
- Salem Hani
- Salem Moacyr
- Salisu Ibrahim
- Salizzoni Stefano
- Sall Ibrahima
- Sallam Asser
- Salunke Pravin
- Salö Martin
- Samadov Elgun
- Saman Pradeep I.H.D.
- Samara Athina
- Samara Evangelia
- Sambhwani Sharan
- Sammour Tarik
- Samo Khursheed Ahmed
- Sandri Giovanni Battista Levi
- Sanli Ahmet Necati
- Santini Alasdair
- Santoro Antonio
- Santos-Costa Paulo
- Santoshi John Ashutosh
- Santric Veljko
- Sapienza Paolo
- Saponaro Gianmarco
- Saraceno Federica
- Saracoglu Ayten
- Saracoglu Kemal
- Sari Ramazan
- Sarjanoja Elise
- Sars Carl
- Sasia Diego
- Sasireka Veerasamy
- Satchithanantham Vinojan
- Satoskar Savni
- Sayed A. Emad
- Sayyed Raza
- Scabini Stefano
- Scacchi Andrea
- Scafa Anthony Kevin
- Scaramuzzo Rosa
- Scaravilli Luca
- Scaringi Stefano
- Schache Andrew
- Schiavone Vincenzo
- Schizas Dimitrios
- Schizas Nikolaos
- Schmitt Françoise
- Schmitz-Rixen Thomas
- Schneck Emmanuel
- Schröder Lars
- Schweitzer Donald
- Scifo Amedeo
- Scopelliti Michele
- Scott Erin
- Seah Kt Matthew
- Sebai Amine
- Seeliger Barbara
- Seenivasagam Rajkumar Kottayasamy
- Segalini Edoardo
- Segaren Neil
- Segaren Nicholas
- Seglenieks Richard
- Segura-Sampedro Juan José
- Seguya Amina
- Seidu Anwar Sadat
- Seiwerth Ingmar
- Sekulić Aleksandar
- Semple Abigail
- Sen Comert
- Senanayake Kithsiri Janakantha
- Senent-Boza Ana
- Seneviratne Sanjeewa
- Senni Carlotta
- Sensi Bruno
- Seraj Shaikh Sanjid
- Serban Andreea-Madalina
- Serenari Matteo
- Serra Margherita
- Serra Marta Lopes
- Seshadri Ramakrishnan Ayloor
- Sethi Aman
- Seyfried Steffen
- Seyi-Olajide Justina
- Sečan Tomislav
- Sgarzani Rossella
- Shaban Naseebah
- Shaddad Ebrahim
- Shaerf Daniel
- Shah Faaiz Ali
- Shah Hemina
- Shah Jaffer
- Shah Karishma
- Shah Pritik A
- Shah Vinay
- Shaikh Shafaque
- Shalaby Mostafa
- Shalhoub Joseph
- Shamim Shahzad
- Sharma Naveen
- Sharma Neil
- Sharma Rahul Deo
- Sharma Shilpa
- Sharpin Claire
- Sheen Jonathon
- Shehata Sherif
- Shehta Ahmed
- Sheik Shahila
- Sheikh Eman
- Shekleton Florence
- Shelat Vishal
- Shelmerdine Lauren
- Sherif Ahmed Elshawadfy
- Shiban Ehab
- Shiota Masaki
- Shirazi Ahmed
- Shiwani Haaris
- Shmukler Daniel
- Shokor Muntaser Abu
- Sholadoye Tunde T.
- Shoukrie Shoukrie I. M.
- Shrestha Rashmit
- Siboe Mark
- Sica Giuseppe
- Siddig Esra
- Siddiqui M. Tayyab
- Sidiropoulos Theodoros
- Sievers Denise
- Sigamoney Kohila
- Silvestri Vania
- Simoes Joana
- Simon Natalie
- Simoncini Tommaso
- Simões Joana Filipa Ferreira
- Singer Georg
- Singh Abhinav
- Singh Baljit
- Singh Kathryn
- Singh Rajdeep
- Singh Tanveer
- Sinnerton Robert
- Siragusa Leandro
- Sivaprakasam Rajesh
- Skipworth Richard Je
- Slavchev Mihail
- Sleem Adham
- Smati Ismail
- Smelt Jeremy
- Smith A.
- Smolle-Juettner Freyja-Maria
- Sodhai Vivek
- Sofi Khalid
- Sohrabi Catrin
- Soibiharry Adaiah
- Sokolov Manol
- Solaini Leonardo
- Sole Oriol Martin
- Sole-Sedeno Josep M.
- Soljic Martina
- Solli Piergiorgio
- Soon Wai Cheong
- Sorbi Flavia
- Sotiropoulou Maria
- Sotudeh Mohadeseh
- Souadka Amine
- Soucheiron Maria Coronas
- Soytas Mustafa
- Sozzi Giulio
- Sparavigna Marco
- Spartalis Michael
- Spellar Kayleigh
- Spiers Harry V. M.
- Spina Alfio
- Spriano Giuseppe
- Squiers John
- Stabler Robert
- Stamatakis Emmanouil
- Stamatis Konstantinos
- Starr Nichole
- Stather Philip
- Stevens Sean
- Stevenson Andrew
- Stewart Grant D.
- Stijns Jasper
- Stogowski Piotr Tomasz
- Stoleriu Mircea Gabriel
- Stoyanov Vladislav
- Street John
- Strotmann Johanna Josefine
- Stroumpoulis Konstantinos
- Su Yu-Xiong
- Suarez Sara Busto
- Subramani Yamini
- Subramaniam Sentilnathan
- Sue-Chue-Lam Colin
- Suer Muhammed Salih
- Sulaiman Bilal
- Sultania Mahesh
- Sundarraju Shalini
- Sungurtekin Hulya
- Suresh Sreelakshmi
- Surya Ilham Utama
- Swed Sarya
- Syllaios Athanasios
- Symeonidis Dimitrios
- Szabómihályová Katarína
- Szakmany Tamas
- Szatmary Peter
- Sztipits Tamás
- Szyluk Karol
- Sá-Marta Eduarda
- Sánchez Alberto Cabañero
- Sánchez Rosa
- Sánchez-Guillén Luis
- Süleyman Marlen
- Tadic Boris
- Taha Anas
- Taha-Mehlitz Stephanie
- Tailor Bhavesh
- Taj Eldeen Samaher Taj Eldeen Hassan
- Takeda Flavio Roberto
- Takkenberg Marijn
- Talat Nabila
- Tallon-Aguilar Luis
- Talwar Rishi
- Tamayo Beatriz Villota
- Tamburello Sara
- Tamini Nicolò
- Tammo Ömer
- Tamoos Khalil
- Tampaki Ekaterini Christina
- Tampakis Athanasios
- Tan Chih Ying
- Tan Shawn Jia Hwang
- Tanal Mert
- Tanas Yousef
- Tang Alethea
- Tang Yita
- Tani Sobhana Iftekhar
- Tantraworasin Apichat
- Tantri Aida Rosita
- Tapia-Herrero Ana-María
- Tarek Ahmed
- Tariq Aiman
- Tarle Marko
- Tarsitano Achille
- Tartaglia Dario
- Tartaglia Nicola
- Tashkandi Wail
- Taskiran Cagatay
- Tatar Cihad
- Tatsis Dimitris
- Tawalbeh Ra'Fat
- Tawiah Augustine
- Tebha Sameer
- Techapongsatorn Suphakarn
- Teixeira Pedro
- Tejero-Pintor Francisco J.
- Tellez Karla Susana Martin
- Tellez Luis Garcia-Sancho
- Thaha Mohamed Adhnan
- Thakar Sumit
- Thaw May Htoo
- Theivendran Kanthan
- Thekkinkattil Dinesh
- Theochari Nikoletta
- Theodoropoulos George
- Theophilidou Elena
- Thereska Dariel
- Thiruchandran Gajendiran
- Thomakos Nikolaos
- Thomas Bradley
- Thomas Jerin Jose
- Thuduvage Vasanthika
- Thumbadoo Ruben
- Tian Sarah
- Tidjane Anisse
- Tirloni Luca
- Toia Francesca
- Tokidis Evripidis
- Tokocin Merve
- Tolani Musliu Adetola
- Toma Elena Adelina
- Tomasicchio Giovanni
- Tomlinson James
- Tonini Valeria
- Torre Beatrice
- Torregrosa Cristina
- Torun Bahar Canbay
- Tottman R.
- Tousidonis Manuel
- Trabulsi Nora
- Tranca Sebastian
- Trebol Jacobo
- Trejo-Avila Mario
- Triantafyllou Alexandra
- Triantafyllou Tania
- Trifunovski Aleksandar
- Tripathi Manjul
- Tripathi Prashant
- Tripathy Sujit
- Trivik-Barrientos Felipe
- Trostchansky Ivan
- Trulson Alexander
- Trungu Sokol
- Truss Adam
- Tsakiridis Ioannis
- Tsakiridis Nikolaos
- Tsiantoula Paraskevi
- Tsironis Dimitrios
- Tsolakidis Alexandros
- Tsoulfas Georgios
- Tucker Olga
- Tuech Jean Jacques
- Turan Alparslan
- Turi Stefano
- Turna Akif
- Turrado-Rodriguez Victor
- Turri Giulia
- Tutino Roberta
- Tuyishime Eugene
- Tzelves Lazaros
- Tzima Ioanna
- Tzimas George
- Ubiali Paolo
- Ubom Akaninyene Eseme
- Ugwu Aloy Okechukwu
- Ugwu Ebere
- Ugwu Ifeanyichukwu
- Ul Huda Maria Noor
- Ulas Ali Bilal
- Uldry Emilie
- Ulgur Hanife Seyda
- Ulkucu Attila
- Ulman Elif Akbas
- Ulman Hilmican
- Ulutaş Mehmet Eşref
- Underwood Kirk
- Unsworth Richard
- Uprak Tevfik Kivilcim
- Urriza Pablo Vallés
- Usman Muhammad
- Usman Mustapha Ibrahim
- Vaassen Lauretta
- Vaccara Vincenzo La
- Vagena Xanthoula
- Vagge Aldo
- Vailas Michail
- Valadez Andrea Estefania Cueto
- Valadez Tania Abigail Cueto
- Valanci Sofia
- Valdespino Cristina Puentes
- Valeanu Liana
- Valioulis Ioannis
- Valladares Sergio Chávez
- Vallve-Bernal Marc
- Van Acker Jill
- Van Den Eynde Jef
- Van Goor Harry
- Van Vliet Helen
- Van Wyk Naomi Natasha
- Vanni Camilla
- Vas Aurelia
- Vasarhelyi Edward
- Vaschetti Roberto
- Vassiliu Panteleimon
- Vatansever Dogan
- Vatish Jamie
- Vaughan-Shaw Peter G.
- Vaysburg Dennis
- Veglia Antonella
- Velten Markus
- Velázquez Maria Jose Martinez
- Venkatappa Sunil Kumar
- Venketeswaran Meenakshi
- Venskutonis Donatas
- Verbic Milena Senica
- Verdi Daunia
- Vergara-Fernandez Omar
- Verhoeff Kevin
- Veroux Massimiliano
- Verras Georgios-Ioannis
- Verre Luigi
- Vida Lucian
- Vidya Raghavan
- Viglietta Edoardo
- Vijay Vardhini
- Vijgen Guy
- Vilaró Blanca Capdevila
- Villanueva Julio
- Vilz Tim O.
- Vincent Elizabeth
- Vinci Danilo
- Viola Simona
- Violante Tommaso
- Vishnoi Jeewan Ram
- Vissapragada Ravi
- Vivancos Laura Guillamon
- Vives Josep Maria Muñoz
- Vizzielli Giuseppe
- Vohra Lubna
- Vokshi Ismail
- Vosinakis Christos
- Vásquez Javier Alberto Gutiérrez
- Vázquez Gil
- Vázquez Irene Ortega
- Vǎcǎraşu Andrei Bogdan
- Wade Ryckie
- Wafi Omar
- Wagner Gabriela
- Wallis Christopher
- Wanjara Samuel
- Waqar Shahzad Hussain
- Warden Claire
- Warner Christian
- Wasim D.
- Wason Shaun
- Wasserman Isaac
- Watcyn-Jones Tom
- Waterson Ben
- Watson David
- Watson Matthew
- Weber Clemens
- Wheatstone P.
- Wheeler James
- Wheldon Luke
- White Michelle
- White Stuart
- White William
- Wickramasinghe Dakshitha
- Widmer Lukas Werner
- Wiedemann Dominik
- Wiesinger Clemens Georg
- Wijekoon Naveen
- Wijenayake Wasantha
- Wijeyaratne Manuk
- Wijeysundera Duminda
- Wiles Matthew
- Wilkin Richard
- Wilkins Alex
- Wilkins James
- William Tinka George
- Williams Omolara Modupe
- Williams Shekinah
- Windsor John
- Winnand Philipp
- Wittmann Maria
- Wolde Amanuel
- Wolfenden John W. D.
- Wong Benjamin Ngie Xiong
- Wong Enoch
- Wong Evan G.
- Wong George Kwok Chu
- Wong Ho Ying Flora
- Wong Kai Yuen
- Wormald Justin
- Wright Deborah
- Wright Joshua
- Wu Fiona
- Wurm Markus
- Xenaki Sofia
- Yadev Ip
- Yahaya Ahmad Shuib
- Yakubu Mustapha
- Yang Wah
- Yanik Özge
- Yanowsky-Reyes Guillermo
- Yassin Abubaker
- Yates Elizabeth
- Yebes Alvaro
- Yenli Edwin Mwintiereh Ta-Ang
- Yeoh Tien
- Yeung Justin
- Yiallourou Anneza
- Yigit Banu
- Yildirim Asif
- Yim Guang
- Yiu Andrew
- Yonekura Hiroshi
- Yotsov Tsanko
- Younis Muhammad Umar
- Yunus Alif
- Yusefi Hossein
- Zabaleta Jon
- Zabkiewicz Catheriner
- Zaccaria Giulia
- Zacharia Bincy
- Zafar Syed Nabeel
- Zago Mauro
- Zaheen Zakia
- Zahid Zahra
- Zaimis Tilemachos
- Zakaria Andee Dzulkarnaen
- Zambon Martina
- Zamora Lindsey
- Zampogna Biagio
- Zancana Giuseppa
- Zani Augusto
- Zanin Luca
- Zanini Nicola
- Zapardiel Ignacio
- Zapata Carlos Shiraishi
- Zarif Pierre
- Zaránd Attila
- Zehnder Philipp
- Zenger Serkan
- Zenha Horácio
- Zhu Michael Z. L.
- Ziemann Sebastian
- Zimak Danijela Mrazovac
- Zimak Zoran
- Zivkovic Dragana
- Zizzo Maurizio
- Zucker Benjamin
- Zwain Yasir
- Zyskowski Michael
- Ávila Clara Castro
- Älgå Andreas
- Çakici Mehmet Çaǧlar
- Çelik Enes
- Çelik Meryem Nur
- Özçay Necdet
- Şevik Hüsnü
- Šantak Goran
- Šimko Kristián
- Žatecký Jan
- Publication venue
- 'Oxford University Press (OUP)'
- Publication date
- 01/01/2023
- Field of study
Abstract
Background
Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres.
Methods
This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries.
Results
In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia.
Conclusion
This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries
Bjergbønder i Guatemala og juletræsdyrkning
- Publication venue
- Publication date
- 01/01/2007
- Field of study
Ticagrelor in patients with diabetes and stable coronary artery disease with a history of previous percutaneous coronary intervention (THEMIS-PCI) : a phase 3, placebo-controlled, randomised trial
- Author
- Abbott J
- Abe Mitsuru
- Abouglila Kamal
- Abrahamovych Orest
- Abu-Fadel Mazen
- Accini Jose
- Acikel Sadik
- Adhyapak Srilakshmi
- Agaiby John
- Aggarwala Guarav
- Aguilera Roberto M
- Ahn Taehoon
- Aksentiev Sergei
- Akyea-Djamson Ayim
- Al-Amin Jessie
- Al-Faleh Hussam
- Al-Saif Shukri
- Al-Shehri Abdullah
- Al-Zoebi Ayham
- Aladellie Layth
- Albisu Juan
- Alfata Sarab
- Alshehri Halia
- Alvarado Odilon
- Alvarez Jose
- Alvarisqueta Andres
- Amerena John
- Amerena John
- Amin Amit
- Amoroso Giovanni
- Andersson Marielle
- Andersson Marielle
- Andersson Marielle
- Andrawis Nabil
- Andries Alin
- Andrássy Péter
- Angerås Oskar
- Angiolillo Dominick
- Angoulvant Denis
- Ansari Saadat
- Antalik Lubomir
- Aoyama Takahiko
- Appel Karl-Friedrich
- Arana Camilo
- Arat Alev
- Arbanil Hugo
- Arora Satish
- Arriagada German
- Arshad Tamjeed
- Arslan Sakir
- Arvind Moogali
- Arya Ktut
- Asenjo Roberto M
- Asfour Wail
- Askar Alfredo N
- Assanelli Emilio
- Atieh Mahmoud
- Auer Johann
- Avino David
- Babapulle Mohan
- Babilonia Noe
- Babilonia Noe A
- Bae Jang-Whan
- Baglikov Andrey
- Bailey Allan
- Bailey Gordon
- Bain Stephen
- Bakai Judit
- Bakhtari Ladan
- Ballyuzek Marina
- Bander Jeffrey
- Bandh Stellan
- Banerjee Subhash
- Banerjee Supratim
- Banerjee Suvro
- Barabashkina Anna
- Baracioli Luciano
- Barbarash Olga
- Barbas Benny
- Barettella Mark
- Bashkin Amir
- Basiak Marcin
- Baszak Jacek
- Bata Iqbal
- Bauer Michael
- Bayat Junaid
- Bazari Rasha
- Bednarova Jana
- Behnke Thomas
- Bell Alan
- Belle-Isle Jasmin
- Bellotti Sandro
- Belohlavek Jan
- Benczur Bela
- Bennett James
- Berg-Johansen Jan
- Berger Rudolf
- Berrospi Percy
- Bertolet Barry
- Bertrand Olivier
- Bertsch John
- Besada Diego
- Bessoudo Ricardo
- Beth Mary
- Bhargava Anuj
- Bhatt Deepak L
- Bhatt Deepak L
- Bhavsar Janak
- Bijata-Bronisz Renata
- Bittar George
- Bitters J'Cinda
- Black Robert
- Blagden Mark
- Blanco Antonio
- Blick David
- Bochenek Anna
- Boldueva Svetlana
- Bolshoun David
- Bonansea Teresa C
- Bongo Angelo S
- Bordonava Anselmo
- Borges Joao
- Borisov Borislav
- Bortnick Anna
- Bos Robert
- Botelho Roberto
- Botero Rodrigo
- Botero Rodrigo
- Bott Jochen
- Bouza Manuel
- Boyrazian Hagop
- Brabham David
- Braganza Denise
- Brath Helmut
- Brockmyre Andrew
- Broker Robert
- Brown Christopher
- Buchbinder Maurice
- Bueno Héctor
- Bugan Viliam
- Bula Larysa
- Burgess Lesley
- Busak Ladislav
- Busch Robert
- Busz-Papiez Benita
- Butman Samuel
- Buysschaert Ian
- Byanov Kolyo
- Cabrera Walter
- Calabrò Paolo
- Cantu Elias G
- Cantú Arnulfo G
- Carda Jiri
- Cardona Jose
- Carell Edgar
- Carnero Gabriela
- Carrasco Jose P
- Carrillo Luis V
- Cartwright Simon
- Castillo Armando G
- Cauthen Brett
- Cayla Guillaume
- Cercato Cintia
- Cermak Ondrej
- Cerqueira Maria J
- Ceyhan Ceyhun
- Cha James
- Cha Kwang S
- Chacon Carolina
- Chae In-Ho
- Chae Jei-Keon
- Chag Milan
- Chai Yingru
- Chamnarnphol Noppadol
- Chan Michael
- Chan Shih-Hung
- Chang Kiyuk
- Chang Kuan-Cheng
- Chatrathi Sridhar
- Chavez Carlos
- Chehayeb Raja
- Cheirif Jorge
- Chen Jersey
- Chen Jersey
- Chen Zhih-Cherng
- Chernyavsky Alexander
- Cheung Deanna
- Cheung Stephen
- Chhabra Anil
- Chiang Chern
- Chiang Chern-En
- Choi Si-Wan
- Choi Young J
- Chompalova Boryana
- Chorin Ehud
- Chouinard Guy
- Cinteza Mircea
- Clavijo Leonardo
- Clifford Piers
- Cobos Jorge
- Coching Raul M
- Coetzee Kathleen
- Colfer Harry
- Colquhoun David
- Coman Ioan
- Conejeros Carlos
- Constance Christian
- Corbalan Ramon
- Corbalán Ramón
- Corder Clinton
- Cordova Fernando
- Cornel Jan H
- Cornel Jan H
- Cortada Jorge B
- Cottin Yves
- Coussement Patrick
- Cox John
- Creteanu Mihai
- Crijns Hendrikus
- Curiac Dan
- Cygler Jerzy
- Cymerman Krzysztof
- Czigány Anna
- Czochra Wojciech
- Czyzycki Mariusz
- D'Agostino Ronald
- D'Urso Michael
- Dada Fredy T
- Dalby Anthony
- Dalby Anthony J
- Danchin Nicolas
- Danchin Nicolas
- Dantzig Jan-Melle
- Darius Harald
- Dart Anthony
- Das Asit
- Dawood Saleem
- de Cosmo Salvatore
- de la Torre Hernández José M
- de Labriolle Axel
- de los Ríos Ibarra Manuel
- de Luca Leonardo
- de Maeseneire Stefan
- de Melker Edwin
- de Nooijer Cornelis
- de Souza Weimar
- Debs-Perez Giselle
- Decoulx Eric
- Dedek Vratislav
- Deering Joseph
- DeGregorio Michele
- Dehghani Payam
- del Blanco Bruno G
- Delforge Marc
- Demchenko Elena
- Desai Pratik
- Deyoung Michael
- Di Pasquale Giuseppe
- Diaz Rafael
- Diaz Rafael
- Dickert Jim
- Didenko Yury
- Dimov Bojidar
- Dincheva Adriana
- Dion Danielle
- Distiller Lawrence
- Dixen Ulrik
- Do Huan
- Dobreanu Viorica
- Doi Tomofumi
- Dolzhenko Maryna
- Domínguez Antonio R
- Dong Xiaolin
- Dor Isaac
- Dorsch Micha
- dos Santos Fabio R
- Dotsenko Sergiy
- Doyle Timothy
- Drelich Grzegorz
- Drexel Heinz
- Drozd Marcin
- Dubreuil Olivier
- Dumas Richard
- Duronto Ernesto
- Dutra Oscar
- Dy Johnny
- Dzhaiani Nino
- Díaz Fernández José F
- Díaz Francisco F
- Eaves William
- Ebenbichler Christoph
- Eder Frank
- Edin Anton
- Egstrup Kenneth
- Eki Yutaka
- El Salah
- El-Amin Omer
- Elamin Omer
- Elbaz Meyer
- Elbl Lubomir
- Eliaschewitz Freddy
- Emerson Ronald
- Ereño Ainhoa R
- Erlinge David
- Ermoshkina Lyudmila
- Eshaghian Shervin
- Estrada José N
- Ezhov Andrey
- Faes Dirk
- Fang Chih
- Fares Issa
- Farsky Stefan
- Fazekas Frantisek
- Feldman Robert
- Fernández Portales Francisco J
- Ferrario Emile
- Ferrario Maurizio
- Ferrolino Arthur
- Figueiredo Estevao
- Figueroa Christian
- Fil Wojciech
- Fillat Angel C
- Fischer Sabine
- Fischer Stuart
- Fließer-Görzer Evelyn
- Fontaine Caroline
- Forgosh Leslie
- Forte Adriana
- Fortes Jose A
- Foster Malcolm
- Foster Michael
- Fourie Nyda
- Fox Kim
- Fox Kim
- Franchetti Marcos
- Frandsen Brad
- Fraser Neil
- Frechette Andre
- French William
- Fresco Claudio
- Fujimoto Kazuteru
- Fujimoto Noritaka
- Fukui Kazuki
- Fullington Douglas
- Fulop Peter
- Furkalo Sergiy
- Földi András
- Förster Andreas
- Fülöp Tibor
- Gadkari Milind
- Gallo Richard
- Galski Thomas
- Galyavich Albert
- Gamba Marco A
- Gandelman Glenn
- Ganim Ricky
- Gaona Raul
- Garas Samer
- García Lledó José A
- García Celso
- García Joel D
- Gardner Timothy
- Gaudet Daniel
- Gazmuri Raul
- Ge Junbo
- Ge Junbo
- Geohas Jeffrey
- Georgiev Svetoslav
- Georgieva Nikolina
- Gibbs Charlotte
- Gigliotti Osvaldo
- Glushko Liubomyr
- Gniot Jacek
- Godoy Armando
- Gogia Harinder
- Gogov Antoni
- Goldberg Cindy
- Goldberg Ronald
- Gomez-Cortes Jose
- Gonzalez Julian
- Gonzalez-Ortiz Elena
- González Juanatey José R
- González Alfonso S
- González Rosa S
- González Vicente B
- Goodfellow Ross
- Gordon Paul
- Gosparini Diego M
- Gossard Denis
- Gosselin Gilbert
- Goto Shinya
- Goto Shinya
- Goto Shinya
- Goube Pascal
- Gowdaiah Prakash
- Graham Bruce
- Graham John
- Gravdal Stein A
- Green Sandy
- Greenberg Gabriel
- Grena Paul
- Greschik István
- Gring Christian
- Grunfeldova Hana
- Guedes Antoine
- Guerra Yamirka D
- Guerrero Diego B
- Guillen Mario
- Guimaraes Fabio
- Guitton Javier
- Gullestad Lars
- Gupta Dinesh
- Guray Umit
- Górska Maria
- Haddad Tariq
- Hage-Korban Elie
- Hagemeier Robert
- Hahn Joo-Yong
- Haisheva Larisa
- Hajek Petr
- Hall Jason
- Halperin Frank
- Hamilton Andrew
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- Haro Jaime M
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- Wong Michelle
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- Yagensky Andriy
- Yakushin Sergey
- Yalcin Ahmet
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- Yaneva Zdravka
- Yeh Hung-I
- Ying Man
- Yokoya Koichi
- Yoon Junghan
- Young Douglas
- Younis Liwa
- Yuan Zuyi
- Zadra Remo
- Zakharov Konstantin
- Zakhary Bosh
- Zaman Azfar
- Zamorano Gómez José L
- Zangroniz Pedro
- Zaniewski Michelle
- Zanini Alejandra
- Zarich Stuart
- Zateyschikova Anna
- Zateyshchikov Dmitry A
- Zebrack James
- Zelazowska Katarzyna
- Zhang Aidong
- Zhang Jian
- Zhang Ningru
- Zhang Wenwu
- Zhao Qiang
- Zhao Qiang
- Zhao Xue-Qiao
- Zharinova Viktoria
- Zidkova Eva
- Zilahi Zsolt
- Zinka Elzbieta
- Zonova Elena
- Zubeeva Galina
- Zucconi-Mazzini Roberto
- Zurakowski Aleksander
- Zólyomi Szilárd
- Édes István
- Publication venue
- 'Elsevier BV'
- Publication date
- 01/01/2019
- Field of study
Background:
Patients with stable coronary artery disease and diabetes with previous percutaneous coronary intervention (PCI), particularly those with previous stenting, are at high risk of ischaemic events. These patients are generally treated with aspirin. In this trial, we aimed to investigate if these patients would benefit from treatment with aspirin plus ticagrelor.
Methods:
The Effect of Ticagrelor on Health Outcomes in diabEtes Mellitus patients Intervention Study (THEMIS) was a phase 3 randomised, double-blinded, placebo-controlled trial, done in 1315 sites in 42 countries. Patients were eligible if 50 years or older, with type 2 diabetes, receiving anti-hyperglycaemic drugs for at least 6 months, with stable coronary artery disease, and one of three other mutually non-exclusive criteria: a history of previous PCI or of coronary artery bypass grafting, or documentation of angiographic stenosis of 50% or more in at least one coronary artery. Eligible patients were randomly assigned (1:1) to either ticagrelor or placebo, by use of an interactive voice-response or web-response system. The THEMIS-PCI trial comprised a prespecified subgroup of patients with previous PCI. The primary efficacy outcome was a composite of cardiovascular death, myocardial infarction, or stroke (measured in the intention-to-treat population).
Findings:
Between Feb 17, 2014, and May 24, 2016, 11 154 patients (58% of the overall THEMIS trial) with a history of previous PCI were enrolled in the THEMIS-PCI trial. Median follow-up was 3·3 years (IQR 2·8–3·8). In the previous PCI group, fewer patients receiving ticagrelor had a primary efficacy outcome event than in the placebo group (404 [7·3%] of 5558 vs 480 [8·6%] of 5596; HR 0·85 [95% CI 0·74–0·97], p=0·013). The same effect was not observed in patients without PCI (p=0·76, p interaction=0·16). The proportion of patients with cardiovascular death was similar in both treatment groups (174 [3·1%] with ticagrelor vs 183 (3·3%) with placebo; HR 0·96 [95% CI 0·78–1·18], p=0·68), as well as all-cause death (282 [5·1%] vs 323 [5·8%]; 0·88 [0·75–1·03], p=0·11). TIMI major bleeding occurred in 111 (2·0%) of 5536 patients receiving ticagrelor and 62 (1·1%) of 5564 patients receiving placebo (HR 2·03 [95% CI 1·48–2·76], p<0·0001), and fatal bleeding in 6 (0·1%) of 5536 patients with ticagrelor and 6 (0·1%) of 5564 with placebo (1·13 [0·36–3·50], p=0·83). Intracranial haemorrhage occurred in 33 (0·6%) and 31 (0·6%) patients (1·21 [0·74–1·97], p=0·45). Ticagrelor improved net clinical benefit: 519/5558 (9·3%) versus 617/5596 (11·0%), HR=0·85, 95% CI 0·75–0·95, p=0·005, in contrast to patients without PCI where it did not, p interaction=0·012. Benefit was present irrespective of time from most recent PCI.
Interpretation:
In patients with diabetes, stable coronary artery disease, and previous PCI, ticagrelor added to aspirin reduced cardiovascular death, myocardial infarction, and stroke, although with increased major bleeding. In that large, easily identified population, ticagrelor provided a favourable net clinical benefit (more than in patients without history of PCI). This effect shows that long-term therapy with ticagrelor in addition to aspirin should be considered in patients with diabetes and a history of PCI who have tolerated antiplatelet therapy, have high ischaemic risk, and low bleeding risk