Temporal Trends in the Use of Antiplatelet Therapy in Patients With Acute Coronary Syndromes
| Autor: | Nuria Vicente-Ibarra, Francisco Marín, Vicente Pernias-Escrig, María Asunción Esteve-Pastor, Luna Carrillo Alemán, Manuel J Macías-Villanego, Elena Candela Sánchez, Miriam Sandín Rollán, José Miguel Rivera-Caravaca, Esteban Orenes-Piñero, Miriam Quintana-Giner, Antonio Tello-Montoliu, Juan M. Ruiz-Nodar, Teresa Lozano, A Veliz-Martinez, Mariano Valdés |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Ticagrelor medicine.medical_specialty Acute coronary syndrome Adenosine Ticlopidine Prasugrel 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Internal medicine Diabetes mellitus medicine Humans Pharmacology (medical) Prospective Studies Registries 030212 general & internal medicine Acute Coronary Syndrome Practice Patterns Physicians' Prospective cohort study Aged Pharmacology Prasugrel Hydrochloride business.industry Age Factors Middle Aged medicine.disease Clopidogrel Hospitalization Practice Guidelines as Topic Purinergic P2Y Receptor Antagonists Cardiology ST Elevation Myocardial Infarction Platelet aggregation inhibitor Female Cardiology and Cardiovascular Medicine business Platelet Aggregation Inhibitors medicine.drug |
| Zdroj: | Journal of Cardiovascular Pharmacology and Therapeutics. 23:57-65 |
| ISSN: | 1940-4034 1074-2484 |
| Popis: | Background: Current clinical guidelines of acute coronary syndromes (ACS) recommend the use of potent antiplatelet therapy, prasugrel or ticagrelor, because both drugs consistently reduce cardiovascular events. Purpose: The aim of this study was to examine temporal changes in the use of optimal antiplatelet therapy in patients with ACS. Methods: A total of 1717 consecutive patients admitted for ACS in 3 tertiary hospitals from February 2014 to December 2015 were enrolled. We divided these 23 months into 4 semesters: period I (0-5 months), period II (6-11 months), period III (12-17 months), and period IV (17-23 months). Demographic, clinical, and treatment data were collected both at admission and at discharge. Results: Treatment with clopidogrel remained constant throughout the periods (52%, 50%, 44%, and 50% for periods I, II, III, and IV, respectively), whereas a progressive increase in ticagrelor treatment was observed (15%, 25%, 26%, and 28%; P = .001). Indeed, new P2Y12 agents showed an increase from 47% at the first semester to 65% in patients with ST-segment elevation myocardial infarction (STEMI), and in patients younger than 75 years from 36% to 53%. However, for patients older than 75 years, diabetic, and patients with end-stage kidney disease, clopidogrel was the second most commonly used antiplatelet agent. Conclusion: In this real-life registry of patients with ACS, we observed there is still a high rate of use of clopidogrel, despite guidelines recommendations, and our analyses also showed a trend toward the use of ticagrelor. Patients who received new antiplatelet agents were patients with STEMI, younger than 75 years, and with less comorbidities. However, the use of ticagrelor and prasugrel remains low, highlighting a therapeutic inertia with considerable gap between evidence-based clinical guidelines and daily clinical practice. |
| Databáze: | OpenAIRE |
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