Use of prasugrel and clinical outcomes in African-American patients treated with percutaneous coronary intervention for acute coronary syndromes

Autor: Brian A. Baker, Samir Kapadia, Bimmer E. Claessen, Sameer Bansilal, Zhen Ge, Timothy Henry, Stuart J. Pocock, Roxana Mehran, Usman Baber, Sunil V. Rao, Craig Strauss, Stuart Keller, William S. Weintraub, Samantha Sartori, Kanhaiya L. Poddar, Clayton Snyder, Annapoorna Kini, Melissa Aquino, Birgit Vogel, Sandra Weiss, Catalin Toma, Brent Muhlestein, Mark B. Effron, Michela Faggioni, Anthony C. DeFranco, Jaya Chandrasekhar
Rok vydání: 2019
Předmět:
Male
Time Factors
Prasugrel
medicine.medical_treatment
Comorbidity
030204 cardiovascular system & hematology
0302 clinical medicine
Risk Factors
Cause of Death
Prevalence
Prospective Studies
Registries
030212 general & internal medicine
Myocardial infarction
Stroke
education.field_of_study
Incidence
Age Factors
General Medicine
Middle Aged
Clopidogrel
Race Factors
Treatment Outcome
Female
Cardiology and Cardiovascular Medicine
medicine.drug
medicine.medical_specialty
Acute coronary syndrome
Population
Hemorrhage
Risk Assessment
03 medical and health sciences
Percutaneous Coronary Intervention
Sex Factors
Internal medicine
medicine
Humans
Radiology
Nuclear Medicine and imaging
Acute Coronary Syndrome
Healthcare Disparities
education
Aged
business.industry
Percutaneous coronary intervention
Health Status Disparities
medicine.disease
United States
Black or African American
Conventional PCI
business
Prasugrel Hydrochloride
Platelet Aggregation Inhibitors
Kidney disease
Zdroj: Catheterization and Cardiovascular Interventions. 94:53-60
ISSN: 1522-1946
Popis: OBJECTIVE: To investigate the use of prasugrel after percutaneous coronary intervention (PCI) in African American (AA) patients presenting with acute coronary syndrome (ACS). BACKGROUND: AA patients are at higher risk for adverse cardiovascular outcomes after PCI and may derive greater benefit from the use of potent antiplatelet therapy. METHODS: Using the multicenter PROMETHEUS observational registry of ACS patients treated with PCI, we grouped patients by self-reported AA or other races. Clinical outcomes at 90-day and 1-year included non-fatal myocardial infarction (MI), major adverse cardiac events (composite of death, MI, stroke, or unplanned revascularization) and major bleeding. RESULTS: The study population included 2,125 (11%) AA and 17,707 (89%) non-AA patients. AA patients were younger, more often female (46% vs. 30%) with a higher prevalence of diabetes mellitus, chronic kidney disease, and prior coronary intervention than non-AA patients. Although AA patients more often presented with troponin (+) ACS, prasugrel use was much less common in AA vs. non-AA (11.9% vs. 21.4%, respectively, P = 0.001). In addition, the use of prasugrel increased with the severity of presentation in non-AA but not in AA patients. Multivariable logistic regression showed AA race was an independent predictor of reduced use of prasugrel (0.42 [0.37-0.49], P
Databáze: OpenAIRE
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