The impact of in-hospital P2Y12 inhibitor switch in patients with acute coronary syndrome
| Autor: | Vinod H. Thourani, Rebecca Torguson, Kyle Buchanan, Toby Rogers, Augusto D. Pichard, William S. Weintraub, Petros Okubagzi, Paul Kolm, Itsik Ben-Dor, Lowell F. Satler, Ron Waksman, Deepakraj Gajanana, Micaela Iantorno |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Acute coronary syndrome medicine.medical_specialty 030204 cardiovascular system & hematology Antithrombins 03 medical and health sciences Percutaneous Coronary Intervention 0302 clinical medicine P2Y12 Internal medicine Humans Medicine Thrombolytic Therapy 030212 general & internal medicine Acute Coronary Syndrome Aged Retrospective Studies Drug Substitution business.industry Warfarin Drug-Eluting Stents General Medicine Hirudins Middle Aged medicine.disease Clopidogrel Peptide Fragments Recombinant Proteins Treatment Outcome medicine.anatomical_structure Purinergic P2Y Receptor Antagonists Cardiology Population study Female Observational study Cardiology and Cardiovascular Medicine business Ticagrelor Follow-Up Studies medicine.drug Artery |
| Zdroj: | Cardiovascular Revascularization Medicine. 19:912-916 |
| ISSN: | 1553-8389 |
| DOI: | 10.1016/j.carrev.2018.09.007 |
| Popis: | BACKGROUND/PURPOSE Dual antiplatelet therapy (DAPT) varies after placement of drug-eluting stents (DES) in patients presenting with acute coronary syndromes (ACS). Our aim was to study patient characteristics and predictors of switching, in-hospital or at discharge, from clopidogrel (CLO) to ticagrelor (TIC) or vice versa. METHODS/MATERIALS The study population included patients with ACS who had DES and initially received either CLO or TIC between January 2011 and December 2017. Patients were divided into 4 groups based on initial DAPT choice and whether DAPT was switched in-hospital or during discharge. Clinical outcomes of interest were bleeding events, need for anticoagulation, and need for in-hospital coronary artery bypass graft (CABG). RESULTS We identified 2837 patients who received DES and started on DAPT. DAPT switch from 1 P2Y12 inhibitor to another occurred in 9%, either in-hospital or at discharge. Of 1834 patients started on CLO, 112 were switched to TIC. Of 1003 patients started on TIC, 142 were switched to CLO. The need for in-hospital CABG was 7.8% in the TIC-CLO group compared to none in the CLO-TIC group (p = 0.002). Adjusted for covariates, the TIC-CLO group was 3 times more likely to need anticoagulation with warfarin than the CLO-CLO group (p |
| Databáze: | OpenAIRE |
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