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Treatment patterns and outcomes in patients undergoing percutaneous coronary intervention treated with prasugrel or clopidogrel (from the Swedish Coronary Angiography and Angioplasty Registry [SCAAR]).
- Source :
-
The American journal of cardiology [Am J Cardiol] 2014 Jan 01; Vol. 113 (1), pp. 64-9. Date of Electronic Publication: 2013 Oct 03. - Publication Year :
- 2014
-
Abstract
- Large real-world registry data are important for understanding the current use and outcomes of novel therapies. The aim of this study was to assess treatment patterns and outcomes in patients who underwent percutaneous coronary intervention (PCI) with prasugrel or clopidogrel. Consecutive patient data from the Swedish Coronary Angiography and Angioplasty Registry (SCAAR) for 2010 and 2011 were used. The study population consisted of all patients with acute coronary syndromes (ACS) and those without ACS who underwent PCI and were treated with prasugrel (with or without a clopidogrel loading dose) or solely with clopidogrel. Outcomes included were 30-day mortality and in-hospital bleeding. In 2010 and 2011, 23,994 patients were treated with clopidogrel during hospitalization for their first PCI during the study period, while 2,142 patients were treated with prasugrel. Prasugrel was mainly used in patients with ST-segment elevation myocardial infarction. Hemorrhagic risk factors such as older age, female gender, and previous stroke were more common in the clopidogrel-treated patients. However, Mehran bleeding risk scores were higher in prasugrel-treated patients. In the ACS group, lower mortality was observed in the prasugrel group compared with the clopidogrel group. Mortality was comparable in patients who underwent elective angiography and PCI. In-hospital bleeding was lower in prasugrel-treated patients. In conclusion, in this real world population of patients who underwent urgent or elective PCI, prasugrel was used mainly in patients with ACS, while it was avoided in patients with characteristics indicating increased bleeding risk. Mortality and bleeding rates were lower with prasugrel than clopidogrel, probably because of patient selection.<br /> (Copyright © 2014 Elsevier Inc. All rights reserved.)
- Subjects :
- Acute Coronary Syndrome diagnostic imaging
Acute Coronary Syndrome mortality
Aged
Cause of Death trends
Clopidogrel
Dose-Response Relationship, Drug
Female
Follow-Up Studies
Hemorrhage chemically induced
Humans
Incidence
Male
Middle Aged
Piperazines adverse effects
Platelet Aggregation Inhibitors administration & dosage
Platelet Aggregation Inhibitors adverse effects
Prasugrel Hydrochloride
Purinergic P2Y Receptor Antagonists administration & dosage
Purinergic P2Y Receptor Antagonists adverse effects
Retrospective Studies
Survival Rate trends
Sweden epidemiology
Thiophenes adverse effects
Ticlopidine administration & dosage
Ticlopidine adverse effects
Treatment Outcome
Acute Coronary Syndrome therapy
Coronary Angiography methods
Hemorrhage epidemiology
Percutaneous Coronary Intervention methods
Piperazines administration & dosage
Registries
Thiophenes administration & dosage
Ticlopidine analogs & derivatives
Subjects
Details
- Language :
- English
- ISSN :
- 1879-1913
- Volume :
- 113
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- The American journal of cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 24169009
- Full Text :
- https://doi.org/10.1016/j.amjcard.2013.09.019