Back to Search
Start Over
Cardiovascular and Bleeding Risks in Acute Myocardial Infarction Newly Treated With Ticagrelor vs. Clopidogrel in Taiwan
- Source :
- Circulation Journal. 82:747-756
- Publication Year :
- 2018
- Publisher :
- Japanese Circulation Society, 2018.
-
Abstract
- Background There are few data on ticagrelor in Asian patients. This study evaluated clinical outcomes with ticagrelor and clopidogrel in Taiwanese patients with acute myocardial infarction (AMI).Methods and Results:We used the Taiwan National Health Insurance Research Database to identify 27,339 AMI patients aged ≥18 years between January 2012 and December 2014, and only patients who survived greater than or equal to 30 days after AMI and took dual antiplatelet therapy were included. Cohorts of ticagrelor and clopidogrel were matched 1:8, based on propensity score matching, to balance baseline covariates. The primary efficacy endpoints were death from any cause, AMI, or stroke. The safety endpoints consisted of major gastrointestinal bleeding or intracerebral hemorrhage. Following propensity matching, the primary efficacy endpoint rate was 22% lower in the ticagrelor group than in the clopidogrel group (10.6% and 16.2%, respectively; adjusted HR, 0.779; 95% CI: 0.684-0.887). The safety endpoint rate was similar between the ticagrelor and clopidogrel groups (3.2% and 4.1% respectively; adjusted HR, 0.731; 95% CI: 0.522-1.026). Conclusions In real-world AMI Taiwanese patients, ticagrelor seemed to offer better anti-ischemic protection than clopidogrel, without an increase in the rate of major bleeding. A large-scale randomized trial is needed to assess the efficacy and safety of ticagrelor in East Asian AMI patients.
- Subjects :
- Risk
Ticagrelor
medicine.medical_specialty
Gastrointestinal bleeding
Acute coronary syndrome
Myocardial Infarction
Taiwan
Hemorrhage
030204 cardiovascular system & hematology
law.invention
03 medical and health sciences
0302 clinical medicine
Asian People
Randomized controlled trial
Ischemia
law
Internal medicine
medicine
Humans
cardiovascular diseases
030212 general & internal medicine
Myocardial infarction
Propensity Score
Stroke
Aged
Retrospective Studies
business.industry
General Medicine
Middle Aged
medicine.disease
Clopidogrel
Treatment Outcome
Cardiovascular Diseases
Propensity score matching
Purinergic P2Y Receptor Antagonists
Cardiology
Cardiology and Cardiovascular Medicine
business
Platelet Aggregation Inhibitors
medicine.drug
Subjects
Details
- ISSN :
- 13474820 and 13469843
- Volume :
- 82
- Database :
- OpenAIRE
- Journal :
- Circulation Journal
- Accession number :
- edsair.doi.dedup.....0b10e381b1876fc00efeb85c11116b98