Clopidogrel, prasugrel, and ticagrelor for all-comers with ST-segment elevation myocardial infarction
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
Standard
Clopidogrel, prasugrel, and ticagrelor for all-comers with ST-segment elevation myocardial infarction. / Jacobsen, Mia Ravn; Engstrom, Thomas; Torp-Pedersen, Christian; Gislason, Gunnar; Glinge, Charlotte; Butt, Jawad Haider; Fosbol, Emil Loldrup; Holmvang, Lene; Pedersen, Frants; Kober, Lars; Jabbari, Reza; Sorensen, Rikke.
I: International Journal of Cardiology, Bind 342, 2021, s. 15-22.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
Harvard
APA
Vancouver
Author
Bibtex
}
RIS
TY - JOUR
T1 - Clopidogrel, prasugrel, and ticagrelor for all-comers with ST-segment elevation myocardial infarction
AU - Jacobsen, Mia Ravn
AU - Engstrom, Thomas
AU - Torp-Pedersen, Christian
AU - Gislason, Gunnar
AU - Glinge, Charlotte
AU - Butt, Jawad Haider
AU - Fosbol, Emil Loldrup
AU - Holmvang, Lene
AU - Pedersen, Frants
AU - Kober, Lars
AU - Jabbari, Reza
AU - Sorensen, Rikke
PY - 2021
Y1 - 2021
N2 - Background: To compare effectiveness and safety of clopidogrel, prasugrel, and ticagrelor among all-comers with ST-segment elevation myocardial infarction (STEMI) and extend the knowledge from randomized clinical trials. Methods: All consecutive patients with STEMI admitted to Copenhagen University Hospital, Rigshospitalet, from 2009 to 2016 were identified via the Eastern Danish Heart Registry. By individual linkage to Danish nationwide registries, claimed drugs and end points were obtained. Patients alive a week post-discharge were included, stratified according to clopidogrel, prasugrel, or ticagrelor treatment, and followed for a year. The effectiveness end point (a composite of all-cause mortality, recurrent myocardial infarction, and ischemic stroke) and safety end point (a composite of bleedings leading to hospitalization) were assessed by multivariate Cox proportionalhazards models. Results: In total, 5123 patients were included (clopidogrel [1245], prasugrel [1902], ticagrelor [1976]) with >95% treatment persistency. Concomitant use of aspirin was >95%. Females accounted for 24% and elderly for 17%. Compared with clopidogrel, the effectiveness end point occurred less often for ticagrelor (HR 0.50, 95% CI 0.35-0.70) and prasugrel (HR 0.48, 95% CI 0.33-0.68) without differences in bleedings leading to hospitalization. No differences in comparative effectiveness or safety were found between prasugrel and ticagrelor. Sensitivity analyses with time-dependent drug exposure and the period 2011-2015 showed similar results. Conclusions: Among all-comers with STEMI, ticagrelor and prasugrel were associated with reduced incidence of the composite end point of all-cause mortality, recurrent myocardial infarction, and ischemic stroke without an increase in bleedings leading to hospitalization compared with clopidogrel. No differences were found between prasugrel and ticagrelor.
AB - Background: To compare effectiveness and safety of clopidogrel, prasugrel, and ticagrelor among all-comers with ST-segment elevation myocardial infarction (STEMI) and extend the knowledge from randomized clinical trials. Methods: All consecutive patients with STEMI admitted to Copenhagen University Hospital, Rigshospitalet, from 2009 to 2016 were identified via the Eastern Danish Heart Registry. By individual linkage to Danish nationwide registries, claimed drugs and end points were obtained. Patients alive a week post-discharge were included, stratified according to clopidogrel, prasugrel, or ticagrelor treatment, and followed for a year. The effectiveness end point (a composite of all-cause mortality, recurrent myocardial infarction, and ischemic stroke) and safety end point (a composite of bleedings leading to hospitalization) were assessed by multivariate Cox proportionalhazards models. Results: In total, 5123 patients were included (clopidogrel [1245], prasugrel [1902], ticagrelor [1976]) with >95% treatment persistency. Concomitant use of aspirin was >95%. Females accounted for 24% and elderly for 17%. Compared with clopidogrel, the effectiveness end point occurred less often for ticagrelor (HR 0.50, 95% CI 0.35-0.70) and prasugrel (HR 0.48, 95% CI 0.33-0.68) without differences in bleedings leading to hospitalization. No differences in comparative effectiveness or safety were found between prasugrel and ticagrelor. Sensitivity analyses with time-dependent drug exposure and the period 2011-2015 showed similar results. Conclusions: Among all-comers with STEMI, ticagrelor and prasugrel were associated with reduced incidence of the composite end point of all-cause mortality, recurrent myocardial infarction, and ischemic stroke without an increase in bleedings leading to hospitalization compared with clopidogrel. No differences were found between prasugrel and ticagrelor.
KW - ST-segment elevation myocardial infarction
KW - Clopidogrel
KW - Prasugrel
KW - Ticagrelor
KW - PERCUTANEOUS CORONARY INTERVENTION
KW - THERAPY
U2 - 10.1016/j.ijcard.2021.07.047
DO - 10.1016/j.ijcard.2021.07.047
M3 - Journal article
C2 - 34311012
VL - 342
SP - 15
EP - 22
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
ER -
ID: 302198027