P2Y12 receptor inhibitors in patients with non-ST-elevation acute coronary syndrome in the real world: use, patient selection, and outcomes from contemporary European registries
Language English Country England, Great Britain Media print-electronic
Document type Journal Article, Research Support, Non-U.S. Gov't
PubMed
27533946
DOI
10.1093/ehjcvp/pvw005
PII: pvw005
Knihovny.cz E-resources
- Keywords
- Acute coronary syndromes, Antiplatelets, Clopidogrel, Non-ST-segment elevation, Observational, P2Y12 receptor inhibitors, Prasugrel, Ticagrelor,
- MeSH
- Acute Coronary Syndrome drug therapy mortality MeSH
- Adult MeSH
- Platelet Aggregation Inhibitors adverse effects therapeutic use MeSH
- Ischemia etiology prevention & control MeSH
- Drug Therapy, Combination MeSH
- Hemorrhage chemically induced epidemiology MeSH
- Middle Aged MeSH
- Humans MeSH
- Purinergic P2Y Receptor Antagonists adverse effects therapeutic use MeSH
- Receptors, Purinergic P2Y12 * MeSH
- Registries MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Patient Selection MeSH
- Treatment Outcome MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Geographicals
- Europe MeSH
- Names of Substances
- Platelet Aggregation Inhibitors MeSH
- Purinergic P2Y Receptor Antagonists MeSH
- Receptors, Purinergic P2Y12 * MeSH
AIMS: Non-ST-elevation acute coronary syndrome (NSTE-ACS) is present in about 60-70% of patients admitted with acute coronary syndromes in clinical practice. This study provides a 'real-life' overview of NSTE-ACS patient characteristics, dual antiplatelet therapy clinical practice, and outcomes at both the time of discharge from hospital and up to 1-year post-discharge. METHODS AND RESULTS: A total of 10 registries (documenting 84 054 NSTE-ACS patients) provided data in a systematic manner on patient characteristics and outcomes for NSTE-ACS in general, and 6 of these (with 52 173 NSTE-ACS patients) also provided more specific data according to P2Y12 receptor inhibitor used. Unadjusted analyses were performed at the study level, and no formal meta-analysis was performed due to large heterogeneity between studies in the settings, patient characteristics, and outcome definitions. All-cause death rates across registries ranged from 0.76 to 4.79% in-hospital, from 1.61 to 6.65% at 30 days, from 3.66 to 7.16% at 180 days, and from 3.14 to 9.73% at 1 year. Major bleeding events were reported in up to 2.77% of patients while in hospital (in seven registries), up to 1.08% at 30 days (data from one registry only), and 2.06% at 1 year (one registry). CONCLUSIONS: There were substantial differences in the use of and patient selection for clopidogrel, prasugrel, and ticagrelor, which were associated with differences in short- and long-term ischaemic and bleeding events. In future registries, data collection should be performed in a more standardized way with respect to endpoints, definitions, and time points.
2nd Department of Medicine with Cardiology and Intensive Care Hospital Rudolfstiftung Vienna Austria
AMIS Plus Data Center University of Zurich Zurich Switzerland
Cardiocenter 3rd Faculty of Medicine Charles University Prague Czech Republic
Cardiology Department Hospital La Paz IdiPaz Madrid Spain
Cardiology Freeman Hospital and Institute of Cellular Medicine Newcastle upon Tyne UK
Cardiology Service Hospital Universitari de Tarragona Joan XXIII IISPV Tarragona Spain
Cardiology Service Hospital Universitari Vall d'Hebron Barcelona Spain
Cardiology Unit Humanitas Research Hospital Rozzano Milano Italy
Department of Cardiology Leiden University Medical Center Leiden The Netherlands
Department of Cardiology Lund University Skåne University Hospital Lund Lund Sweden
Department of Cardiology University Hospital Antwerp Edegem Belgium
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