Forskning
Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

Clopidogrel, prasugrel, and ticagrelor for all-comers with ST-segment elevation myocardial infarction

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. The impact of peripheral artery disease on major adverse cardiovascular events following myocardial infarction

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Assessment of cardiac arrhythmias using long-term continuous monitoring in patients with pulmonary hypertension

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Prolonged QT-interval in cirrhosis: is it reversible?

    Publikation: Bidrag til tidsskriftLederForskningpeer review

  4. Electrocardiographic T-wave morphology and risk of mortality

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  5. Association between the E-wave propagation index and left ventricular thrombus formation after ST-elevation myocardial infarction

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Diabetes increases the risk of bone fractures in patients on kidney replacement therapy: A DANISH national cohort study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. The impact of peripheral artery disease on major adverse cardiovascular events following myocardial infarction

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Nationwide cardiovascular disease admission rates during a second COVID-19 lockdown

    Publikation: Bidrag til tidsskriftLetterForskningpeer review

  4. Workforce Attachment after Ischemic Stroke – The Importance of Time to Thrombolytic Therapy

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  5. De novo electrocardiographic abnormalities in persons living with HIV

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Vis graf over relationer

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 proportional-hazards 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.

OriginalsprogEngelsk
TidsskriftInternational Journal of Cardiology
Vol/bind342
Sider (fra-til)15-22
Antal sider8
ISSN0167-5273
DOI
StatusUdgivet - 1 nov. 2021

Bibliografisk note

Copyright © 2021 The Author(s). Published by Elsevier B.V. All rights reserved.

ID: 67986679