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The Capital Region of Denmark - a part of Copenhagen University Hospital
E-pub ahead of print

Ticagrelor and The Risk of Staphylococcus Aureus Bacteremia and Other Infections

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AIM: To investigate the 1-year risks of Staphylococcus aureus bacteremia (SAB), sepsis, and pneumonia in patients who underwent percutaneous coronary intervention and were treated with ticagrelor versus clopidogrel.

METHODS AND RESULTS: In this nationwide observational cohort study, 26,606 patients who underwent urgent or emergent percutaneous coronary intervention (January 2011-December 2017) and initiated treatment with ticagrelor (N = 20,073 [75.5%]; median age 64 years [25th-75th percentile 55-72 years]; 74.8% men) or clopidogrel (N = 6,533 [24.5%]; median age 68 years [25th-75th percentile 58-77 years]; 70.2% men) were identified using Danish nationwide registries. The 1-year standardized absolute risks of outcomes was calculated based on cause-specific Cox regression models, and average treatment effects between treatment groups were obtained as standardized differences in absolute 1-year risks. The absolute 1-year risk of SAB was 0.10% [95% CI, 0.05% to 0.15%] in the ticagrelor group and 0.29% [95% CI, 0.17% to 0.42%] in the clopidogrel group. Compared with clopidogrel, treatment with ticagrelor was associated with a significantly lower absolute 1-year risk of SAB (absolute risk difference -0.19% [95% CI, -0.32% to -0.05%], p-value 0.006). Likewise, treatment with ticagrelor was associated with a significantly lower absolute 1-year risk of sepsis (0.99% [95% CI, 0.83% to 1.14% versus 1.49% [95%CI, 1.17% to 1.80%]; absolute risk difference -0.50% [95% CI, -0.86% to -0.14%], p-value 0.007) and pneumonia (3.13% [95%CI, 2.86% to 3.39% versus 4.56% [95%CI, 4.03% to 5.08%]; absolute risk difference -1.43% [95% CI, -2.03% to -0.82%], p-value < 0.001) compared with clopidogrel.

CONCLUSIONS: Treatment with ticagrelor was associated with a significantly lower 1-year risk of SAB, sepsis, and pneumonia compared with clopidogrel.

Original languageEnglish
JournalEuropean heart journal. Cardiovascular pharmacotherapy
ISSN2055-6837
DOIs
Publication statusE-pub ahead of print - 2021

ID: 60682489