Use of Clopidogrel, Prasugrel, or Ticagrelor and Patient Outcome after Acute Coronary Syndrome in Austria from 2015 to 2017
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Preparation
2.2. Statistical Methods
3. Results
3.1. Drug Survival of P2Y12 Inhibitor Therapy
3.2. P2Y12 Inhibitor Therapy and Clinical Outcome
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Characteristics | Clopidogrel (n = 10626) | Prasugrel (n = 4788) | p-Value Clopi vs. Prasu | Ticagrelor (n = 9383) | p-Value Clopi vs. Tica |
---|---|---|---|---|---|
Age—median years (IQR) | 74 (64; 81) | 57 (51; 65) | p < 0.001 | 63 (54; 73) | p < 0.001 |
Female sex—n (%) | 4103 (38.6) | 933 (19.5) | p < 0.001 | 2622 (27.9) | p < 0.001 |
Cardiovascular medication—n (%) | 5585 (52.6) | 1481 (30.9) | p < 0.001 | 3880 (41.4) | p < 0.001 |
HMG CoA reductase inhibitors—n (%) | 5926 (55.8) | 1961 (41.0) | p < 0.001 | 4579 (48.8) | p < 0.001 |
Drugs for obstructive airway diseases—n (%) | 1026(9.7) | 247 (5.2) | p < 0.001 | 616(6.6) | p < 0.001 |
Anti-diabetic medicines—n (%) | 1743 (16.4) | 506 (10.6) | p < 0.001 | 1278 (13.6) | p < 0.001 |
NOAC—(%) | 1221 (11.5) | 9 (0.2) | p < 0.001 | 34 (0.4) | p < 0.001 |
Clopidogrel | Prasugrel | p-Value Clopi vs. Prasu | Ticagrelor | p-Value Clopi vs. Tica | |
---|---|---|---|---|---|
Age | |||||
Age 18–39 (n = 454) | 14.8% | 38.8% | p < 0.001 | 46.5% | p < 0.001 |
Age 40–49 (n = 2374) | 16.2% | 37.4% | p < 0.001 | 46.5% | p < 0.001 |
Age 50–59 (n = 5749) | 23.6% | 31.8% | p < 0.001 | 44.6% | p < 0.001 |
Age 60–69 (n = 5963) | 37.8% | 20.9% | p < 0.001 | 41.3% | p < 0.001 |
Age 70–79 (n = 6205) | 55.5% | 9.6% | p < 0.001 | 34.9% | p < 0.001 |
Age 80–89 (n = 3532) | 75.3% | 1.5% | p < 0.001 | 23.2% | p < 0.001 |
Age ≥ 90 (n = 520) | 88.5% | 0.2% | p < 0.001 | 11.3% | p < 0.001 |
Calendar year | |||||
2015 (n = 8040) | 44.3% | 21.9% | p < 0.001 | 33.7% | p < 0.001 |
2016 (n = 8417) | 43.5% | 18.7% | p < 0.001 | 37.8% | p < 0.001 |
2017 (n = 8340) | 40.8% | 17.4% | p < 0.001 | 41.9% | p < 0.001 |
Drug survival | |||||
6 months | 77.2% | 95.0% | p < 0.001 | 91.7% | p < 0.001 |
12 months | 47.1% | 52.9% | p < 0.001 | 47.7% | p < 0.001 |
18 months | 23.5% | 11.4% | p < 0.001 | 8.4% | p < 0.001 |
24 months | 17.3% | 6.8% | p < 0.001 | 5.1% | p < 0.001 |
(n = 23816) | P2Y12 Inhibitors | Crude HR (95% CI) | Adjusted HR (95%CI) |
---|---|---|---|
Medication | prasugrel | 0.49 (0.44; 0.55) | 0.70 (0.61; 0.79) |
ticagrelor | 0.57 (0.52; 0.62) | 0.70 (0.64; 0.77) | |
clopidogrel | 1 | 1 | |
Age (median 61 years) | 56–66 (2.Qu) | 1.01 (0.89; 1.16) | |
(median 72 years) | 67–76 (3.Qu) | 1.44 (1.28; 1.60) | |
(median 82 years) | ≥77 (4.Qu) | 2.18 (1.97; 2.41) | |
(median 51 years) | 18–55 (1.Qu) | 1 | |
Age, males | |||
(median 61 years) | 56–66 (2.Qu) | 1.02 (0.88; 1.18) | |
(median 72 years) | 67–76 (3.Qu) | 1.29 (1.12; 1.47) | |
(median 82 years) | ≥77 (4.Qu) | 1.93 (1.69; 2.20) | |
(median 51 years) | 18–55 (1.Qu) | 1 | |
Age, females | |||
(median 61 years) | 56–66 (2.Qu) | 0.63 (0.48; 0.84) | |
(median 72 years) | 67–76 (3.Qu) | 0.93 (0.74; 1.17) | |
(median 82 years) | ≥77 (4.Qu) | 1.31 (1.07; 1.61) | |
(median 51 years) | 18–55 (1.Qu) | 1 | |
Sex | male vs. female | 0.87 (0.80; 0.94) | |
Sex, 18–55 years | male vs. female | 0.81 (0.67; 1.00) | |
Sex, 56–66 years | male vs. female | 1.31 (1.02; 1.69) | |
Sex, 67–76 years | male vs. female | 1.13 (0.93; 1.37) | |
Sex, ≥77 years | male vs. female | 1.20 (1.10; 1.34) | |
Cardiovascular medicines | yes vs. no | 1.41 (1.32; 1.52) | 1.18 (1.08; 1.29) |
HMG CoA reductase inhibitors | yes vs. no | 1.20 (1.12; 1.29) | 0.98 (0.90; 1.07) |
Drugs for obstructive airway diseases | yes vs. no | 1.57 (1.39; 1.77) | 1.36 (1.21; 1.54) |
Anti-diabetic medicines | yes vs. no | 1.46 (1.33; 1.60) | 1.33 (1.21; 1.47) |
Non-Vitamin K oral anticoagulant | yes vs. no | 1.40 (1.21; 1.65) | 0.93 (0.79; 1.09) |
Calendar year | 2016 vs. 2015 | 1.01 (0.92; 1.01) | 1.01 (0.92; 1.10) |
2017 vs. 2015 | 1.14 (1.03; 1.27) | 1.17 (1.05; 1.30) |
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Sheikh Rezaei, S.; Gleiss, A.; Reichardt, B.; Wolzt, M. Use of Clopidogrel, Prasugrel, or Ticagrelor and Patient Outcome after Acute Coronary Syndrome in Austria from 2015 to 2017. J. Clin. Med. 2020, 9, 3398. https://doi.org/10.3390/jcm9113398
Sheikh Rezaei S, Gleiss A, Reichardt B, Wolzt M. Use of Clopidogrel, Prasugrel, or Ticagrelor and Patient Outcome after Acute Coronary Syndrome in Austria from 2015 to 2017. Journal of Clinical Medicine. 2020; 9(11):3398. https://doi.org/10.3390/jcm9113398
Chicago/Turabian StyleSheikh Rezaei, Safoura, Andreas Gleiss, Berthold Reichardt, and Michael Wolzt. 2020. "Use of Clopidogrel, Prasugrel, or Ticagrelor and Patient Outcome after Acute Coronary Syndrome in Austria from 2015 to 2017" Journal of Clinical Medicine 9, no. 11: 3398. https://doi.org/10.3390/jcm9113398