Advanced

P2Y12 receptor inhibitors in patients with non-STelevation acute coronary syndrome in the real world : Use, patient selection, and outcomes from contemporary European registries

, ; Zeymer, Uwe; Widimsky, Petr; Danchin, Nicolas; Lettino, Maddalena; Bardaji, Alfredo; Barrabes, Jose A.; Cequier, Angel; Claeys, Marc J. and De Luca, Leonardo, et al. (2016) In European Heart Journal - Cardiovascular Pharmacotherapy 2(4). p.229-243
Abstract

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... (More)

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.

(Less)
Please use this url to cite or link to this publication:
author
, et al. (More)
(Less)
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Acute coronary syndromes, Antiplatelets, Clopidogrel, Non-ST-segment elevation, Observational, P2Y12 receptor inhibitors, Prasugrel, Ticagrelor
in
European Heart Journal - Cardiovascular Pharmacotherapy
volume
2
issue
4
pages
15 pages
publisher
Oxford University Press
external identifiers
  • scopus:85019913127
ISSN
2055-6837
DOI
10.1093/ehjcvp/pvw005
language
English
LU publication?
yes
id
689d0c35-ec75-4a12-98c1-1974185886d0
date added to LUP
2019-05-23 10:40:38
date last changed
2019-09-17 04:54:59
@article{689d0c35-ec75-4a12-98c1-1974185886d0,
  abstract     = {<p>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.</p>},
  author       = {,  and Zeymer, Uwe and Widimsky, Petr and Danchin, Nicolas and Lettino, Maddalena and Bardaji, Alfredo and Barrabes, Jose A. and Cequier, Angel and Claeys, Marc J. and De Luca, Leonardo and Dörler, Jakob and Erlinge, David and Erne, Paul and Goldstein, Patrick and Koul, Sasha M. and Lemesle, Gilles and Lüscher, Thomas F. and Matter, Christian M. and Montalescot, Gilles and Radovanovic, Dragana and Sendón, Jose Lopez and Tousek, Petr and Weidinger, Franz and Weston, Clive F.M. and Zaman, Azfar and Andell, Pontus and Li, Jin and Wouter Jukema, J.},
  issn         = {2055-6837},
  keyword      = {Acute coronary syndromes,Antiplatelets,Clopidogrel,Non-ST-segment elevation,Observational,P2Y12 receptor inhibitors,Prasugrel,Ticagrelor},
  language     = {eng},
  month        = {10},
  number       = {4},
  pages        = {229--243},
  publisher    = {Oxford University Press},
  series       = {European Heart Journal - Cardiovascular Pharmacotherapy},
  title        = {P2Y12 receptor inhibitors in patients with non-STelevation acute coronary syndrome in the real world : Use, patient selection, and outcomes from contemporary European registries},
  url          = {http://dx.doi.org/10.1093/ehjcvp/pvw005},
  volume       = {2},
  year         = {2016},
}