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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

Uwe Zeymer, Petr Widimsky, Nicolas Danchin, Maddalena Lettino, Alfredo Bardaji, Jose A. Barrabes, Angel Cequier, Marc J. Claeys, Leonardo De Luca, Jakob Dörler, David Erlinge, Paul Erne, Patrick Goldstein, Sasha M. Koul, Gilles Lemesle, Thomas F. Lüscher, Christian M. Matter, Gilles Montalescot, Dragana Radovanovic, Jose Lopez Sendón, Petr Tousek, Franz Weidinger, Clive Weston Orcid Logo, Azfar Zaman, Pontus Andell, Jin Li, J. Wouter Jukema

European Heart Journal - Cardiovascular Pharmacotherapy, Volume: 2, Issue: 4, Pages: 229 - 243

Swansea University Author: Clive Weston Orcid Logo

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DOI (Published version): 10.1093/ehjcvp/pvw005

Abstract

Non-ST-elevation acute coronary syndrome (NSTE-ACS) is present in about 60–70% of patients admitted with ACS. This study provides a ‘real-life’ overview of NSTE-ACS patient characteristics, dual antiplatelet therapy, and outcomes at both the time of discharge from hospital and up to 1-year post-disc...

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Published in: European Heart Journal - Cardiovascular Pharmacotherapy
ISSN: 2055-6837 2055-6845
Published: 2016
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URI: https://cronfa.swan.ac.uk/Record/cronfa31533
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Abstract: Non-ST-elevation acute coronary syndrome (NSTE-ACS) is present in about 60–70% of patients admitted with ACS. This study provides a ‘real-life’ overview of NSTE-ACS patient characteristics, dual antiplatelet therapy, and outcomes at both the time of discharge from hospital and up to 1-year post-discharge.10 registries (including 84 054 NSTE-ACS patients) provided data on patient characteristics and outcomes, 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.
Keywords: Acute coronary syndrome, myocardial infarction, anti-platelet, registry
College: Faculty of Medicine, Health and Life Sciences
Issue: 4
Start Page: 229
End Page: 243