Long-term Clinical Outcome after Percutaneous Coronary Intervention with Ticagrelor or Clopidogrel in Patients with Acute Coronary Syndrome
Refereed conference paper presented and published in conference proceedings

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AbstractPurpose: We aim to compare long-term clinical outcomes among acute coronary syndrome (ACS) patients who underwent percutaneous coronary intervention (PCI) using ticagrelor versus clopidogrel.

Methods: We retrospectively analysed 1,336 consecutive ACS patients who underwent in-hospital PCI with drug-eluting stent (DES) implantation between August 2010 and July 2014 to 3 hospitals in the Hong Kong New Territory East Cluster using the electronic medical records of the Clinical Data Analysis and Reporting System of the Hospital Authority. The primary outcome was major adverse events (MACE) at 24 months. Univariate Kaplan-Meier analyses were performed for incidence of outcomes and multivariate Cox analysis was performed to identify independent predictor of MACE.

Results: Clopidogrel and ticagrelor were used in 1,235 (92.4%) and 101 (7.6%) patients. From 2010-2014, there was a trend towards ticagrelor from 5.1% to 16.9% by the end of the period. Patients treated with ticagrelor were more likely to present with ST-elevation myocardial infarction (STEMI) and younger. Unadjusted 24-month mortality (4.2% vs. 1.0%, p=0.17), recurrent ACS (6.6% vs. 1.0%, p=0.03) and MACE (9.8% vs. 2.0%, p=0.01) were higher in patients who received clopidogrel compared to ticagrelor. After adjustment, ticagrelor remained an independent predictor of MACE free survival (Adjusted Hazard Ratio (AHR), 0.19, 95% CI 0.04 to 0.97, p=0.05).

Conclusions: Ticagrelor is increasingly used in ACS patients who underwent early revascularization. Although antiplatelet therapy should still be individualized based on the thrombotic and bleeding risk, our study highlights the safety of the new P2Y12 inhibitors in contemporary Hong Kong practice.
All Author(s) ListKY Chan, KH Yiu, A Cheong, BP Yan
Name of Conference24th ASC of HKCC 2016
Start Date of Conference10/06/2016
End Date of Conference12/06/2016
Place of ConferenceHong Kong
Country/Region of ConferenceHong Kong
LanguagesEnglish-United States

Last updated on 2018-25-07 at 15:50