Switching of Oral P2Y12 Inhibitor Treatment in Patients with Acute Coronary Syndrome: Prevalence, Predictors, and Prognosis
| العنوان: | Switching of Oral P2Y12 Inhibitor Treatment in Patients with Acute Coronary Syndrome: Prevalence, Predictors, and Prognosis |
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| المؤلفون: | Luna Carrillo-Alemán, Juan Gabriel Martínez-Martínez, Nuria Vicente-Ibarra, María Asunción Esteve-Pastor, Miriam Sandín-Rollán, Francisco Marcos Marín, Manuel Macías, Juan M. Ruiz-Nodar, Esteban Orenes-Piñero, Teresa Lozano, José Miguel Rivera-Caravaca, Vicente Pernias-Escrig, Elena Candela-Sánchez, Andrea Veliz, Miriam Quintana-Giner |
| المصدر: | Clinical Drug Investigation. 39:275-283 |
| بيانات النشر: | Springer Science and Business Media LLC, 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Acute coronary syndrome, medicine.medical_specialty, Prasugrel, business.industry, medicine.medical_treatment, General Medicine, 030204 cardiovascular system & hematology, Revascularization, medicine.disease, Clopidogrel, 030226 pharmacology & pharmacy, Loading dose, 03 medical and health sciences, 0302 clinical medicine, Pharmacotherapy, Internal medicine, medicine, Pharmacology (medical), cardiovascular diseases, Myocardial infarction, business, Ticagrelor, medicine.drug |
| الوصف: | Dual antiplatelet therapy is one of the main treatments in acute coronary syndrome (ACS). Switching antiplatelet agents may be necessary in some patients to improve efficacy or safety. The objective of this study was to determine the prevalence, predictors, and implications of clinical switching in patients during hospital admission and 1-year follow-up at discharge. Observational, prospective, multicenter registry study in patients discharged following an admission for ACS and followed up for 1 year. We analyzed ischemic and bleeding events as well as treatment changes. We recruited 1717 patients; in-hospital switching occurred in 425 (24.8%): 15.1% to clopidogrel and 84.9% to newer antiplatelet drugs (prasugrel or ticagrelor). Those switched to newer antiplatelets were younger, with lower scores on the GRACE and CRUSADE scales, admitted more frequently for ST-elevation myocardial infarction and underwent more invasive management and percutaneous revascularization. The clinical cardiologist was responsible for most in-hospital switching to newer antiplatelets (79.6%). The loading dose of the second antiplatelet did not affect incidence of bleeding events. Post-discharge switching was infrequent (2%) and depended mainly on clinical indications; only 30% was related to a new ACS. In a contemporary registry with ACS, in-hospital switching of antiplatelet drugs was frequent. Those switched to newer antiplatelets were younger and admitted more frequently for ST-elevation myocardial infarction. Post-discharge switching was infrequent. |
| تدمد: | 1179-1918 1173-2563 |
| DOI: | 10.1007/s40261-018-0736-z |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_________::d46aef030890e0064206f042e89f1d06 https://doi.org/10.1007/s40261-018-0736-z |
| Rights: | CLOSED |
| رقم الانضمام: | edsair.doi...........d46aef030890e0064206f042e89f1d06 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 11791918 11732563 |
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| DOI: | 10.1007/s40261-018-0736-z |