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One-year clinical outcomes of ticagrelor compared with clopidogrel after percutaneous coronary intervention in patients with acute myocardial infarction: From Korean Health Insurance Review and Assessment Data

Authors
 Choongki Kim  ;  Dong-Ho Shin  ;  Sung-Jin Hong  ;  Chul-Min Ahn  ;  Jung-Sun Kim  ;  Byeong-Keuk Kim  ;  Young-Guk Ko  ;  Donghoon Choi  ;  Myeong-Ki Hong  ;  Juhee Park  ;  Hyeyeong Lee  ;  Dong-Sook Kim  ;  Sang-Kwon Oh  ;  Yangsoo Jang 
Citation
 JOURNAL OF CARDIOLOGY, Vol.73(3~4) : 191-197, 2019-03 
Journal Title
JOURNAL OF CARDIOLOGY
ISSN
 0914-5087 
Issue Date
2019-03
MeSH
Aged ; Cause of Death ; Clopidogrel / administration & dosage* ; Clopidogrel / adverse effects ; Combined Modality Therapy ; Drug Substitution ; Female ; Hemorrhage / chemically induced ; Humans ; Incidence ; Insurance, Health ; Male ; Middle Aged ; Myocardial Infarction / complications ; Myocardial Infarction / mortality ; Myocardial Infarction / therapy* ; Odds Ratio ; Percutaneous Coronary Intervention* ; Platelet Aggregation Inhibitors / administration & dosage* ; Platelet Aggregation Inhibitors / adverse effects ; Republic of Korea / epidemiology ; Stroke / epidemiology ; Stroke / etiology ; Ticagrelor / administration & dosage* ; Ticagrelor / adverse effects ; Treatment Outcome
Keywords
Myocardial infarction ; Treatment ; Platelet inhibitors ; Coronary artery disease
Abstract
Background: Ticagrelor has been widely accepted in clinical practice for treatment of acute myocardial infarction (AMI), however its clinical safety and efficacy have not been revealed sufficiently in Asian populations. Methods and results: Among a total 20,270 patients (age <75 years) with AMI undergoing percutaneous coronary intervention who received dual antiplatelet therapy for at least 30 days, clinical outcomes at 1 year were assessed from the database of Health Insurance Review and Assessment Service in Korea between 2013 and 2014. Ticagrelor showed a significant effect on reduction of all-cause death [stabilized inverse probability of treatment weighted (sIPTW)-adjusted odds ratio (aOR) 0.57, 95% confidence interval (CI) 0.42-0.77, p < 0.001]. Stroke was also reduced by using ticagrelor (sIPTW-aOR 0.58, 95% CI 0.41-0.82, p = 0.002). Bleeding risk was not increased by ticagrelor use. There were nearly 30% of patients who switched from ticagrelor to different P2Y12 inhibitors. Switching P2Y12 inhibitors was associated with clinical adverse events including MI, stroke, and bleeding. Conclusions: Among patients aged younger than 75 years, ticagrelor was associated with lower incidence of all-cause mortality. Stroke risk was also reduced in patients with a prescription for ticagrelor without an increase in bleeding risk. (C) 2018 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.
Files in This Item:
T9992019163.pdf Download
DOI
10.1016/j.jjcc.2018.08.005
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Ko, Young Guk(고영국) ORCID logo https://orcid.org/0000-0001-7748-5788
Kim, Byeong Keuk(김병극) ORCID logo https://orcid.org/0000-0003-2493-066X
Kim, Jung Sun(김중선) ORCID logo https://orcid.org/0000-0003-2263-3274
Kim, Choong Ki(김충기)
Shin, Dong Ho(신동호) ORCID logo https://orcid.org/0000-0002-7874-5542
Ahn, Chul-Min(안철민) ORCID logo https://orcid.org/0000-0002-7071-4370
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
Hong, Myeong Ki(홍명기) ORCID logo https://orcid.org/0000-0002-2090-2031
Hong, Sung Jin(홍성진) ORCID logo https://orcid.org/0000-0003-4893-039X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/189166
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