Abstract:
:Background Prior reports indicate that the effect of P2Y12 inhibitors may be different in East Asian patients ("East Asian paradox"); therefore, understanding the outcomes associated with potent P2Y12 inhibitors in different populations is clinically important. Methods and Results In this observational cohort study using administrative healthcare data sets, we compared safety and effectiveness of contemporary P2Y12 inhibitors in patients with acute coronary syndrome. The primary safety outcomes were major and any bleeding, and the primary effectiveness outcomes were major cardiovascular events (a composite of cardiovascular death, myocardial infarction, or stroke) and all-cause mortality. Among 70 715 patients with acute coronary syndrome, 56 216 (79.5%) used clopidogrel, 11 402 (16.1%) used ticagrelor, and 3097 (4.4%) used prasugrel. The median follow-up period was 18.0 months (interquartile range: 9.6-26.4 months). In a propensity-matched cohort, compared with clopidogrel, ticagrelor was associated with a higher risk of any bleeding (hazard ratio: 1.23; 95% CI, 1.14-1.33) but a lower risk of mortality (hazard ratio: 0.76; 95% CI, 0.63-0.91). Prasugrel, compared with clopidogrel, was associated with higher risks of any bleeding (hazard ratio: 1.23; 95% CI, 1.06-1.43) and major bleeding (hazard ratio: 1.50; 95% CI, 1.01-2.21) but a similar risk of effectiveness outcomes. No significant difference was noted between ticagrelor and prasugrel with respect to key safety or effectiveness outcomes. Several sensitivity analyses showed similar results. Conclusions In East Asian patients with acute coronary syndrome, compared with clopidogrel, ticagrelor was associated with an increased risk of bleeding but a decreased risk of mortality. Prasugrel was associated with an increase of any bleeding without difference in effectiveness outcomes. The risks of bleeding and ischemic events were similar between ticagrelor and prasugrel.
journal_name
J Am Heart Assocjournal_title
Journal of the American Heart Associationauthors
Yun JE,Kim YJ,Park JJ,Kim S,Park K,Cho MS,Nam GB,Park DWdoi
10.1161/JAHA.119.012078subject
Has Abstractpub_date
2019-07-16 00:00:00pages
e012078issue
14issn
2047-9980journal_volume
8pub_type
杂志文章abstract::Background The purpose of this study was to determine whether the presence of antegrade blood flow was related to stroke subtype in patients with acute intracranial large artery occlusion. Methods and Results The prospectively collected data for consecutive patients who had occlusion of the unilateral M1 segment of th...
journal_title:Journal of the American Heart Association
pub_type: 杂志文章
doi:10.1161/JAHA.119.015759
更新日期:2020-10-20 00:00:00
abstract::Background Although coffee consumption is often reported as a trigger for atrial fibrillation (AF) among patients with paroxysmal AF, prospective studies on the relation of coffee consumption with AF risk have been inconsistent. Hence, we sought to assess the association between coffee consumption and risk of AF in me...
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更新日期:2017-04-10 00:00:00
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更新日期:2020-02-18 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2017-08-10 00:00:00
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更新日期:2013-01-15 00:00:00
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更新日期:2013-02-19 00:00:00
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abstract:BACKGROUND:Although guidelines for antiarrhythmic drug therapy in atrial fibrillation (AF) were published in 2006, it remains uncertain whether adherence to these guidelines affects patient outcomes. METHODS AND RESULTS:We retrospectively evaluated the records of 5976 consecutive AF patients who were prescribed at lea...
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更新日期:2021-01-26 00:00:00
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doi:10.1161/JAHA.113.000297
更新日期:2014-02-26 00:00:00
abstract::Background Recent studies suggest that mavacamten (Myk461), a small myosin-binding molecule, decreases hypercontractility in myocardium expressing hypertrophic cardiomyopathy-causing missense mutations in myosin heavy chain. However, the predominant feature of most mutations in cardiac myosin binding protein-C ( cMyBP...
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abstract::See Article Lee et al. ...
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pub_type: 评论,社论
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更新日期:2019-05-21 00:00:00
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更新日期:2020-09-15 00:00:00
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journal_title:Journal of the American Heart Association
pub_type: 杂志文章
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更新日期:2013-03-18 00:00:00
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