Comparative Effectiveness and Safety of Ticagrelor versus Prasugrel in Patients with Acute Coronary Syndrome: A Retrospective Cohort Analysis.
Acute Coronary Syndrome
/ drug therapy
Age Factors
Aged
Comorbidity
Female
Hemorrhage
/ chemically induced
Humans
Insurance Claim Review
Male
Medicare
Middle Aged
Platelet Aggregation Inhibitors
/ administration & dosage
Prasugrel Hydrochloride
/ administration & dosage
Propensity Score
Proportional Hazards Models
Retrospective Studies
Secondary Prevention
/ methods
Sex Factors
Ticagrelor
/ administration & dosage
United States
acute coronary syndrome
effectiveness
prasugrel
ticagrelor
Journal
Pharmacotherapy
ISSN: 1875-9114
Titre abrégé: Pharmacotherapy
Pays: United States
ID NLM: 8111305
Informations de publication
Date de publication:
09 2019
09 2019
Historique:
pubmed:
25
7
2019
medline:
12
5
2020
entrez:
24
7
2019
Statut:
ppublish
Résumé
To compare the effectiveness and safety of ticagrelor versus prasugrel in preventing recurrent cardiovascular disease (CVD) and major bleeding events in patients with acute coronary syndrome (ACS). Retrospective cohort analysis. Truven Commercial and Medicare Supplemental claims database (2011-2016). Study consisted of adults with ACS who newly initiated ticagrelor or prasugrel within 7 days of their first ACS diagnosis and had no prior use for at least 12 months; after propensity score matching, 10,073 patients were in each group. The primary study outcomes, first occurrence of a recurrent nonfatal CVD event (composite of myocardial infarction and stroke) and occurrence of a major bleeding event, were compared between the ticagrelor and prasugrel groups. Secondary outcomes included occurrence of minor bleeding events, defined based on the presence of bleeding events in outpatient claims. Cox proportional hazards models after propensity score matching were used to obtain the hazard ratio (HR) and 95% confidence interval (CI). In the Cox proportional hazards model, the use of ticagrelor was associated with a decreased risk of recurrent nonfatal CVD events (HR 0.80, 95% CI 0.70-0.92) and major bleeding events (HR 0.54, 95% CI 0.41-0.70) compared with prasugrel. Additionally, the use of ticagrelor was associated with a lower risk of minor bleeding events compared with prasugrel (HR 0.71, 95% CI 0.65-0.78). In this population-based cohort of incident ACS patients, ticagrelor was associated with a reduced rate of recurrent nonfatal CVD events, major and minor bleeding events compared with prasugrel.
Substances chimiques
Platelet Aggregation Inhibitors
0
Prasugrel Hydrochloride
G89JQ59I13
Ticagrelor
GLH0314RVC
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
912-920Informations de copyright
© 2019 Pharmacotherapy Publications, Inc.
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