Long-term antithrombotic management patterns in Asian patients with acute coronary syndrome: 2-year observations from the EPICOR Asia study.
Acute Coronary Syndrome
/ diagnosis
Aged
Anticoagulants
/ administration & dosage
Asia
Asian People
Drug Administration Schedule
Drug Utilization
/ trends
Dual Anti-Platelet Therapy
Female
Fibrinolytic Agents
/ administration & dosage
Healthcare Disparities
/ trends
Humans
Male
Middle Aged
Myocardial Revascularization
/ adverse effects
Platelet Aggregation Inhibitors
/ administration & dosage
Practice Patterns, Physicians'
/ trends
Prospective Studies
Risk Assessment
Risk Factors
Thrombosis
/ diagnosis
Time Factors
Treatment Outcome
EPICOR
acute coronary care antithrombotic management patterns
acute coronary syndrome
observational
Journal
Clinical cardiology
ISSN: 1932-8737
Titre abrégé: Clin Cardiol
Pays: United States
ID NLM: 7903272
Informations de publication
Date de publication:
Sep 2020
Sep 2020
Historique:
received:
30
04
2020
revised:
20
05
2020
accepted:
21
05
2020
pubmed:
4
7
2020
medline:
21
7
2021
entrez:
4
7
2020
Statut:
ppublish
Résumé
Despite guideline recommendations, dual antiplatelet therapy (DAPT) is frequently used for longer than 1 year after an acute coronary syndrome (ACS) event. In Asia, information on antithrombotic management patterns (AMPs), including DAPT post discharge, is sparse. This analysis evaluated real-world AMPs up to 2 years post discharge for ACS. There is wide variability in AMP use for ACS management in Asia. EPICOR Asia (NCT01361386) is a prospective observational study of patients discharged after hospitalization for an ACS in eight countries/regions in Asia, followed up for 2 years. Here, we describe AMPs used and present an exploratory analysis of characteristics and outcomes in patients who received DAPT for ≤12 months post discharge compared with >12 months. Data were available for 12 922 patients; of 11 639 patients discharged on DAPT, 2364 (20.3%) received DAPT for ≤12 months and 9275 (79.7%) for >12 months, with approximately 60% still on DAPT at 2 years. Patients who received DAPT for >12 months were more likely to be younger, obese, lower Killip class, resident in India (vs China), and to have received invasive reperfusion. Clinical event rates during year 2 of follow-up were lower in patients with DAPT >12 vs ≤12 months, but no causal association can be implied in this non-randomized study. Most ACS patients remained on DAPT up to 1 year, in accordance with current guidelines, and over half remained on DAPT at 2 years post discharge. Patients not on DAPT at 12 months are a higher risk group requiring careful monitoring.
Sections du résumé
BACKGROUND
BACKGROUND
Despite guideline recommendations, dual antiplatelet therapy (DAPT) is frequently used for longer than 1 year after an acute coronary syndrome (ACS) event. In Asia, information on antithrombotic management patterns (AMPs), including DAPT post discharge, is sparse. This analysis evaluated real-world AMPs up to 2 years post discharge for ACS.
HYPOTHESIS
OBJECTIVE
There is wide variability in AMP use for ACS management in Asia.
METHODS
METHODS
EPICOR Asia (NCT01361386) is a prospective observational study of patients discharged after hospitalization for an ACS in eight countries/regions in Asia, followed up for 2 years. Here, we describe AMPs used and present an exploratory analysis of characteristics and outcomes in patients who received DAPT for ≤12 months post discharge compared with >12 months.
RESULTS
RESULTS
Data were available for 12 922 patients; of 11 639 patients discharged on DAPT, 2364 (20.3%) received DAPT for ≤12 months and 9275 (79.7%) for >12 months, with approximately 60% still on DAPT at 2 years. Patients who received DAPT for >12 months were more likely to be younger, obese, lower Killip class, resident in India (vs China), and to have received invasive reperfusion. Clinical event rates during year 2 of follow-up were lower in patients with DAPT >12 vs ≤12 months, but no causal association can be implied in this non-randomized study.
CONCLUSIONS
CONCLUSIONS
Most ACS patients remained on DAPT up to 1 year, in accordance with current guidelines, and over half remained on DAPT at 2 years post discharge. Patients not on DAPT at 12 months are a higher risk group requiring careful monitoring.
Identifiants
pubmed: 32618009
doi: 10.1002/clc.23400
pmc: PMC7462192
doi:
Substances chimiques
Anticoagulants
0
Fibrinolytic Agents
0
Platelet Aggregation Inhibitors
0
Types de publication
Journal Article
Multicenter Study
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
999-1008Informations de copyright
© 2020 The Authors. Clinical Cardiology published by Wiley Periodicals LLC.
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