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

Choongki Kim, Dong Ho Shin, Sung Jin Hong, Chul Min Ahn, Jung Sun Kim, Byeong Keuk Kim, Young Guk Ko, Donghoon Choi, Myeongki Hong, Juhee Park, Hyeyeong Lee, Dong Sook Kim, Sang Kwon Oh, Yangsoo Jang

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)191-197
Number of pages7
JournalJournal of Cardiology
Volume73
Issue number3
DOIs
Publication statusPublished - 2019 Mar 1

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clopidogrel
Percutaneous Coronary Intervention
Health Insurance
Myocardial Infarction
Stroke
Hemorrhage
Odds Ratio
Confidence Intervals
Therapeutics
Korea
Ticagrelor
Prescriptions
Cause of Death

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Kim, Choongki ; Shin, Dong Ho ; Hong, Sung Jin ; Ahn, Chul Min ; Kim, Jung Sun ; Kim, Byeong Keuk ; Ko, Young Guk ; Choi, Donghoon ; Hong, Myeongki ; Park, Juhee ; Lee, Hyeyeong ; Kim, Dong Sook ; Oh, Sang Kwon ; Jang, Yangsoo. / 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. In: Journal of Cardiology. 2019 ; Vol. 73, No. 3. pp. 191-197.
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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.",
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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. / Kim, Choongki; Shin, Dong Ho; Hong, Sung Jin; Ahn, Chul Min; Kim, Jung Sun; Kim, Byeong Keuk; Ko, Young Guk; Choi, Donghoon; Hong, Myeongki; Park, Juhee; Lee, Hyeyeong; Kim, Dong Sook; Oh, Sang Kwon; Jang, Yangsoo.

In: Journal of Cardiology, Vol. 73, No. 3, 01.03.2019, p. 191-197.

Research output: Contribution to journalArticle

TY - JOUR

T1 - One-year clinical outcomes of ticagrelor compared with clopidogrel after percutaneous coronary intervention in patients with acute myocardial infarction

T2 - From Korean Health Insurance Review and Assessment Data

AU - Kim, Choongki

AU - Shin, Dong Ho

AU - Hong, Sung Jin

AU - Ahn, Chul Min

AU - Kim, Jung Sun

AU - Kim, Byeong Keuk

AU - Ko, Young Guk

AU - Choi, Donghoon

AU - Hong, Myeongki

AU - Park, Juhee

AU - Lee, Hyeyeong

AU - Kim, Dong Sook

AU - Oh, Sang Kwon

AU - Jang, Yangsoo

PY - 2019/3/1

Y1 - 2019/3/1

N2 - 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.

AB - 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.

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