Longer-term oral antiplatelet use in stable post-myocardial infarction patients: Insights from the long Term risk, clinical manaGement and healthcare Resource utilization of stable coronary artery dISease (TIGRIS) observational study

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art_GOODMAN_Longerterm_oral_antiplatelet_use_in_stable_postmyocardial_infarction_2017.PDF (301.3 KB)
Citações na Scopus
30
Tipo de produção
article
Data de publicação
2017
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
ELSEVIER IRELAND LTD
Autores
GOODMAN, Shaun G.
REQUENA, Gema
MAGUIRE, Andrew
BLANKENBERG, Stefan
CHEN, Ji Yan
GRANGER, Christopher B.
GRIEVE, Richard
POCOCK, Stuart J.
SIMON, Tabassome
Citação
INTERNATIONAL JOURNAL OF CARDIOLOGY, v.236, p.54-60, 2017
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Objective: To describe contemporary patient characteristics and treatment patterns, including antithrombotic management, of post-myocardial infarction (MI) stable coronary artery disease (CAD) patients at high atherothrombotic risk from different geographical regions. Methods: Patients >= 50 years with prior MI 1-3 years ago and >= 1 risk factor (age >= 65 years, diabetes, 2nd prior MI >1 yr ago, multivessel CAD, creatinine clearance 15-<60 ml/min) were enrolled by 369 physicians (96% cardiologists) in 25 countries (2013-14) in the prospective TIGRIS study (NCT01866904). Results: 9225 patients were enrolled (median 1.8 years) post-MI: 52% with prior ST-elevation MI, median age 67 years, 24% women, 67% Caucasian, 55% had >= 2 additional qualifying risk factors, 14% current smokers, 67% overweight/obese, 34% with blood pressure >= 140/90 mm Hg. 81% underwent percutaneous coronary intervention (PCI; 66% with drug-eluting stents) for the indexMI. receptor inhibitor [ADPri]), mainly clopidogrel (75%). 63% had discontinued antiplatelet treatment (60% ADPri) around 1 year, most commonly by physician recommendation (90%). At enrolment, 97% were taking an antithrombotic drug, most commonly ASA (88%), with 27% on DAPT (median duration 1.6 years); continued DAPT >1 year was highest (39%) in Asia-Pacific and lowest (12%) in Europe. Conclusions: Despite guideline recommendations, 1 in 4 post-MI patients did not receive DAPT for >1 year. In contrast to guideline recommendations supporting newer ADPris, clopidogrel was mainly prescribed. Prior to recent RCT data supporting DAPT >1 year post-MI/PCI, >1 in 4 patients have continued on DAPT, though with substantial international variability.
Palavras-chave
Antiplatelet therapy, Myocardial infarction
URI
https://observatorio.fm.usp.br/handle/OPI/21275
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MCP
Artigos e Materiais de Revistas Científicas - HC/InCor
Artigos e Materiais de Revistas Científicas - LIM/11
Artigos e Materiais de Revistas Científicas - ODS/03