| Impact of Baseline Bleeding Risk on Efficacy and Safety of Ticagrelor versus Clopidogrel in Chinese Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention | |
| Alternative Title | Impact of Baseline Bleeding Risk on Efficacy and Safety of Ticagrelor versus Clopidogrel in Chinese Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention |
| Wang HeYang; Li Yi; Xu XiaoMing; Li Jing; Han YaLing | |
| 2018 | |
| Source Publication | Chinese Medical Journal
 |
| ISSN | 0366-6999 |
| Volume | 131Issue:17Pages:2017-+ |
| Abstract | Background: There was still conflict on the antithrombotic advantage of ticagrelor versus clopidogrel among East Asian population with acute coronary syndrome (ACS). We considered that the baseline bleeding risk might be an undetected key factor that significantly affected the efficacy of ticagrelor. Methods: A total of 20,816 serial patients who underwent percutaneous coronary intervention (PCI) from October 2011 to August 2014 in the General Hospital of Shenyang Military Region were enrolled in the present study. Patients receiving ticagrelor or clopidogrel were further subdivided according to basic bleeding risk. The primary outcome was net adverse clinical events (NACEs) defined as major adverse cardiac or cerebral events (MACCE, including all-cause death, myocardial infarction, ischemia-driven target vessel revascularization, or stroke) and any bleeding during 1-year follow-up. Comparison between ticagrelor and clopidogrel was adjusted by propensity score matching (PSM). Results: Among the 20,816 eligible PCI patients who were included in this study, there were 1578 and 779 patients in the clopidogrel and ticagrelor groups, respectively, after PSM, their clinical parameters were well matched. Patients receiving ticagrelor showed comparable NACE risk compared with those treated by clopidogrel (5.3% vs. 5.1%, P = 0.842). Furthermore, ticagrelor might reduce the MACCE risk in patients with low bleeding risk but increase MACCE in patients with moderate-to-high bleeding potential (ticagrelor vs. clopidogrel, low bleeding risk: 2.5% vs. 4.9%, P = 0.022; moderate-to-high bleeding risk: 4.8% vs. 3.0%, P = 0.225; interaction P = 0.021), with vast differences in all bleeding (low bleeding risk: 1.5% vs. 0.8%, P = 0.210; moderate-to-high bleeding risk: 4.8% vs. 3.0%, P = 0.002; interaction P = 0.296). Conclusion: Among real-world Chinese patients with ACS treated by PCI, ticagrelor only showed superior efficacy in patients with low bleeding risk but lost its advantage in patients with moderate-to-high bleeding potential. |
| Other Abstract | Background： There was still conflict on the antithrombotic advantage of ticagrelor versus clopidogrel among East Asian population with acute coronary syndrome （ACS）. We considered that the baseline bleeding risk might be an undetected key factor that significantly affected the efficacy of ticagrelor. Methods： A total of 20,816 serial patients who underwent percutaneous coronary intervention （PCI） from October 20l 1 to August 2014 in the General Hospital of Shenyang Military Region were enrolled in the present study. Patients receiving ticagrelor or clopidogrel were further subdivided according to basic bleeding risk. The primary outcome was net adverse clinical events （NACEs） defined as major adverse cardiac or cerebral events （MACCE, including all-cause death, myocardial infarction, ischemia-driven target vessel revascularization, or stroke） and any bleeding during l-year lbllow-up. Comparison between ticagrelor and clopidogrel was adjusted by propensity score matching （PSM）. Results： Among the 20,816 eligible PCI patients who were included in this study, there were 1578 and 779 patients in the clopidogrel and ticagrelor groups, respectively, alter PSM, their clinical parameters were well matched. Patients receiving ticagrelor showed comparable NACE risk compared with those treated by copidogrel （5.3% vs. 5. I%, P = 0.842）. Furthermore, ticagrelor might reduce the MACCE risk in patients with low bleeding risk but increase MACCE in patients with moderate-to-high bleeding potential （ticagrelor vs. clopidogrel, low bleeding risk： 2.5% vs. 4.9%, P = 0.022： moderate-to-high bleeding risk： 4.8% vs. 3.0%, P =0.225; interaction P = 0.021）, with vast differences in all bleeding （low bleeding risk： 1.5% vs. 0.8%, P =0.210： moderate-to-high bleeding risk： 4.8% vs. 3.0%, P = 0.002; interaction P- 0.296）.Conclusion： Among real-world Chinese patients with ACS treated by PCI, ticagrelor only showed superior efficacy in patients with low bleeding risk but lost its advantage in patients with moderate-to-high bleeding potential. |
| Keyword | Baseline Bleeding Risk Medicine R Clopidogrel Crusade Score Efficacy Ticagrelor |
| Indexed By | CSCD |
| Language | 英语 |
| Funding Project | [National Key Research and Development Project] |
| CSCD ID | CSCD:6311999 |
| Citation statistics |
Cited Times:3[CSCD]
[CSCD Record]
|
| Document Type | 期刊论文 |
| Identifier | http://ir.imr.ac.cn/handle/321006/144258 |
| Collection | 中国科学院金属研究所 |
| Affiliation | 中国科学院金属研究所 |
| Recommended Citation GB/T 7714 | Wang HeYang,Li Yi,Xu XiaoMing,et al. Impact of Baseline Bleeding Risk on Efficacy and Safety of Ticagrelor versus Clopidogrel in Chinese Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention[J]. Chinese Medical Journal,2018,131(17):2017-+. |
| APA | Wang HeYang,Li Yi,Xu XiaoMing,Li Jing,&Han YaLing.(2018).Impact of Baseline Bleeding Risk on Efficacy and Safety of Ticagrelor versus Clopidogrel in Chinese Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention.Chinese Medical Journal,131(17),2017-+. |
| MLA | Wang HeYang,et al."Impact of Baseline Bleeding Risk on Efficacy and Safety of Ticagrelor versus Clopidogrel in Chinese Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention".Chinese Medical Journal 131.17(2018):2017-+. |
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