Tags

Type your tag names separated by a space and hit enter

Extended dual antiplatelet therapy after acute coronary syndrome in Spain: Results from the EPICOR study.
Cardiovasc Ther. 2017 04; 35(2)CT

Abstract

INTRODUCTION

Real-world, country-specific studies of dual antiplatelet therapy (DAPT) duration among survivors of acute coronary syndrome (ACS) are important for improving long-term prognosis.

AIMS

To investigate DAPT duration after hospital discharge for ACS in Spain.

RESULTS

Data from patients enrolled in the Spanish cohort of the EPICOR (long-tErm follow-up of antithrombotic management Patterns In acute CORonary syndrome patients) study (NCT01171404) were analyzed for changes to antithrombotic medication up to 2 years postdischarge according to index event diagnosis and patient characteristics. Deaths, coronary events, and bleeding events were analyzed over the same period. Overall, a high proportion of patients remained on DAPT at 2 years (53.1%). Among patients who experienced any on-treatment bleeding event, almost two-thirds remained on DAPT at the end of follow-up. Patients >65 years, diabetic, or those that were medically managed were more likely to continue with DAPT until 2 years following discharge. At 2 years, the incidence of bleeding events requiring hospitalization was low compared with the incidence of coronary events (1.4% vs 6.6%). There was a numerical reduction in coronary events, but no increase in bleeding events, with DAPT continuation compared with single antiplatelet therapy.

CONCLUSIONS

More than half of patients in this unselected cohort study remained on DAPT at 2 years following discharge for ACS. Continuation with DAPT was greater among patients with additional cardiovascular risk factors, which suggests that treating physicians in Spain prioritizes ischemic risk reduction over bleeding risk in patients with ACS, according to patient's risk profile.

Authors+Show Affiliations

Servicio de Cardiología, Hospital Universitario de Tarragona Joan XXIII, IISPV, Universidad Rovira Virgili, Tarragona, Spain.AstraZeneca, Madrid, Spain.Servicio de Cardiología, Hospital General Universitario, Alicante, Spain.Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.Department of Cardiology, Clinical Hospital San Carlos, Health Research Institute, San Carlos, Madrid, Spain. Universidad Complutense de Madrid, Madrid, Spain.Universidad Complutense de Madrid, Madrid, Spain. Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain. Instituto de investigación i+12 and Cardiology Department, Hospital Universitario 12 de Octubre, Madrid, Spain.

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Observational Study

Language

eng

PubMed ID

27885830

Citation

Bardají, Alfredo, et al. "Extended Dual Antiplatelet Therapy After Acute Coronary Syndrome in Spain: Results From the EPICOR Study." Cardiovascular Therapeutics, vol. 35, no. 2, 2017.
Bardají A, Leal M, Arrarte V, et al. Extended dual antiplatelet therapy after acute coronary syndrome in Spain: Results from the EPICOR study. Cardiovasc Ther. 2017;35(2).
Bardají, A., Leal, M., Arrarte, V., Garcia-Moll, X., Pérez de Isla, L., & Bueno, H. (2017). Extended dual antiplatelet therapy after acute coronary syndrome in Spain: Results from the EPICOR study. Cardiovascular Therapeutics, 35(2). https://doi.org/10.1111/1755-5922.12237
Bardají A, et al. Extended Dual Antiplatelet Therapy After Acute Coronary Syndrome in Spain: Results From the EPICOR Study. Cardiovasc Ther. 2017;35(2) PubMed PMID: 27885830.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Extended dual antiplatelet therapy after acute coronary syndrome in Spain: Results from the EPICOR study. AU - Bardají,Alfredo, AU - Leal,Manuel, AU - Arrarte,Vicente, AU - Garcia-Moll,Xavier, AU - Pérez de Isla,Leopoldo, AU - Bueno,Héctor, PY - 2016/09/20/received PY - 2016/11/02/revised PY - 2016/11/20/accepted PY - 2016/11/26/pubmed PY - 2017/3/28/medline PY - 2016/11/26/entrez KW - ADP Receptor antagonists KW - Acute coronary syndrome KW - Antiplatelet agents KW - Coronary artery disease KW - Myocardial infarction KW - Secondary prevention JF - Cardiovascular therapeutics JO - Cardiovasc Ther VL - 35 IS - 2 N2 - INTRODUCTION: Real-world, country-specific studies of dual antiplatelet therapy (DAPT) duration among survivors of acute coronary syndrome (ACS) are important for improving long-term prognosis. AIMS: To investigate DAPT duration after hospital discharge for ACS in Spain. RESULTS: Data from patients enrolled in the Spanish cohort of the EPICOR (long-tErm follow-up of antithrombotic management Patterns In acute CORonary syndrome patients) study (NCT01171404) were analyzed for changes to antithrombotic medication up to 2 years postdischarge according to index event diagnosis and patient characteristics. Deaths, coronary events, and bleeding events were analyzed over the same period. Overall, a high proportion of patients remained on DAPT at 2 years (53.1%). Among patients who experienced any on-treatment bleeding event, almost two-thirds remained on DAPT at the end of follow-up. Patients >65 years, diabetic, or those that were medically managed were more likely to continue with DAPT until 2 years following discharge. At 2 years, the incidence of bleeding events requiring hospitalization was low compared with the incidence of coronary events (1.4% vs 6.6%). There was a numerical reduction in coronary events, but no increase in bleeding events, with DAPT continuation compared with single antiplatelet therapy. CONCLUSIONS: More than half of patients in this unselected cohort study remained on DAPT at 2 years following discharge for ACS. Continuation with DAPT was greater among patients with additional cardiovascular risk factors, which suggests that treating physicians in Spain prioritizes ischemic risk reduction over bleeding risk in patients with ACS, according to patient's risk profile. SN - 1755-5922 UR - https://www.unboundmedicine.com/medline/citation/27885830/Extended_dual_antiplatelet_therapy_after_acute_coronary_syndrome_in_Spain:_Results_from_the_EPICOR_study_ L2 - https://doi.org/10.1111/1755-5922.12237 DB - PRIME DP - Unbound Medicine ER -