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Antithrombotic management and long-term outcomes following percutaneous coronary intervention for acute coronary syndrome in Asia.
Int J Cardiol. 2020 07 01; 310:16-22.IJ

Abstract

BACKGROUND

Cardiovascular diseases account for approximately half of all deaths in Asia. The present analysis aimed to evaluate characteristics, antithrombotic management patterns (AMPs), and outcomes in patients with acute coronary syndrome (ACS) who underwent in-hospital percutaneous coronary intervention (PCI) and survived to hospital discharge, using data from the EPICOR Asia registry (NCT01361386).

METHODS

Two-year post-discharge follow-up data were analyzed from 8757 ACS PCI patients from EPICOR Asia (218 centers, eight countries). Major adverse cardiovascular events (MACE; death, non-fatal myocardial infarction [MI], non-fatal ischemic stroke), PCI characteristics, and AMPs were recorded. For MACE, time - to - event was analyzed using Cox regression.

RESULTS

Primary PCI was performed in 62.0% of ST-segment elevation MI (STEMI), 38.7% of non-STEMI (NSTEMI), and 24.2% of unstable angina (UA) patients. At 12 months, 88.1% of patients were on dual antiplatelet therapy (DAPT), with no differences by index event. Most (61.5%) still received DAPT at 2 years. Two-year incidences of mortality, composite MACE, and bleeding were 3.6%, 6.2%, and 6.6%, respectively. Risk of death and MACE was increased with STEMI and NSTEMI vs. UA. Patients from East Asia showed lower mortality and more bleeding vs. Southeast Asia/India.

CONCLUSIONS

Many patients in EPICOR Asia underwent PCI and received DAPT up to 2 years post-discharge. These real-world findings improve our understanding of AMP impact on outcomes in Asian patients with ACS undergoing PCI.

Authors+Show Affiliations

Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China.Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China.Sir Ganga Ram Hospital, New Delhi, India.Siriraj Hospital, Bangkok, Thailand.Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.Cho Ray Hospital, Ho Chi Minh City, Viet Nam.Queen Mary Hospital, Hong Kong, SAR, China.Sarawak General Hospital, Kuching, Malaysia.National Heart Centre Singapore, Singapore.London School of Hygiene and Tropical Medicine, London, United Kingdom.Peking University First Hospital, Beijing, China.Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China.Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China. Electronic address: jbge@zs-hospital.sh.cn.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32192746

Citation

Zhang, Shuning, et al. "Antithrombotic Management and Long-term Outcomes Following Percutaneous Coronary Intervention for Acute Coronary Syndrome in Asia." International Journal of Cardiology, vol. 310, 2020, pp. 16-22.
Zhang S, Wang W, Sawhney JPS, et al. Antithrombotic management and long-term outcomes following percutaneous coronary intervention for acute coronary syndrome in Asia. Int J Cardiol. 2020;310:16-22.
Zhang, S., Wang, W., Sawhney, J. P. S., Krittayaphong, R., Kim, H. S., Nhan, V. T., Lee, S. W., Ong, T. K., Chin, C. T., Pocock, S. J., Huo, Y., Qian, J., & Ge, J. (2020). Antithrombotic management and long-term outcomes following percutaneous coronary intervention for acute coronary syndrome in Asia. International Journal of Cardiology, 310, 16-22. https://doi.org/10.1016/j.ijcard.2020.01.008
Zhang S, et al. Antithrombotic Management and Long-term Outcomes Following Percutaneous Coronary Intervention for Acute Coronary Syndrome in Asia. Int J Cardiol. 2020 07 1;310:16-22. PubMed PMID: 32192746.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Antithrombotic management and long-term outcomes following percutaneous coronary intervention for acute coronary syndrome in Asia. AU - Zhang,Shuning, AU - Wang,Wei, AU - Sawhney,Jitendra P S, AU - Krittayaphong,Rungroj, AU - Kim,Hyo-Soo, AU - Nhan,Vo Thanh, AU - Lee,Stephen W-L, AU - Ong,Tiong Kiam, AU - Chin,Chee Tang, AU - Pocock,Stuart J, AU - Huo,Yong, AU - Qian,Juying, AU - Ge,Junbo, Y1 - 2020/03/17/ PY - 2019/09/30/received PY - 2019/12/11/revised PY - 2020/01/08/accepted PY - 2020/3/21/pubmed PY - 2020/3/21/medline PY - 2020/3/21/entrez KW - ACS KW - NSTEMI KW - Prior PCI KW - STEMI SP - 16 EP - 22 JF - International journal of cardiology JO - Int J Cardiol VL - 310 N2 - BACKGROUND: Cardiovascular diseases account for approximately half of all deaths in Asia. The present analysis aimed to evaluate characteristics, antithrombotic management patterns (AMPs), and outcomes in patients with acute coronary syndrome (ACS) who underwent in-hospital percutaneous coronary intervention (PCI) and survived to hospital discharge, using data from the EPICOR Asia registry (NCT01361386). METHODS: Two-year post-discharge follow-up data were analyzed from 8757 ACS PCI patients from EPICOR Asia (218 centers, eight countries). Major adverse cardiovascular events (MACE; death, non-fatal myocardial infarction [MI], non-fatal ischemic stroke), PCI characteristics, and AMPs were recorded. For MACE, time - to - event was analyzed using Cox regression. RESULTS: Primary PCI was performed in 62.0% of ST-segment elevation MI (STEMI), 38.7% of non-STEMI (NSTEMI), and 24.2% of unstable angina (UA) patients. At 12 months, 88.1% of patients were on dual antiplatelet therapy (DAPT), with no differences by index event. Most (61.5%) still received DAPT at 2 years. Two-year incidences of mortality, composite MACE, and bleeding were 3.6%, 6.2%, and 6.6%, respectively. Risk of death and MACE was increased with STEMI and NSTEMI vs. UA. Patients from East Asia showed lower mortality and more bleeding vs. Southeast Asia/India. CONCLUSIONS: Many patients in EPICOR Asia underwent PCI and received DAPT up to 2 years post-discharge. These real-world findings improve our understanding of AMP impact on outcomes in Asian patients with ACS undergoing PCI. SN - 1874-1754 UR - https://www.unboundmedicine.com/medline/citation/32192746/Antithrombotic_management_and_long_term_outcomes_following_percutaneous_coronary_intervention_for_acute_coronary_syndrome_in_Asia_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0167-5273(19)34854-5 DB - PRIME DP - Unbound Medicine ER -
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