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Long-term antithrombotic management patterns in Asian patients with acute coronary syndrome: 2-year observations from the EPICOR Asia study.
Clin Cardiol. 2020 Sep; 43(9):999-1008.CC

Abstract

BACKGROUND

Despite guideline recommendations, dual antiplatelet therapy (DAPT) is frequently used for longer than 1 year after an acute coronary syndrome (ACS) event. In Asia, information on antithrombotic management patterns (AMPs), including DAPT post discharge, is sparse. This analysis evaluated real-world AMPs up to 2 years post discharge for ACS.

HYPOTHESIS

There is wide variability in AMP use for ACS management in Asia.

METHODS

EPICOR Asia (NCT01361386) is a prospective observational study of patients discharged after hospitalization for an ACS in eight countries/regions in Asia, followed up for 2 years. Here, we describe AMPs used and present an exploratory analysis of characteristics and outcomes in patients who received DAPT for ≤12 months post discharge compared with >12 months.

RESULTS

Data were available for 12 922 patients; of 11 639 patients discharged on DAPT, 2364 (20.3%) received DAPT for ≤12 months and 9275 (79.7%) for >12 months, with approximately 60% still on DAPT at 2 years. Patients who received DAPT for >12 months were more likely to be younger, obese, lower Killip class, resident in India (vs China), and to have received invasive reperfusion. Clinical event rates during year 2 of follow-up were lower in patients with DAPT >12 vs ≤12 months, but no causal association can be implied in this non-randomized study.

CONCLUSIONS

Most ACS patients remained on DAPT up to 1 year, in accordance with current guidelines, and over half remained on DAPT at 2 years post discharge. Patients not on DAPT at 12 months are a higher risk group requiring careful monitoring.

Authors+Show Affiliations

Department of Cardiology, Peking University First Hospital, Beijing, China.Department of Cardiology, Peking University First Hospital, Beijing, China.Department of Medicine, Queen Mary Hospital, Hong Kong, SAR, China.Department of Cardiology, Sir Ganga Ram Hospital, New Delhi, India.Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea.Division of Cardiology, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Bangkok, Thailand.Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK.Department of Medicine, Cho Ray Hospital, Ho Chi Minh City, Vietnam.Imperial College, National Health Service (NHS) Trust, London, UK.Department of Cardiology, National Heart Centre, Singapore, Singapore.Department of Cardiology, Peking University First Hospital, Beijing, China.Health Economics Program, The George Institute for Global Health, University of New South Wales, Sydney, Australia.Observational Research Centre, Global Medical Affairs, AstraZeneca, Madrid, Spain.Department of Biometrics, AstraZeneca K.K, Osaka, Japan.Department of Cardiology, Sarawak General Hospital, Kuching, Malaysia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32618009

Citation

Zheng, Bo, et al. "Long-term Antithrombotic Management Patterns in Asian Patients With Acute Coronary Syndrome: 2-year Observations From the EPICOR Asia Study." Clinical Cardiology, vol. 43, no. 9, 2020, pp. 999-1008.
Zheng B, Huo Y, Lee SW, et al. Long-term antithrombotic management patterns in Asian patients with acute coronary syndrome: 2-year observations from the EPICOR Asia study. Clin Cardiol. 2020;43(9):999-1008.
Zheng, B., Huo, Y., Lee, S. W., Sawhney, J. P. S., Kim, H. S., Krittayaphong, R., Pocock, S. J., Nhan, V. T., Alonso Garcia, A., Chin, C. T., Jiang, J., Jan, S., Vega, A. M., Hayashi, N., & Ong, T. K. (2020). Long-term antithrombotic management patterns in Asian patients with acute coronary syndrome: 2-year observations from the EPICOR Asia study. Clinical Cardiology, 43(9), 999-1008. https://doi.org/10.1002/clc.23400
Zheng B, et al. Long-term Antithrombotic Management Patterns in Asian Patients With Acute Coronary Syndrome: 2-year Observations From the EPICOR Asia Study. Clin Cardiol. 2020;43(9):999-1008. PubMed PMID: 32618009.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term antithrombotic management patterns in Asian patients with acute coronary syndrome: 2-year observations from the EPICOR Asia study. AU - Zheng,Bo, AU - Huo,Yong, AU - Lee,Stephen W-L, AU - Sawhney,Jitendra P S, AU - Kim,Hyo-Soo, AU - Krittayaphong,Rungroj, AU - Pocock,Stuart J, AU - Nhan,Vo T, AU - Alonso Garcia,Angeles, AU - Chin,Chee Tang, AU - Jiang,Jie, AU - Jan,Stephen, AU - Vega,Ana Maria, AU - Hayashi,Nobuya, AU - Ong,Tiong K, Y1 - 2020/07/02/ PY - 2020/04/30/received PY - 2020/05/20/revised PY - 2020/05/21/accepted PY - 2020/7/4/pubmed PY - 2020/7/4/medline PY - 2020/7/4/entrez KW - EPICOR KW - acute coronary care antithrombotic management patterns KW - acute coronary syndrome KW - observational SP - 999 EP - 1008 JF - Clinical cardiology JO - Clin Cardiol VL - 43 IS - 9 N2 - BACKGROUND: Despite guideline recommendations, dual antiplatelet therapy (DAPT) is frequently used for longer than 1 year after an acute coronary syndrome (ACS) event. In Asia, information on antithrombotic management patterns (AMPs), including DAPT post discharge, is sparse. This analysis evaluated real-world AMPs up to 2 years post discharge for ACS. HYPOTHESIS: There is wide variability in AMP use for ACS management in Asia. METHODS: EPICOR Asia (NCT01361386) is a prospective observational study of patients discharged after hospitalization for an ACS in eight countries/regions in Asia, followed up for 2 years. Here, we describe AMPs used and present an exploratory analysis of characteristics and outcomes in patients who received DAPT for ≤12 months post discharge compared with >12 months. RESULTS: Data were available for 12 922 patients; of 11 639 patients discharged on DAPT, 2364 (20.3%) received DAPT for ≤12 months and 9275 (79.7%) for >12 months, with approximately 60% still on DAPT at 2 years. Patients who received DAPT for >12 months were more likely to be younger, obese, lower Killip class, resident in India (vs China), and to have received invasive reperfusion. Clinical event rates during year 2 of follow-up were lower in patients with DAPT >12 vs ≤12 months, but no causal association can be implied in this non-randomized study. CONCLUSIONS: Most ACS patients remained on DAPT up to 1 year, in accordance with current guidelines, and over half remained on DAPT at 2 years post discharge. Patients not on DAPT at 12 months are a higher risk group requiring careful monitoring. SN - 1932-8737 UR - https://www.unboundmedicine.com/medline/citation/32618009/Long_term_antithrombotic_management_patterns_in_Asian_patients_with_acute_coronary_syndrome:_2_year_observations_from_the_EPICOR_Asia_study_ L2 - https://doi.org/10.1002/clc.23400 DB - PRIME DP - Unbound Medicine ER -
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