Annual Incidence of Confirmed Stent Thrombosis and Clinical Predictors in Patients With ACS Treated With Ticagrelor or Prasugrel.

Abstract

INTRODUCTION AND OBJECTIVES:

There is little evidence on rates of stent thrombosis (ST) in patients receiving dual antiplatelet therapy (DAPT) with ticagrelor or prasugrel. The aim of this study was to analyze the incidence and predictors of ST after an acute coronary syndrome among patients receiving DAPT with ticagrelor vs prasugrel.

METHODS:

We used data from the RENAMI registry (REgistry of New Antiplatelet therapy in patients with acute Myocardial Infarction), analyzing a total of 4123 acute coronary syndrome patients discharged with DAPT with ticagrelor or prasugrel in 11 centers in 6 European countries. The endpoint was definite ST within the first year. A competitive risk analysis was carried out using a Fine and Gray regression model, with death being the competitive event.

RESULTS:

A total of 2604 patients received DAPT with ticagrelor and 1519 with prasugrel; ST occurred in 41 patients (1.10%), with a similar cumulative incidence between ticagrelor (1.21%) and prasugrel (0.90%). The independent predictors of ST were age (sHR, 1.03; 95%CI, 1.01-1.06), ST segment elevation (sHR, 2.24; 95%CI, 1.22-4.14), previous myocardial infarction (sHR, 2.56; 95%CI, 1.19-5.49), and serum creatinine (sHR, 1.29; 95%CI, 1.08-1.54).

CONCLUSIONS:

Stent thrombosis is infrequent in patients receiving DAPT with ticagrelor or prasugrel. The variables associated with an increased risk of ST were advanced age, ST segment elevation, previous myocardial infarction, and serum creatinine.

• Authors: Sergio Raposeiras-Roubín, Emad Abu-Assi, Fabrizio D'Ascenzo, Saleta Fernández-Barbeira, Tim Kinnaird, Albert Ariza-Solé, Sergio Manzano-Fernández, Christian Templin, Lazar Velicki, Ioanna Xanthopoulou, Enrico Cerrato, Giorgio Quadri, Andrea Rognoni, Giacome Boccuzzi, Andrea Montabone, Salma Taha, Alessandro Durante, Sebastiano Gili, Giulia Magnani, Michele Autelli, Alberto Grosso, Pedro Flores Blanco, Alberto Garay, Ferdinando Varbella, Francesco Tommassini, Berenice Caneiro Queija, Rafael Cobas Paz, María Cespón Fernández, Isabel Muñoz Pousa, Diego Gallo, Umberto Morbiducci, Alberto Domínguez-Rodríguez, José Antonio Baz-Alonso, Mariano Valdés, Ángel Cequier, Fiorenzo Gaita, Dimitrios Alexopoulos, Andrés Íñiguez-Romo
• Journal: Revista espanola de cardiologia (English ed.) (Rev Esp Cardiol (Engl Ed)) Vol. 72 Issue 4 Pg. 298-304 (Apr 2019) ISSN: 1885-5857 [Electronic] Spain
• PMID: 29954720 (Publication Type: Journal Article, Multicenter Study, Observational Study)
• Copyright: Copyright © 2018 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Chemical References

• Platelet Aggregation Inhibitors
• Prasugrel Hydrochloride
• Ticagrelor

Topics

• Absorbable Implants (statistics & numerical data)
• Acute Coronary Syndrome (therapy)
• Drug-Eluting Stents
• Female
• Graft Occlusion, Vascular (etiology)
• Humans
• Incidence
• Male
• Middle Aged
• Percutaneous Coronary Intervention (statistics & numerical data)
• Platelet Aggregation Inhibitors (therapeutic use)
• Prasugrel Hydrochloride (therapeutic use)
• Prosthesis Failure (adverse effects)
• Retrospective Studies
• Stents
• Thrombosis (etiology)
• Ticagrelor (therapeutic use)