Ticagrelor and the risk of Staphylococcus aureus bacteraemia and other infections.

Abstract

AIMS:

To investigate the 1-year risks of Staphylococcus aureus bacteraemia (SAB), sepsis, and pneumonia in patients who underwent percutaneous coronary intervention and were treated with ticagrelor vs. clopidogrel.

METHODS AND RESULTS:

In this nationwide observational cohort study, 26 606 patients who underwent urgent or emergent percutaneous coronary intervention (January 2011-December 2017) and initiated treatment with ticagrelor [N = 20 073 (75.5%); median age 64 years (25th-75th percentile 55-72 years); 74.8% men] or clopidogrel [N = 6533 (24.5%); median age 68 years (25th-75th percentile 58-77 years); 70.2% men] were identified using Danish nationwide registries. The 1-year standardized absolute risks of outcomes was calculated based on cause-specific Cox regression models, and average treatment effects between treatment groups were obtained as standardized differences in absolute 1-year risks. The absolute 1-year risk of SAB was 0.10% [95% confidence interval (CI), 0.05-0.15%] in the ticagrelor group and 0.29% (95% CI, 0.17-0.42%) in the clopidogrel group. Compared with clopidogrel, treatment with ticagrelor was associated with a significantly lower absolute 1-year risk of SAB [absolute risk difference -0.19% (95% CI, -0.32% to -0.05%), P value 0.006]. Likewise, treatment with ticagrelor was associated with a significantly lower absolute 1-year risk of sepsis [0.99% (95% CI, 0.83-1.14%) vs. 1.49% (95% CI, 1.17-1.80%); absolute risk difference -0.50% (95% CI, -0.86% to -0.14%), P value 0.007] and pneumonia [3.13% (95% CI, 2.86-3.39%) vs. 4.56% (95% CI, 4.03-5.08%); absolute risk difference -1.43% (95% CI, -2.03% to -0.82%), P value < 0.001] compared with clopidogrel.

CONCLUSION:

Treatment with ticagrelor was associated with a significantly lower 1-year risk of SAB, sepsis, and pneumonia compared with clopidogrel.

• Authors: Jawad H Butt, Emil L Fosbøl, Thomas A Gerds, Kasper Iversen, Henning Bundgaard, Niels Eske Bruun, Anders R Larsen, Andreas Petersen, Paal S Andersen, Robert L Skov, Lauge Østergaard, Eva Havers-Borgersen, Gunnar H Gislason, Christian Torp-Pedersen, Lars Køber, Jonas B Olesen
• Journal: European heart journal. Cardiovascular pharmacotherapy (Eur Heart J Cardiovasc Pharmacother) Vol. 8 Issue 1 Pg. 13-19 (01 05 2022) ISSN: 2055-6845 [Electronic] England
• PMID: 32750138 (Publication Type: Journal Article, Observational Study)
• Copyright: Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: [email protected].

Chemical References

• Platelet Aggregation Inhibitors
• Ticagrelor

Topics

• Acute Coronary Syndrome (therapy)
• Aged
• Bacteremia (diagnosis, drug therapy, epidemiology)
• Female
• Humans
• Male
• Middle Aged
• Platelet Aggregation Inhibitors (adverse effects)
• Staphylococcal Infections (diagnosis, drug therapy, epidemiology)
• Staphylococcus aureus
• Ticagrelor (adverse effects)
• Treatment Outcome