Real-world observations with prasugrel compared to clopidogrel in acute coronary syndrome patients treated with percutaneous coronary intervention in the United States
Real-world observations with prasugrel compared to clopidogrel in acute coronary syndrome patients treated with percutaneous coronary intervention in the United States
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DOI：
10.1185/03007995.2014.941055
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发表时间：
2014-11-01
影响因子：
2.3
通讯作者：
Effron, Mark B.
中科院分区：
文献类型：
--
作者：
Bae, Jay P.;Faries, Douglas E.;Effron, Mark B.
目的：比较接受氯吡格雷或普拉格雷治疗的急性冠脉综合征(ACS)患者30天和90天的急性心肌梗死(AMI)和出血相关再住院率。研究设计和方法：利用Premier医院数据库，分析2009年7月至2011年6月接受药物洗脱(DES)或裸金属(BMS)支架和氯吡格雷或普拉格雷治疗的ACS-PCI患者。患者是根据美国处方信息(USPI)纳入的，排除了有短暂性脑缺血发作/中风病史和75年无糖尿病或既往心肌梗死史的患者。主要终点是调整后30天的急性心肌梗死再住院率。次要终点包括90天急性心肌梗死和30天和90天出血相关的再住院率。结果：在指数事件中，普拉格雷患者(N=9404)与氯吡格雷患者(N=74,163)不同，他们合并出血的风险较低，更可能是年轻和男性，有ST段抬高心肌梗死和接受DES。30天时，氯吡格雷和普拉格雷的急性心肌梗死再住院率分别为4.7%和3.9%(P
Objectives:To compare 30 and 90 day real-world acute myocardial infarction (AMI) and bleeding related rehospitalization rates in acute coronary syndrome (ACS) patients receiving percutaneous coronary intervention (PCI; ACS-PCI) treated with clopidogrel or prasugrel.Research design and methods:Using the Premier hospital database, ACS-PCI patients receiving a drug-eluting (DES) or bare-metal (BMS) stent and clopidogrel or prasugrel from July 2009 to June 2011 were analyzed. Patients were included based on the prasugrel US prescribing information (USPI), excluding patients with a history of transient ischemic attack/stroke and patients >= 75 years without diabetes or prior MI. The primary endpoint was 30 day adjusted AMI rehospitalization rate. Secondary endpoints included 90 day AMI and 30 and 90 day bleeding-related rehospitalization rates. Treatment comparisons were adjusted using propensity score stratification.Results:At the index event, prasugrel patients (N = 9404) differed from clopidogrel patients (N = 74,163) by having a lower risk of comorbid conditions associated with bleeding, being more likely younger and male, having ST-elevation MI and receiving a DES. For clopidogrel and prasugrel, respectively, the observed AMI-related rehospitalization rates were 4.7% and 3.9% at 30 days (p