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Comparison Between ...
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Szummer, KarolinaKarolinska Institutet,Karolinska Institute,Karolinska University Hospital,Karolinska Inst, Dept Med Huddinge, Stockholm, Sweden; Karolinska Univ Hosp, Dept Cardiol, Stockholm, Sweden.
(författare)
Comparison Between Ticagrelor and Clopidogrel in Elderly Patients With an Acute Coronary Syndrome : Insights From the SWEDEHEART Registry
- Artikel/kapitelEngelska2020
Förlag, utgivningsår, omfång ...
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Lippincott Williams & Wilkins,2020
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9 s.
Nummerbeteckningar
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LIBRIS-ID:oai:lup.lub.lu.se:985a7171-7657-4e0e-a6a2-21a1c98a5cf2
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https://lup.lub.lu.se/record/985a7171-7657-4e0e-a6a2-21a1c98a5cf2URI
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https://doi.org/10.1161/CIRCULATIONAHA.120.050645DOI
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-427117URI
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https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-171720URI
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http://kipublications.ki.se/Default.aspx?queryparsed=id:145111257URI
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https://gup.ub.gu.se/publication/297029URI
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Språk:engelska
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Sammanfattning på:engelska
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Ämneskategori:art swepub-publicationtype
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Ämneskategori:ref swepub-contenttype
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Funding Agencies|Stockholm County CouncilStockholm County Council; Swedish Medical Association (Svenska Lakarsallskapet); Swedish Heart Association (Svenska Hjartforbundet); Swedish Heart and Lung FoundationSwedish Heart-Lung Foundation
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BACKGROUND: The comparative efficacy and safety of ticagrelor versus clopidogrel in older patients with myocardial infarction (MI) has received limited study. METHODS: We performed an observational analysis of all patients ≥80 years (n=14 005) who were discharged alive with aspirin combined with either clopidogrel (60.2%) or ticagrelor (39.8%) after a MI between 2010 and 2017 registered in the national registry SWEDEHEART (Swedish Web-System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies). Inverse probability treatment weighting was used in Cox regression models to adjust for differences in demographics, in-hospital therapies, and medications. The primary ischemic outcome (death, MI, or stroke), and bleeding were obtained from national registries at 1 year. A sensitivity analysis in <80-year-old patients was performed. RESULTS: In patients ≥80 years, the incidence of the primary ischemic outcome (hazard ratio [HR], 0.97 [95% CI, 0.88-1.06]) was similar for ticagrelor- and clopidogrel-treated patients. Ticagrelor was associated with a 17% and 48% higher risk of death (HR, 1.17 [95% CI, 1.03-1.32]) and bleeding (HR, 1.48 [95% CI, 1.25-1.76]), but a lower risk of MI (HR, 0.80 [95% CI, 0.70-0.92]) and stroke (HR, 0.72 [95% CI, 0.56-0.93]). In <80-year-old patients, the incidence of the primary ischemic outcome was 17% (HR, 0.83 [95% CI, 0.77-0.89]) lower with ticagrelor. Ticagrelor was associated with 15% (HR, 0.85 [95% CI, 0.76-0.96]) lower risk of death, 32% higher risk of bleeding (HR, 1.32 [95% CI, 1.18-1.47]), but lower risk of MI (HR, 0.82 [95% CI, 0.75-0.91]) and stroke (HR, 0.82 [95% CI, 0.69-0.98]). CONCLUSIONS: Ticagrelor use among elderly patients with MI was associated with higher risk of bleeding and death compared with clopidogrel. A randomized study of ticagrelor versus clopidogrel in the elderly is needed.
Ämnesord och genrebeteckningar
Biuppslag (personer, institutioner, konferenser, titlar ...)
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Montez-Rath, Maria E.Stanford University,Stanford Univ, Sch Med, Div Nephrol, Palo Alto, CA 94304 USA.
(författare)
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Alfredsson, JoakimLinköpings universitet,Linköping University,Linkoping Univ, Dept Cardiol, Linkoping, Sweden; Linkoping Univ, Dept Med & Hlth Sci, Linkoping, Sweden.,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Region Östergötland, Kardiologiska kliniken US(Swepub:liu)joaal38
(författare)
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Erlinge, DavidLund University,Lunds universitet,Molekylär kardiologi,Forskargrupper vid Lunds universitet,Molecular Cardiology,Lund University Research Groups,Lund Univ, Dept Cardiol, Clin Sci, Lund, Sweden.(Swepub:lu)kard-der
(författare)
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Lindahl, Bertil,1957-Uppsala universitet,Uppsala University,Uppsala University Hospital,Kardiologi,Uppsala kliniska forskningscentrum (UCR),Uppsala Univ, Sweden(Swepub:uu)belin227
(författare)
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Hofmann, RobinKarolinska Institutet,Karolinska Institute,Stockholm South General Hospital,Karolinska Inst, Dept Clin Sci & Educ, Div Cardiol, Sodersjukhuset, Stockholm, Sweden.
(författare)
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Ravn-Fischer, Annica,1974Gothenburg University,Göteborgs universitet,University of Gothenburg,Sahlgrenska University Hospital,Univ Gothenburg, Dept Mol & Clin Med, Gothenburg, Sweden; Sahlgrens Univ Hosp, Dept Cardiol, Gothenburg, Sweden.,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine(Swepub:gu)xravan
(författare)
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Svensson, PerKarolinska Institutet,Karolinska Institute,Stockholm South General Hospital,Karolinska Inst, Dept Clin Sci & Educ, Div Cardiol, Sodersjukhuset, Stockholm, Sweden.
(författare)
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Jernberg, TomasKarolinska Institutet,Karolinska Institute,Danderyd Hospital,Karolinska Inst, Danderyd Univ Hosp, Dept Clin Sci, Stockholm, Sweden.
(författare)
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Karolinska InstituteKarolinska University Hospital
(creator_code:org_t)
Sammanhörande titlar
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Ingår i:Circulation: Lippincott Williams & Wilkins142:18, s. 1700-17081524-45390009-7322
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Szummer, Karolin ...
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Montez-Rath, Mar ...
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Alfredsson, Joak ...
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Erlinge, David
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Lindahl, Bertil, ...
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Hofmann, Robin
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Ravn-Fischer, An ...
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Svensson, Per
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Jernberg, Tomas
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- Om ämnet
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Kardiologi
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MEDICIN OCH HÄLS ...
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och Medicinska och f ...
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Circulation
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Lunds universitet
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Uppsala universitet
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Linköpings universitet
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Karolinska Institutet
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Göteborgs universitet