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Comparison Between ...
Comparison Between Ticagrelor and Clopidogrel in Elderly Patients With an Acute Coronary Syndrome : Insights From the SWEDEHEART Registry
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- Szummer, Karolina (författare)
- Karolinska Institutet,Karolinska Institute,Karolinska University Hospital,Karolinska Inst, Dept Med Huddinge, Stockholm, Sweden; Karolinska Univ Hosp, Dept Cardiol, Stockholm, Sweden.
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- Montez-Rath, Maria E. (författare)
- Stanford University,Stanford Univ, Sch Med, Div Nephrol, Palo Alto, CA 94304 USA.
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- Alfredsson, Joakim (författare)
- Linköpings 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
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- Erlinge, David (författare)
- Lund University,Lunds universitet,Molekylär kardiologi,Forskargrupper vid Lunds universitet,Molecular Cardiology,Lund University Research Groups,Lund Univ, Dept Cardiol, Clin Sci, Lund, Sweden.
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- Lindahl, Bertil, 1957- (författare)
- Uppsala universitet,Uppsala University,Uppsala University Hospital,Kardiologi,Uppsala kliniska forskningscentrum (UCR),Uppsala Univ, Sweden
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- Hofmann, Robin (författare)
- Karolinska Institutet,Karolinska Institute,Stockholm South General Hospital,Karolinska Inst, Dept Clin Sci & Educ, Div Cardiol, Sodersjukhuset, Stockholm, Sweden.
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- Ravn-Fischer, Annica, 1974 (författare)
- Gothenburg 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
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- Svensson, Per (författare)
- Karolinska Institutet,Karolinska Institute,Stockholm South General Hospital,Karolinska Inst, Dept Clin Sci & Educ, Div Cardiol, Sodersjukhuset, Stockholm, Sweden.
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- Jernberg, Tomas (författare)
- Karolinska Institutet,Karolinska Institute,Danderyd Hospital,Karolinska Inst, Danderyd Univ Hosp, Dept Clin Sci, Stockholm, Sweden.
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(creator_code:org_t)
- Lippincott Williams & Wilkins, 2020
- 2020
- Engelska 9 s.
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Ingår i: Circulation. - : Lippincott Williams & Wilkins. - 1524-4539 .- 0009-7322. ; 142:18, s. 1700-1708
- Relaterad länk:
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http://dx.doi.org/10...
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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https://urn.kb.se/re...
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https://urn.kb.se/re...
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http://kipublication...
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https://gup.ub.gu.se...
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Abstract
Ämnesord
Stäng
- 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
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Farmakologi och toxikologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Pharmacology and Toxicology (hsv//eng)
Nyckelord
- antiplatelet therapy
- elderly
- myocardial infarction
- prognosis
- risk-benefit
- antiplatelet therapy
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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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- 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 HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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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