Author + information
- Dimitrios Alexopoulos,
- Ioanna Xanthopoulou,
- Argyro Siapika,
- Spyridon Deftereos,
- George Sitafidis,
- Ioannis Goudevenos,
- Filippos Triposkiadis,
- Vlassis Pyrgakis,
- Ioannis Kanakakis and
- Periklis Davlouros
Data on the prevalence of contraindications and conditions requiring precaution for the administration of P2Y12 inhibitors in real-life patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI) are scarce.
We performed detailed recording of contraindications and conditions requiring precaution for clopidogrel, prasugrel and ticagrelor in ACS patients undergoing PCI in the context of a prospective multi-centre, observational study of antiplatelet treatment patterns in ACS patients subjected to PCI in Greece.
From January to August 2012, 875 patients were included in analysis, 82.3% men, with a mean age of 62.5±18.8 years, 23.3% diabetics, 53.5% current smokers and 50.4% admitted with ST elevation myocardial infarction. In total 16.7%, 42.7% and 35.5% of patients had at least one absolute contraindication or special condition requiring precaution for clopidogrel, prasugrel and ticagrelor respectively. Conditions, common among the 3 agents, requiring precaution were: recent injury or surgery (0.5%), recent gastrointestinal bleeding (0.9%), home-medication increasing bleeding risk (3.4%), renal failure (3.1%) and concomitant conditions increasing bleeding risk (5.6%). Contraindications/conditions requiring precaution only for prasugrel were prior stroke (18.6%), age ≥75 years (16.1%) and weight < 60Kg (3.1%) while only for ticagrelor were severe chronic obstructive pulmonary disease (4.2%), hyperuricaemia/prior gout crisis (6.3%) and increased risk of bradycardia (0.7%). In total 116(13.3%) patients had at least 1 contraindication or condition requiring precaution for the administration of all 3 agents.
In a real-world ACS population treated with PCI, there is a relative high rate of contraindications or specific conditions requiring precaution for the administration of P2Y12 inhibitors, especially for prasugrel and ticagrelor.
Poster Sessions, Expo North
Saturday, March 09, 2013, 10:00 a.m.-10:45 a.m.
Session Title: ACS Therapy: Antiplatelet Agents
Abstract Category: 3. Acute Coronary Syndromes: Therapy
Presentation Number: 1129-204
- 2013 American College of Cardiology Foundation