Author + information
- Ron Waksman,
- Kyle Buchanan,
- M. Chadi Alraies,
- Toby Rogers,
- Arie Steinvil,
- Edward Koifman,
- Rebecca Torguson,
- Jiaxiang Gai,
- Itsik Ben-Dor,
- Augusto Pichard and
- Lowell Satler
Background: Dual-antiplatelet therapy (DAPT) for 12 months is recommended for patients with acute coronary syndrome (ACS) who undergo percutaneous coronary intervention (PCI). The newer antiplatelet agents prasugrel and ticagrelor reduce cardiovascular events more than clopidogrel in those patients. However, many clinicians transition patients to clopidogrel following hospital discharge or are reluctant to use the newer agents at all. The trend and patterns of prescription of DAPT in ACS patients remain uncertain.
Methods: We performed a retrospective analysis of patients with ACS who underwent PCI at our center between 2010 and 2016. Details of DAPT at discharge and follow-up were obtained.
Results: A total of 3,651 patients were analyzed. The distribution of DAPT postprocedure and those maintained on the same regimen at 30 days follow-up was as follows: 2,749 (75.3%) clopidogrel, 437 (12.0%) prasugrel, 505(13.8%) ticagrelor. At 30 days, only 41 patients (1.1%) were switched to a different P2Y12 inhibitor. Of those patients, 24.4% were transitioned from clopidogrel to prasugrel, 4.9% from clopiogrel to ticagrelor and 58.5% from ticagrelor or prasugrel to clopidogrel. At 6 months and 12 months follow-up, an additional 205 (5.6%) patients and 389 (10.6%) patients, respectively, were switched to different P2Y12 inhibitors. By 12 months, 70.0% of the patients transitioned to a different P2Y12 inhibitor were switched from ticagrelor or prasugrel to clopidogrel.
Conclusions: The majority of patients undergoing primary PCI for ACS receive clopidogrel postprocedure and are discharged and maintained on the antiplatelet agent. Within the first year following treatment for ACS, 11.8% of patients are transitioned from one P2Y12 inhibitor to another, mainly to clopidogrel and more often at 6–12 months following PCI.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Considerations in Antiplatelet Therapy and in ACS
Abstract Category: 15. Interventional Cardiology: ACS/AMI/Hemodynamics and Pharmacology
Presentation Number: 1113-139
- 2017 American College of Cardiology Foundation