Author + information
- Devraj Sukul,
- Milan Seth,
- James M. Dupree,
- Akshay Khandelwal,
- Simon Dixon,
- David Wohns,
- Thomas LaLonde and
- Hitinder Gurm
Background: In randomized trials, ticagrelor and prasugrel were superior to clopidogrel in the treatment of acute coronary syndrome (ACS); however, the comparative effectiveness of these two drugs in real-world practice remains unknown. We compared post-discharge outcomes among older pts discharged on ticagrelor versus prasugrel after percutaneous coronary intervention (PCI) for ACS.
Methods: We linked clinical data from PCIs performed in older pts (age ≥65) for ACS at 47 Michigan hospitals to Medicare fee-for-service episodes of care from 1/2013 through 12/2014. Propensity matching adjusted for the non-random use of ticagrelor and prasugrel at discharge. Kaplan-Meier cumulative mortality was estimated, and Cox and logistic regression modeling was used to compare outcomes between groups.
Results: Pts discharged on ticagrelor (n=1,243) more frequently had a history of atrial fibrillation and stroke, and presented with ST-/ non-ST-elevation myocardial infarction as compared to prasugrel (n=1,014). After matching (n=756 per group), there were no significant differences in 90-day readmission (16.7% ticagrelor vs. 14.6% prasugrel; p = .35) or long-term mortality (figure).
Conclusions: Patients discharged on ticagrelor had more comorbidities than those discharged on prasugrel; however, among similar older pts who underwent PCI for ACS, there were no differences in long-term outcomes between ticagrelor and prasugrel.
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: 1113-140
- 2017 American College of Cardiology Foundation