1. Antithrombotic management and long-term outcomes following percutaneous coronary intervention for acute coronary syndrome in Asia.
- Author
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Zhang S, Wang W, Sawhney JPS, Krittayaphong R, Kim HS, Nhan VT, Lee SW, Ong TK, Chin CT, Pocock SJ, Huo Y, Qian J, and Ge J
- Subjects
- Aftercare, Asia epidemiology, Asia, Eastern, Fibrinolytic Agents therapeutic use, Humans, India, Patient Discharge, Prospective Studies, Registries, Treatment Outcome, Acute Coronary Syndrome diagnosis, Acute Coronary Syndrome drug therapy, Acute Coronary Syndrome surgery, Percutaneous Coronary Intervention
- Abstract
Background: Cardiovascular diseases account for approximately half of all deaths in Asia. The present analysis aimed to evaluate characteristics, antithrombotic management patterns (AMPs), and outcomes in patients with acute coronary syndrome (ACS) who underwent in-hospital percutaneous coronary intervention (PCI) and survived to hospital discharge, using data from the EPICOR Asia registry (NCT01361386)., Methods: Two-year post-discharge follow-up data were analyzed from 8757 ACS PCI patients from EPICOR Asia (218 centers, eight countries). Major adverse cardiovascular events (MACE; death, non-fatal myocardial infarction [MI], non-fatal ischemic stroke), PCI characteristics, and AMPs were recorded. For MACE, time - to - event was analyzed using Cox regression., Results: Primary PCI was performed in 62.0% of ST-segment elevation MI (STEMI), 38.7% of non-STEMI (NSTEMI), and 24.2% of unstable angina (UA) patients. At 12 months, 88.1% of patients were on dual antiplatelet therapy (DAPT), with no differences by index event. Most (61.5%) still received DAPT at 2 years. Two-year incidences of mortality, composite MACE, and bleeding were 3.6%, 6.2%, and 6.6%, respectively. Risk of death and MACE was increased with STEMI and NSTEMI vs. UA. Patients from East Asia showed lower mortality and more bleeding vs. Southeast Asia/India., Conclusions: Many patients in EPICOR Asia underwent PCI and received DAPT up to 2 years post-discharge. These real-world findings improve our understanding of AMP impact on outcomes in Asian patients with ACS undergoing PCI., Competing Interests: Declaration of competing interest S.Z., W.W., J.P.S.S., H.S.K., S.W.L.L., Y.H., J.Q., and J.G. declare no conflict of interest. R.K. reports having been a consultant or advisory board member for AstraZeneca and Boehringer Ingelheim (both modest). V.T.N. reports research grants from AstraZeneca, Servier, Sanofi, and Boston Scientific, and has been a consultant or advisory board member for AstraZeneca, Pfizer, Sanofi, Boehringer Ingelheim, Servier, MSD, Abbott, Bayer, Novartis, Merck Serono, Biosensor, Biotronic, Boston Scientific, Terumo, and Medtronic (all modest). T.K.O. reports having acted as a consultant or advisory board member for Sanofi-Aventis, Abbott Vascular, Boston Scientific, Boehringer Ingelheim, Novartis, and AstraZeneca (all modest). C.T.C. reports research support from Eli Lilly, honoraria from Medtronic, and has been a consultant or advisory board member for AstraZeneca (all modest). S.J.P. reports receiving research funds from AstraZeneca (modest)., (Copyright © 2020. Published by Elsevier B.V.)
- Published
- 2020
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