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SHR Neuro Cancer Cardio Lipid Metab Microb

Tscharre, M; Egger, F; Machata, M; Rohla, M; Michael, N; Neumayr, M; Zweiker, R; Hajos, J; Adlbrecht, C; Suppan, M; Helmreich, W; Eber, B; Huber, K; Weiss, TW.
Contemporary use of P2Y12-inhibitors in patients with acute coronary syndrome undergoing percutaneous coronary intervention in Austria: A prospective, multi-centre registry.
PLoS One. 2017; 12(6):e0179349-e0179349 Doi: 10.1371/journal.pone.0179349 [OPEN ACCESS]
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Co-authors Med Uni Graz: Zweiker Robert
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Abstract:: To this day, there is no data concerning guideline adherence on P2Y12-inhibitors in Austria. Prasugrel and ticagrelor have been shown to be superior to clopidogrel in the treatment of acute coronary syndromes (ACS). However, recent data from European registries showed a reluctant prescription policy with rates of clopidogrel at discharge ranging from 35 to 55%. In this prospective, multi-centre registry we assessed prescription rates of P2Y12-inhibitors in patients with ACS in four Austrian PCI centres. Parameters associated with the use of clopidogrel have been evaluated in multivariate logistic regression. Between January and June 2015, 808 patients with ACS undergoing PCI were considered for further analysis. 416 (51.5%) presented with STEMI and 392 (48.5%) with NSTE-ACS. Mean age was 65.7 ± 12.4 and 240 (30.9%) were female. Twenty-eight (3.5%) died during the hospital stay. At discharge, 212 (27.2% of all patients) received clopidogrel, 260 (32.2%) prasugrel and 297 (36.8%) ticagrelor, while 11 (1.4%) did not receive any P2Y12-inhibitor. Of those patients, who were discharged with clopidogrel, 117 (55.2%) had no absolute contraindication against a more potent P2Y12-inhibitor. Diagnosis of NSTE-ACS (p<0.001), COPD (p = 0.049), and age (p<0.001) next to factors contributing to absolute contraindication were positively associated with the use of clopidogrel. Despite a high level of care, a considerable number of patients were not treated with the more potent P2Y12-inhibitors. Parameters associated with a presumably higher risk of bleeding and side-effects against the more effective P2Y12 inhibitors were the most prominent factors for the prescription of clopidogrel.
Find related publications in this database (using NLM MeSH Indexing): Acute Coronary Syndrome - drug therapy; Acute Coronary Syndrome - mortality; Acute Coronary Syndrome - surgery; Adenosine - analogs & derivatives; Aged -; Aspirin - therapeutic use; Austria -; Clopidogrel -; Female -; Hemorrhage - etiology; Hospital Mortality -; Humans -; Male -; Middle Aged -; Odds Ratio -; Percutaneous Coronary Intervention -; Platelet Aggregation Inhibitors - therapeutic use; Prasugrel Hydrochloride - therapeutic use; Prescription Drugs -; Prospective Studies -; Purinergic P2Y Receptor Antagonists - adverse effects; Purinergic P2Y Receptor Antagonists - therapeutic use; Registries -; Ticagrelor -; Ticlopidine - adverse effects; Ticlopidine - analogs & derivatives; Ticlopidine - therapeutic use