Extended dual antiplatelet therapy after acute coronary syndrome in Spain: Results from the EPICOR study
Por:
Bardaji, A, Leal, M, Arrarte, V, Garcia-Moll, X, de Isla, LP, Bueno, H
Publicada:
1 abr 2017
Resumen:
IntroductionReal-world, country-specific studies of dual antiplatelet therapy (DAPT) duration among survivors of acute coronary syndrome (ACS) are important for improving long-term prognosis.
AimsTo investigate DAPT duration after hospital discharge for ACS in Spain.
ResultsData from patients enrolled in the Spanish cohort of the EPICOR (long-tErm follow-up of antithrombotic management Patterns In acute CORonary syndrome patients) study (NCT01171404) were analyzed for changes to antithrombotic medication up to 2years postdischarge according to index event diagnosis and patient characteristics. Deaths, coronary events, and bleeding events were analyzed over the same period. Overall, a high proportion of patients remained on DAPT at 2years (53.1%). Among patients who experienced any on-treatment bleeding event, almost two-thirds remained on DAPT at the end of follow-up. Patients >65years, diabetic, or those that were medically managed were more likely to continue with DAPT until 2years following discharge. At 2years, the incidence of bleeding events requiring hospitalization was low compared with the incidence of coronary events (1.4% vs 6.6%). There was a numerical reduction in coronary events, but no increase in bleeding events, with DAPT continuation compared with single antiplatelet therapy.
ConclusionsMore than half of patients in this unselected cohort study remained on DAPT at 2 years following discharge for ACS. Continuation with DAPT was greater among patients with additional cardiovascular risk factors, which suggests that treating physicians in Spain prioritizes ischemic risk reduction over bleeding risk in patients with ACS, according to patient's risk profile.
Filiaciones:
Bardaji, A:
Univ Rovira Virgili, Serv Cardiol, IISPV, Hosp Univ Tarragona Joan 23, Tarragona, Spain
Leal, M:
AstraZeneca, Madrid, Spain
Arrarte, V:
Hosp Gen Univ, Serv Cardiol, Alicante, Spain
Garcia-Moll, X:
Hosp Santa Creu & Sant Pau, Serv Cardiol, Barcelona, Spain
de Isla, LP:
Clin Hosp San Carlos, Dept Cardiol, Hlth Res Inst, Madrid, Spain
Univ Complutense Madrid, Madrid, Spain
Bueno, H:
Univ Complutense Madrid, Madrid, Spain
CNIC, Madrid, Spain
Hosp Univ 12 Octubre, Inst Invest I 12, Madrid, Spain
Hosp Univ 12 Octubre, Dept Cardiol, Madrid, Spain
Open Access
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