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https://ir.csmu.edu.tw:8080/ir/handle/310902500/24924
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Title: | P2Y12 Inhibitor Monotherapy with Clopidogrel versus Ticagrelor in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention |
Authors: | Chen, PW;Feng, WH;Ho, MY;Su, CH;Huang, SW;Cheng, CW;Yeh, HI;Chen, CP;Huang, WC;Fang, CC;Lin, HW;Lin, SH;Hsieh, IC;Li, YH |
Keywords: | ticagrelor;clopidogrel;acute coronary syndrome |
Date: | 2020 |
Issue Date: | 2022-08-09T08:10:14Z (UTC)
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Publisher: | MDPI |
Abstract: | Background: P2Y12 inhibitor monotherapy is an alternative antiplatelet strategy in patients undergoing percutaneous coronary intervention (PCI). However, the ideal P2Y12 inhibitor for monotherapy is unclear. Methods and Results: We performed a multicenter, retrospective, observational study to compare the efficacy and safety of monotherapy with clopidogrel versus ticagrelor in patients with acute coronary syndrome (ACS) undergoing PCI. From 1 January 2014 to 31 December 2018, 610 patients with ACS who received P2Y12 monotherapy with either clopidogrel (n= 369) or ticagrelor (n= 241) after aspirin was discontinued prematurely were included. Inverse probability of treatment weighting was used to balance covariates between the groups. The primary endpoint was the composite of all-cause mortality, recurrent ACS or unplanned revascularization, and stroke within 12 months after discharge. Overall, 84 patients reached the primary endpoint, with 57 (15.5%) in the clopidogrel group and 27 (11.2%) in the ticagrelor group. Multivariate adjustment in Cox proportional-hazards models revealed a lower risk of the primary endpoint with ticagrelor than with clopidogrel (adjusted hazard ratio (aHR): 0.67, 95% confidence interval (CI): 0.49-0.93). Ticagrelor significantly reduced the risk of recurrent ACS or unplanned revascularization (aHR: 0.46, 95% CI: 0.28-0.75). No significant difference in all-cause mortality and major bleeding events was observed between the 2 groups. Conclusions: Among patients with ACS undergoing PCI who cannot complete course of dual antiplatelet therapy, a significantly lower risk of cardiovascular events was associated with ticagrelor monotherapy than with clopidogrel monotherapy. The major bleeding risk was similar in both the groups. |
URI: | http://dx.doi.org/10.3390/jcm9061657 https://www.webofscience.com/wos/woscc/full-record/WOS:000549219200001 https://ir.csmu.edu.tw:8080/handle/310902500/24924 |
Relation: | JOURNAL OF CLINICAL MEDICINE ,2020 ,v9 ,issue 6 |
Appears in Collections: | [中山醫學大學研究成果] 期刊論文
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