In-hospital switching of oral P2Y12 inhibitor treatment in patients with acute coronary syndrome undergoing percutaneous coronary intervention: prevalence, predictors and short-term outcome

American Heart Journal
Dimitrios AlexopoulosChristodoulos Stefanadis

Abstract

P2Y12 inhibitor switching has appeared in clinical practice as a consequence of prasugrel and ticagrelor availability, apart from clopidogrel, for use in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). In the context of the GReek AntiPlatelet REgistry (GRAPE) we assessed the prevalence, predictive factors and short-term outcome of in-hospital P2Y12 inhibitor switching in 1794 ACS patients undergoing PCI. Switching occurred in 636 (35.5%) patients of which in the form of clopidogrel to a novel agent, novel agent to clopidogrel and between prasugrel and ticagrelor in 574 (90.4%), 34 (5.3%) and 27 (4.3%) patients, respectively. Presentation to non PCI-capable hospital, bivalirudin use, age ≥75 years (inverse predictor), and regional trends emerged as predictive factors of switching to a novel agent. At combined in-hospital and one-month follow-up, propensity matched pairs analysis showed no differences in major adverse cardiovascular (MACE) or bleeding events between switching from clopidogrel to a novel agent vs novel agent constant administration. More Bleeding Academic Research Consortium type 1, type 2 and any type events and fewer MACE were seen when switching from clopidogrel ...Continue Reading

References

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Citations

Oct 11, 2015·European Journal of Clinical Pharmacology·Jaya ChandrasekharUNKNOWN CAPITAL investigators
Aug 19, 2015·Nature Reviews. Cardiology·Fabiana RolliniDominick J Angiolillo
Apr 26, 2017·The Annals of Pharmacotherapy·James C CoonsChristopher R Ensor
Apr 5, 2017·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Leonardo De LucaLeonardo Bolognese
Jan 15, 2017·Heart·Kalpa De SilvaGregg W Stone
Oct 19, 2017·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Marco ValgimigliUNKNOWN ESC Scientific Document Group
Feb 9, 2018·Journal of Atherosclerosis and Thrombosis·Jessica RistortoOlivier Morel
Nov 1, 2017·Circulation·Dominick J AngiolilloMatthew J Price
Jun 6, 2018·European Heart Journal Supplements : Journal of the European Society of Cardiology·Michele Massimo GuliziaUNKNOWN Faculty for approval of the Consensus Document
Jul 19, 2019·Genetics in Medicine : Official Journal of the American College of Medical Genetics·Jesse MartinCraig R Lee
Apr 20, 2018·Journal of Cardiovascular Pharmacology and Therapeutics·Jeness CampodonicoGiancarlo Marenzi
Feb 7, 2019·Journal of Cardiovascular Pharmacology and Therapeutics·Dimitrios AlexopoulosCharalambos Varlamos

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