Longer-term oral antiplatelet use in stable post-myocardial infarction patients: Insights from the long Term rIsk, clinical manaGement and healthcare Resource utilization of stable coronary artery dISease (TIGRIS) observational study
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Longer-term oral antiplatelet use in stable post-myocardial infarction patients: Insights from the long Term rIsk, clinical manaGement and healthcare Resource utilization of stable coronary artery dISease (TIGRIS) observational study. / Goodman, Shaun G; Nicolau, Jose C; Requena, Gema; Maguire, Andrew; Blankenberg, Stefan; Chen, Ji Yan; Granger, Christopher B; Grieve, Richard; Pocock, Stuart J; Simon, Tabassome; Yasuda, Satoshi; Vega, Ana Maria; Brieger, David; TIGRIS Study Investigators.
In: INT J CARDIOL, Vol. 236, 01.06.2017, p. 54-60.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Longer-term oral antiplatelet use in stable post-myocardial infarction patients: Insights from the long Term rIsk, clinical manaGement and healthcare Resource utilization of stable coronary artery dISease (TIGRIS) observational study
AU - Goodman, Shaun G
AU - Nicolau, Jose C
AU - Requena, Gema
AU - Maguire, Andrew
AU - Blankenberg, Stefan
AU - Chen, Ji Yan
AU - Granger, Christopher B
AU - Grieve, Richard
AU - Pocock, Stuart J
AU - Simon, Tabassome
AU - Yasuda, Satoshi
AU - Vega, Ana Maria
AU - Brieger, David
AU - TIGRIS Study Investigators
N1 - Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.
PY - 2017/6/1
Y1 - 2017/6/1
N2 - OBJECTIVE: To describe contemporary patient characteristics and treatment patterns, including antithrombotic management, of post-myocardial infarction (MI) stable coronary artery disease (CAD) patients at high atherothrombotic risk from different geographical regions.METHODS: Patients ≥50years with prior MI 1-3years ago and ≥1 risk factor (age ≥65years, diabetes, 2nd prior MI >1yr ago, multivessel CAD, creatinine clearance 15-<60ml/min) were enrolled by 369 physicians (96% cardiologists) in 25 countries (2013-14) in the prospective TIGRIS study (NCT01866904).RESULTS: 9225 patients were enrolled (median 1.8years) post-MI: 52% with prior ST-elevation MI, median age 67years, 24% women, 67% Caucasian, 55% had ≥2 additional qualifying risk factors, 14% current smokers, 67% overweight/obese, 34% with blood pressure ≥140/90mmHg. 81% underwent percutaneous coronary intervention (PCI; 66% with drug-eluting stents) for the index MI. 75% of patients had been discharged on dual antiplatelet therapy (DAPT; acetylsalicylic acid [ASA]+ADP receptor inhibitor [ADPri]), mainly clopidogrel (75%). 63% had discontinued antiplatelet treatment (60% ADPri) around 1year, most commonly by physician recommendation (90%). At enrolment, 97% were taking an antithrombotic drug, most commonly ASA (88%), with 27% on DAPT (median duration 1.6years); continued DAPT >1year was highest (39%) in Asia-Pacific and lowest (12%) in Europe.CONCLUSIONS: Despite guideline recommendations, 1 in 4 post-MI patients did not receive DAPT for ~1year. In contrast to guideline recommendations supporting newer ADPris, clopidogrel was mainly prescribed. Prior to recent RCT data supporting DAPT >1year post-MI/PCI, >1 in 4 patients have continued on DAPT, though with substantial international variability.
AB - OBJECTIVE: To describe contemporary patient characteristics and treatment patterns, including antithrombotic management, of post-myocardial infarction (MI) stable coronary artery disease (CAD) patients at high atherothrombotic risk from different geographical regions.METHODS: Patients ≥50years with prior MI 1-3years ago and ≥1 risk factor (age ≥65years, diabetes, 2nd prior MI >1yr ago, multivessel CAD, creatinine clearance 15-<60ml/min) were enrolled by 369 physicians (96% cardiologists) in 25 countries (2013-14) in the prospective TIGRIS study (NCT01866904).RESULTS: 9225 patients were enrolled (median 1.8years) post-MI: 52% with prior ST-elevation MI, median age 67years, 24% women, 67% Caucasian, 55% had ≥2 additional qualifying risk factors, 14% current smokers, 67% overweight/obese, 34% with blood pressure ≥140/90mmHg. 81% underwent percutaneous coronary intervention (PCI; 66% with drug-eluting stents) for the index MI. 75% of patients had been discharged on dual antiplatelet therapy (DAPT; acetylsalicylic acid [ASA]+ADP receptor inhibitor [ADPri]), mainly clopidogrel (75%). 63% had discontinued antiplatelet treatment (60% ADPri) around 1year, most commonly by physician recommendation (90%). At enrolment, 97% were taking an antithrombotic drug, most commonly ASA (88%), with 27% on DAPT (median duration 1.6years); continued DAPT >1year was highest (39%) in Asia-Pacific and lowest (12%) in Europe.CONCLUSIONS: Despite guideline recommendations, 1 in 4 post-MI patients did not receive DAPT for ~1year. In contrast to guideline recommendations supporting newer ADPris, clopidogrel was mainly prescribed. Prior to recent RCT data supporting DAPT >1year post-MI/PCI, >1 in 4 patients have continued on DAPT, though with substantial international variability.
KW - Aged
KW - Aspirin/administration & dosage
KW - Clopidogrel
KW - Coronary Artery Disease/diagnosis
KW - Coronary Restenosis/epidemiology
KW - Drug-Eluting Stents/statistics & numerical data
KW - Female
KW - Humans
KW - International Cooperation
KW - Long Term Adverse Effects/epidemiology
KW - Male
KW - Middle Aged
KW - Outcome Assessment, Health Care
KW - Percutaneous Coronary Intervention/adverse effects
KW - Platelet Aggregation Inhibitors/administration & dosage
KW - Practice Guidelines as Topic
KW - Risk Factors
KW - ST Elevation Myocardial Infarction/surgery
KW - Ticlopidine/administration & dosage
U2 - 10.1016/j.ijcard.2017.02.062
DO - 10.1016/j.ijcard.2017.02.062
M3 - SCORING: Journal article
C2 - 28268087
VL - 236
SP - 54
EP - 60
JO - INT J CARDIOL
JF - INT J CARDIOL
SN - 0167-5273
ER -
