Contraindications/Special Warnings and Precautions for Use of Contemporary Oral Antiplatelet Treatment in Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention:– Insights From the GReek AntiPlatelet rEgistry (GRAPE) –

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概要

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• Background: The prevalence of contraindications/special warnings and precautions (CON/SWP) for clopidogrel, prasugrel and ticagrelor use is not adequately studied and might affect P2Y12 inhibitor choice in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI). Methods and Results: In the context of the GReek AntiPlatelet rEgistry (GRAPE) a detailed recording of CON/SWP for use of clopidogrel, prasugrel and ticagrelor was done for 1,280 consecutive, moderate–high-risk ACS patients undergoing PCI. At least 1 CON for use of clopidogrel, prasugrel and ticagrelor was present in 5 (0.4%), 49 (3.8%) and 12 patients (0.9%), respectively. Prevalence of at least 1 CON/SWP to clopidogrel (45.8%) was less frequent compared to prasugrel (49.1%) or ticagrelor (49.1%; P=0.02 and P=0.04, respectively), while 34% of patients had at least 1 CON/SWP to all the 3 P2Y12 inhibitors. At discharge, 482 (38.6%), 301 (24.1%) and 464 patients (37.2%) received clopidogrel, prasugrel and ticagrelor, respectively. Age ≥75 years, co-medication related to increased bleeding risk, and history of asthma/chronic obstructive pulmonary disease favored clopidogrel vs. prasugrel or ticagrelor use as discharge medication, while geographic region also affected this choice (C-statistic, 0.81; 95% CI: 0.78–0.83). Conclusions: In patients with ACS undergoing PCI the prevalence of CON to antiplatelet agents is low, whereas that of SWP is high. Certain SWP, along with regional trends may affect the choice of newer P2Y12 inhibitors vs. clopidogrel.

• 一般社団法人 日本循環器学会の論文

著者

• Stefanadis Christodoulos

  First Cardiology Clinic University Of Athens Hippokration Hospital

• Kanakakis Ioannis

  Department Of Clinical Therapeutics Division Of Medicine Athens University

• Hahalis George

  Department Of Cardiology Patras University Hospital

• ALEXOPOULOS Dimitrios

  Department of Cardiology, Patras University Hospital

• DAVLOUROS Periklis

  Department of Cardiology, Patras University Hospital

• Davlouros Periklis

  Department Of Cardiology Patras University Hospital

• Xanthopoulou Ioanna

  Department Of Cardiology Patras University Hospital

• Alexopoulos Dimitrios

  Department Of Cardiology Patras University Hospital

• HAHALIS George

  Department of Cardiology, Patras University Hospital

• Hamilos Michalis

  Department of Cardiology, Iraklion University Hospital

• Deftereos Spyridon

  Department of Cardiology, Athens General Hospital "G. Gennimatas"

• Sitafidis George

  Department of Cardiology, Larissa University Hospital

• Vavuranakis Manolis

  First Department of Cardiology, Ippokration General Hospital

• Ntalas Ioannis

  Department of Cardiology, Ioannina University Hospital

• Angelidis Christos

  Department of Cardiology, Athens General Hospital "G. Gennimatas"

• Triposkiadis Filippos

  Department of Cardiology, Larissa University Hospital

• Vardas Panos

  Department of Cardiology, Iraklion University Hospital

• Goudevenos John

  Department of Cardiology, Ioannina University Hospital

• Deftereos Spyridon

  Department of Cardiology, Athens General Hospital "G. Gennimatas"

• Stefanadis Christodoulos

  First Department of Cardiology, Ippokration General Hospital

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• Contraindications/Special Warnings and Precautions for Use of Contemporary Oral Antiplatelet Treatment in Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention:– Insights From the GReek AntiPlatelet rEgistry (GRAPE) –

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