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Effect of discontinuation of ticagrelor and switching-over to other P2Y12 agents in patients with acute coronary syndrome: a single-center real-world experience from India
BACKGROUND: Dual antiplatelet therapy is the current standard of care after acute coronary syndrome (ACS) and percutaneous coronary intervention (PCI). We intended to study the pattern of use of ticagrelor in patients with acute coronary syndrome undergoing PCI and the effect of switching over to ot...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Springer Berlin Heidelberg
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7801539/ https://www.ncbi.nlm.nih.gov/pubmed/33428005 http://dx.doi.org/10.1186/s43044-020-00128-3 |
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author | Senguttuvan, Nagendra Boopathy Sankaran, Ramesh Rajeev, Yashasvi Thaiyal, Devi Mathew, Angel Dharsini, K. Marcelene, Divya Kalsingh, Maria Jusler Sahu, Sujit Kumar Sampath, Aravind Prem Kumar, K. J. Parthasarathy, Harikrishnan Louis, Amal Gnanaraj, Anand Reddy, K. N. Abraham, K. A. |
author_facet | Senguttuvan, Nagendra Boopathy Sankaran, Ramesh Rajeev, Yashasvi Thaiyal, Devi Mathew, Angel Dharsini, K. Marcelene, Divya Kalsingh, Maria Jusler Sahu, Sujit Kumar Sampath, Aravind Prem Kumar, K. J. Parthasarathy, Harikrishnan Louis, Amal Gnanaraj, Anand Reddy, K. N. Abraham, K. A. |
author_sort | Senguttuvan, Nagendra Boopathy |
collection | PubMed |
description | BACKGROUND: Dual antiplatelet therapy is the current standard of care after acute coronary syndrome (ACS) and percutaneous coronary intervention (PCI). We intended to study the pattern of use of ticagrelor in patients with acute coronary syndrome undergoing PCI and the effect of switching over to other P2Y12 receptor inhibition on clinical outcomes. RESULTS: All patients aged > 18 years who had been admitted with acute coronary syndrome and had been provided ticagrelor as the second antiplatelet agent were included as study participants. The primary outcome of the study was the composite outcome of death, recurrent myocardial infarctions, re-intervention, and major bleeding. We studied 321 patients (54 female patients, 16.82%). The mean age of the patients was 56.65 ± 11.01 years. Ticagrelor was stopped in 76.7% on follow-up. It was stopped in 6.3%, 13.5%, 13.1%, 21.9%, and 45.1% of patients during the first month but after discharge, between first and third months, between 3 and 6 months, between 6 and 12 months, and after 12 months, respectively. In the majority of patients, ticagrelor was replaced by clopidogrel (97.9%). It was stopped according to the physician’s discretion in 79.3% of patients, whereas it was the cost of the drug that made the patient to get swapped to another agent in 18.6%. No difference in the primary composite outcome was observed between the groups where ticagrelor was continued post 12 months and ticagrelor was continued and ticagrelor was switched-over to another agent. Similarly, no difference in death, recurrent myocardial infarctions, re-interventions, or major bleeding manifestations was observed between the two groups. CONCLUSION: In patients with acute coronary syndrome who undergo PCI, we observed that early discontinuation of ticagrelor and switching over to other P2Y12 inhibitors after discharge did not affect clinical outcomes. |
format | Online Article Text |
id | pubmed-7801539 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-78015392021-01-14 Effect of discontinuation of ticagrelor and switching-over to other P2Y12 agents in patients with acute coronary syndrome: a single-center real-world experience from India Senguttuvan, Nagendra Boopathy Sankaran, Ramesh Rajeev, Yashasvi Thaiyal, Devi Mathew, Angel Dharsini, K. Marcelene, Divya Kalsingh, Maria Jusler Sahu, Sujit Kumar Sampath, Aravind Prem Kumar, K. J. Parthasarathy, Harikrishnan Louis, Amal Gnanaraj, Anand Reddy, K. N. Abraham, K. A. Egypt Heart J Research BACKGROUND: Dual antiplatelet therapy is the current standard of care after acute coronary syndrome (ACS) and percutaneous coronary intervention (PCI). We intended to study the pattern of use of ticagrelor in patients with acute coronary syndrome undergoing PCI and the effect of switching over to other P2Y12 receptor inhibition on clinical outcomes. RESULTS: All patients aged > 18 years who had been admitted with acute coronary syndrome and had been provided ticagrelor as the second antiplatelet agent were included as study participants. The primary outcome of the study was the composite outcome of death, recurrent myocardial infarctions, re-intervention, and major bleeding. We studied 321 patients (54 female patients, 16.82%). The mean age of the patients was 56.65 ± 11.01 years. Ticagrelor was stopped in 76.7% on follow-up. It was stopped in 6.3%, 13.5%, 13.1%, 21.9%, and 45.1% of patients during the first month but after discharge, between first and third months, between 3 and 6 months, between 6 and 12 months, and after 12 months, respectively. In the majority of patients, ticagrelor was replaced by clopidogrel (97.9%). It was stopped according to the physician’s discretion in 79.3% of patients, whereas it was the cost of the drug that made the patient to get swapped to another agent in 18.6%. No difference in the primary composite outcome was observed between the groups where ticagrelor was continued post 12 months and ticagrelor was continued and ticagrelor was switched-over to another agent. Similarly, no difference in death, recurrent myocardial infarctions, re-interventions, or major bleeding manifestations was observed between the two groups. CONCLUSION: In patients with acute coronary syndrome who undergo PCI, we observed that early discontinuation of ticagrelor and switching over to other P2Y12 inhibitors after discharge did not affect clinical outcomes. Springer Berlin Heidelberg 2021-01-11 /pmc/articles/PMC7801539/ /pubmed/33428005 http://dx.doi.org/10.1186/s43044-020-00128-3 Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Research Senguttuvan, Nagendra Boopathy Sankaran, Ramesh Rajeev, Yashasvi Thaiyal, Devi Mathew, Angel Dharsini, K. Marcelene, Divya Kalsingh, Maria Jusler Sahu, Sujit Kumar Sampath, Aravind Prem Kumar, K. J. Parthasarathy, Harikrishnan Louis, Amal Gnanaraj, Anand Reddy, K. N. Abraham, K. A. Effect of discontinuation of ticagrelor and switching-over to other P2Y12 agents in patients with acute coronary syndrome: a single-center real-world experience from India |
title | Effect of discontinuation of ticagrelor and switching-over to other P2Y12 agents in patients with acute coronary syndrome: a single-center real-world experience from India |
title_full | Effect of discontinuation of ticagrelor and switching-over to other P2Y12 agents in patients with acute coronary syndrome: a single-center real-world experience from India |
title_fullStr | Effect of discontinuation of ticagrelor and switching-over to other P2Y12 agents in patients with acute coronary syndrome: a single-center real-world experience from India |
title_full_unstemmed | Effect of discontinuation of ticagrelor and switching-over to other P2Y12 agents in patients with acute coronary syndrome: a single-center real-world experience from India |
title_short | Effect of discontinuation of ticagrelor and switching-over to other P2Y12 agents in patients with acute coronary syndrome: a single-center real-world experience from India |
title_sort | effect of discontinuation of ticagrelor and switching-over to other p2y12 agents in patients with acute coronary syndrome: a single-center real-world experience from india |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7801539/ https://www.ncbi.nlm.nih.gov/pubmed/33428005 http://dx.doi.org/10.1186/s43044-020-00128-3 |
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