کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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5604944 | 1576112 | 2017 | 7 صفحه PDF | دانلود رایگان |
ObjectiveTo 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.MethodsPatients â¥Â 50 years with prior MI 1-3 years ago and â¥Â 1 risk factor (age â¥Â 65 years, diabetes, 2nd prior MI > 1 yr ago, multivessel CAD, creatinine clearance 15-<60 ml/min) were enrolled by 369 physicians (96% cardiologists) in 25 countries (2013-14) in the prospective TIGRIS study (NCT01866904).Results9225 patients were enrolled (median 1.8 years) post-MI: 52% with prior ST-elevation MI, median age 67 years, 24% women, 67% Caucasian, 55% had â¥Â 2 additional qualifying risk factors, 14% current smokers, 67% overweight/obese, 34% with blood pressure â¥Â 140/90 mm Hg. 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 1 year, most commonly by physician recommendation (90%). At enrolment, 97% were taking an antithrombotic drug, most commonly ASA (88%), with 27% on DAPT (median duration 1.6 years); continued DAPT > 1 year was highest (39%) in Asia-Pacific and lowest (12%) in Europe.ConclusionsDespite guideline recommendations, 1 in 4 post-MI patients did not receive DAPT for ~ 1 year. In contrast to guideline recommendations supporting newer ADPris, clopidogrel was mainly prescribed. Prior to recent RCT data supporting DAPT > 1 year post-MI/PCI, > 1 in 4 patients have continued on DAPT, though with substantial international variability.
Journal: International Journal of Cardiology - Volume 236, 1 June 2017, Pages 54-60