The current status and outcomes of in-hospital P2Y12 receptor inhibitor switching in Korean patients with acute myocardial infarction
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Background/Aims: While switching strategies of P2Y12 receptor inhibitors (RIs) have sometimes been used in acute myocardial infarction (AMI) patients, the current status of in-hospital P2Y12RI switching remains unknown. Methods: Overall, 8,476 AMI patients who underwent successful revascularization from Korea Acute Myocardial Infarction Registry-National Institute of Health (KAMIR-NIH) were divided according to in-hospital P2Y12RI strategies, and net adverse cardiovascular events (NACEs), defined as a composite of cardiac death, non-fatal myocardial infarction (MI), stroke, or thrombolysis in myocardial infarction (TIMI) major bleeding during hospitalization were compared. Results: Patients with in-hospital P2Y12RI switching accounted for 16.5%, of which 867 patients were switched from clopidogrel to potent P2Y12RI (C-P) and 532 patients from potent P2Y12RI to clopidogrel (P-C). There were no differences in NACEs among the unchanged clopidogrel, the unchanged potent P2Y12RIs, and the P2Y12RI switching groups. However, compared to the unchanged clopidogrel group, the C-P group had a higher incidence of non-fatal MI, and the P-C group had a higher incidence of TIMI major bleeding. In clinical events of in-hospital P2Y12RI switching, 90.9% of non-fatal MI occurred during pre-switching clopidogrel administration, 60.7% of TIMI major bleeding was related to pre-switching P2Y12RIs, and 71.4% of TIMI major bleeding was related to potent P2Y12RIs. Only 21.6% of the P2Y12RI switching group switched to P2Y12RIs after a loading dose (LD); however, there were no differences in clinical events between patients with and without LD. Conclusions: In-hospital P2Y12RI switching occurred occasionally, but had relatively similar clinical outcomes compared to unchanged P2Y12RIs in Korean AMI patients. Non-fatal MI and bleeding appeared to be mainly related to pre-switching P2Y12RIs.
Abstract
Background/Aims: While switching strategies of P2Y12 receptor inhibitors (RIs) have sometimes been used in acute myocardial infarction (AMI) patients, the current status of in-hospital P2Y12RI switching remains unknown. Methods: Overall, 8,476 AMI patients who underwent successful revascularization from Korea Acute Myocardial Infarction Registry-National Institute of Health (KAMIR-NIH) were divided according to in-hospital P2Y12RI strategies, and net adverse cardiovascular events (NACEs), defined as a composite of cardiac death, non-fatal myocardial infarction (MI), stroke, or thrombolysis in myocardial infarction (TIMI) major bleeding during hospitalization were compared. Results: Patients with in-hospital P2Y12RI switching accounted for 16.5%, of which 867 patients were switched from clopidogrel to potent P2Y12RI (C-P) and 532 patients from potent P2Y12RI to clopidogrel (P-C). There were no differences in NACEs among the unchanged clopidogrel, the unchanged potent P2Y12RIs, and the P2Y12RI switching groups. However, compared to the unchanged clopidogrel group, the C-P group had a higher incidence of non-fatal MI, and the P-C group had a higher incidence of TIMI major bleeding. In clinical events of in-hospital P2Y12RI switching, 90.9% of non-fatal MI occurred during pre-switching clopidogrel administration, 60.7% of TIMI major bleeding was related to pre-switching P2Y12RIs, and 71.4% of TIMI major bleeding was related to potent P2Y12RIs. Only 21.6% of the P2Y12RI switching group switched to P2Y12RIs after a loading dose (LD); however, there were no differences in clinical events between patients with and without LD. Conclusions: In-hospital P2Y12RI switching occurred occasionally, but had relatively similar clinical outcomes compared to unchanged P2Y12RIs in Korean AMI patients. Non-fatal MI and bleeding appeared to be mainly related to pre-switching P2Y12RIs.
참고문헌 (26)
- Wiviott SD, "Prasugrel versus clopidogrel in patients with acute coronary syndromes", N Engl J Med, 357, pp.2001~2015 (2007)
- Wallentin L, "Ticagrelor versus clopidogrel in patients with acute coronary syndromes", N Engl J Med, 361, pp.1045~1057 (2009)
- Navarese EP, "Comparative efficacy and safety of oral P2Y12 inhibitors in acute coronary syndrome : network meta-analysis of 52 816 patients from 12randomized trials", Circulation, 142, pp.150~160 (2020)
- Amsterdam EA, "2014 AHA", ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes : executive summary : a report of the American College of Cardiology, Circulation, pp.2014, 130[DOI]
- Ibanez B, "2017 ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation : the Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevati on of the European Society of Cardiology(ESC)", Eur Heart J, 39, pp.119~177 (2018)
- Kang J, "Third-generation P2Y12 inhibitors in East Asian acute myocardial infarction patients : a nationwide prospective multicentre study", Thromb Haemost, 118, pp.591~600 (2018)
- Yun JE, "Safety and effectiveness of contemporary P2Y12 inhibitors in an East Asian population with acute coronary syndrome : a nationwide population-based cohort study", J Am Heart Assoc, 8, pp.e012078~ (2019)
- Park DW, "Clinically significant bleeding with ticagrelor versus clopidogrel in Korean patients with acute coronary syndromes intended for invasive management : a randomized clinical trial", Circulation, 140, pp.1865~1877 (2019)
- Motovska Z, "1-Year outcomes of patients undergoing primary angioplasty for myocardial infarction treated with prasugrel versus ticagrelor", J Am Coll Cardiol, 71, pp.371~381 (2018)
- Kim C, "One-year clinical outcomes of ticagrelor compared with clopidogrel after percutaneous coronary intervention in patients with acute myocardial infarction : from Korean Health Insurance Review and Assessment Data", J Cardiol, 73, pp.191~197 (2019)
- Kim JH, "Multicenter cohort study of acute myocardial infarction in Korea : interim analysis of the Korea Acute Myocardial Infarction Registry. National Institutes of Health Registry", Circ J, 80, pp.1427~1436 (2016)
- Gurbel PA, "Randomized double-blind assessment of the ONSET and OFFSET of the antiplatelet effects of ticagrelor versus clopidogrel in patients with stable coronary artery disease : the ONSET", OFFSET study, 2009, pp.120, 2577~2585
- Angiolillo DJ, "Increased platelet inhibition after switching from maintenance clopidogrel to prasugrel in patients with acute coronary syndromes : results of the SWAP(SWitching Anti Platelet)study", J Am Coll Cardiol, 56, pp.1017~1023 (2010)
- Thygesen K, "Third universal definition of myocardial infarction", Circulation, 126, pp.2020~2035 (2012)
- De Luca L, "Switching of platelet P2Y12 receptor inhibitors in patients with acute coronary syndromes undergoing percutaneous coronary intervention : review of the literature and practical considerations", Am Heart J, 176, pp.44~52 (2016)
- Kudaravalli M, "Assessment of P2Y12 inhibitor usage and switching in acute coronary syndrome patients undergoing percutaneous coronary revascularization", Int J Cardiol, 223, pp.854~859 (2016)
- De Luca L, "Incidence and outcome of switching of oral platelet P2Y12 receptor inhibitors in patients with acute coronary syndromes undergoing percutaneous coronary intervention : the SCOPE registry", Euro-Intervention, 13, pp.459~466 (2017)
- Rollini F, "Switching P2Y12-receptor inhibitors in patients with coronary artery disease", Nat Rev Cardiol, 13, pp.11~27 (2016)
- Park KH, "Comparison of prasugrel versus clopidogrel in Korean patients with acute myocardial infarction undergoing successful revascularization", J Cardiol, 71, pp.36~43 (2018)
- Park KH, "Comparison of shortterm clinical outcomes between ticagrelor versus clopidogrel in patients with acute myocardial infarction undergoing successful revascularization : from Korea Acute Myocardial Infarction Registry-National Institute of Health", Int J Cardiol, 215, pp.193~200 (2016)
- Hyun Kuk Kim, "Ethnic Difference of Thrombogenicity in Patients with Cardiovascular Disease: a Pandora Box to Explain Prognostic Differences", Korean Circulation Journal, 51(3), pp.202~221 (2021), 대한심장학회[DOI]
- Danny Kupka, "De-Escalation of P2Y12 Receptor Inhibitor Therapy after Acute Coronary Syndromes in Patients Undergoing Percutaneous Coronary Intervention", Korean Circulation Journal, 48(10), pp.863~872 (2018), 대한심장학회
- Kim HK, "The East Asian paradox : an updated position statement on the challenges to the current antithrombotic strategy in patients with cardiovascular disease", Thromb Haemost, 121, pp.422~432 (2021)
- Kim HS, "Prasugrel-based de-escalation of dual antiplatelet therapy after percutaneous coronary intervention in patients with acute coronary syndrome(HOSTREDUCE-POLYTECH-ACS) : an open-label, multicentre, non-inferiority randomised trial", Lancet, 396, pp.1079~1089 (2020)
- Kim BK, "Effect of ticagrelor monotherapy vs ticagrelor with aspirin on major bleeding and cardiovascular events in patients with acute coronary syndrome : the TICO randomized clinical trial", JAMA, 323, pp.2407~2416 (2020)
- Angiolillo DJ, "International expert consensus on switching platelet P2Y12 receptor-inhibiting therapies", Circulation, 136, pp.1955~1975 (2017)