Bleeding risk and P2Y12 inhibitors in all-comer patients with ST-segment elevation myocardial infarction treated with percutaneous coronary intervention: a single-centre cohort study
Authors' conclusion
One-third of PCI-treated all-comer patients with STEMI were at HBR according to the PRECISE-DAPT score and were more often treated with potent P2Y12 inhibitors instead of clopidogrel.
Study context
- Population
- Consecutive STEMI patients undergoing percutaneous coronary intervention (PCI) at Copenhagen University Hospital, Rigshospitalet, 2009–20165,532 with PRECISE-DAPT scores
- Participants
- 6,179 patients
- Exposure
- High bleeding risk (HBR) vs non-HBR; potent P2Y12 inhibitors vs clopidogrel
- Outcome
- Prevalence of HBR (PRECISE-DAPT); MACE and major bleeding
- Follow-up
- 1 year
Methodological detailssingle-centre, nationwide registry linkage
- Single-centre
- Nationwide registry linkage
Main finding
As reported in the abstract
| Group | Value | Major bleeding | Major adverse cardiovascular events (MACE) |
|---|---|---|---|
| HBR | 33.0% | 8.7 per 100 person-years | 36.8 per 100 person-years |
| non-HBR | 2.1 per 100 person-years | 8.3 per 100 person-years |
Value
HBR33.0%
non-HBR— not stated in the abstract
Major bleeding
HBR8.7 per 100 person-years
non-HBR2.1 per 100 person-years
Major adverse cardiovascular events (MACE)
HBR36.8 per 100 person-years
non-HBR8.3 per 100 person-years
Observational data: associations, not effects.
Further findings
P2Y12 inhibitor use (survivors collecting P2Y12 inhibitor ≤7 days from discharge, n = 4749)
Ticagrelor or prasugrel HBR 68.2%
Clopidogrel
- P2Y12 inhibitor use (survivors collecting P2Y12 inhibitor ≤7 days from discharge, n = 4749) — Adherence high for all
- >75% days coverage
MACE, ticagrelor/prasugrel vs clopidogrel
- Lower MACE risk with ticagrelor or prasugrel than clopidogrel
Safety
Major bleeding, ticagrelor/prasugrel vs clopidogrel
- No differences in major bleeding
Original publication
Bleeding risk and P2Y12 inhibitors in all-comer patients with ST-segment elevation myocardial infarction treated with percutaneous coronary intervention: a single-centre cohort study. Eur Heart J Cardiovasc Pharmacother. Published 4 July 2023. doi:10.
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