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Coronary disease & ACSCohort study

High-Potency P2Y12 Inhibitors Among Patients With Chronic Coronary Syndrome Undergoing PCI: An Analysis From the NCDR CathPCI Registry

Circ Cardiovasc IntervPublished

  • registry analysis
  • mixed-effects multivariable logistic regression model with a random intercept for hospital
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Authors' conclusion

Nearly one-third of chronic coronary syndrome patients undergoing percutaneous coronary intervention were discharged on high-potency P2Y12 inhibitors, with decreasing trends over time. Practice patterns reflected perceived ischemic versus bleeding risk and significant institutional variation, underscoring opportunities for quality improvement and guideline alignment.

Study context

Population
Patients with chronic coronary syndrome undergoing percutaneous coronary intervention, NCDR CathPCI registry, April 2018 to June 2024, excluding those discharged on oral anticoagulantspatients across 1815 hospitals
Participants
783,977 patients

Main finding

As reported in the abstract

High-potency P2Y12 inhibitor prescribed at discharge

Prescribed a high-potency P2Y12 inhibitor at discharge

35%

Observational data: associations, not effects.

Further findings

Temporal trend in high-potency P2Y12 inhibitor use · 2018 to 2024

High-potency P2Y12 inhibitors, 2018 to 2024
from 35% in 2018 to 31% in 2024 ( P -trend=0.019)
Ticagrelor
from 29% to 23%, P -trend <0.001
Prasugrel
from 6.2% to 8%, P -trend=0.10

Factors associated with high-potency P2Y12 inhibitor prescription

Higher odds: male sex, prior myocardial infarction, markers of procedural complexity (high-complexity/type C lesions, left main coronary artery, proximal left anterior descending artery, or use of mechanical circulatory support)
Lower odds: older age (≥75 years), prior stroke/transient ischemic attack, prior coronary artery bypass graft, severe renal dysfunction, and chronic total occlusion
University hospitals had lower odds of prescribing high-potency P2Y12 inhibitors

Between-hospital variation in prescription

median odds ratio
2.59

Original publication

High-Potency P2Y12 Inhibitors Among Patients With Chronic Coronary Syndrome Undergoing PCI: An Analysis From the NCDR CathPCI Registry. Circ Cardiovasc Interv. Published 12 October 2026. doi:10.1161/circinterventions.126.016658
Read the original article ↗PubMedCite RIS · BibTeX

Summarised from the published abstract; every number is checked against it