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- Title
Extended dual antiplatelet therapy after acute coronary syndrome in Spain: Results from the EPICOR study.
- Authors
Bardají, Alfredo; Leal, Manuel; Arrarte, Vicente; Garcia‐Moll, Xavier; Pérez de Isla, Leopoldo; Bueno, Héctor
- Abstract
Introduction Real-world, country-specific studies of dual antiplatelet therapy ( DAPT) duration among survivors of acute coronary syndrome ( ACS) are important for improving long-term prognosis. Aims To investigate DAPT duration after hospital discharge for ACS in Spain. Results Data from patients enrolled in the Spanish cohort of the EPICOR (long- tErm follow-up of antithrombotic management Patterns In acute CORonary syndrome patients) study ( NCT01171404) were analyzed for changes to antithrombotic medication up to 2 years postdischarge according to index event diagnosis and patient characteristics. Deaths, coronary events, and bleeding events were analyzed over the same period. Overall, a high proportion of patients remained on DAPT at 2 years (53.1%). Among patients who experienced any on-treatment bleeding event, almost two-thirds remained on DAPT at the end of follow-up. Patients >65 years, diabetic, or those that were medically managed were more likely to continue with DAPT until 2 years following discharge. At 2 years, the incidence of bleeding events requiring hospitalization was low compared with the incidence of coronary events (1.4% vs 6.6%). There was a numerical reduction in coronary events, but no increase in bleeding events, with DAPT continuation compared with single antiplatelet therapy. Conclusions More than half of patients in this unselected cohort study remained on DAPT at 2 years following discharge for ACS. Continuation with DAPT was greater among patients with additional cardiovascular risk factors, which suggests that treating physicians in Spain prioritizes ischemic risk reduction over bleeding risk in patients with ACS, according to patient's risk profile.
- Subjects
SPAIN; PLATELET aggregation inhibitors; CORONARY disease; ACUTE coronary syndrome; CARDIOVASCULAR diseases
- Publication
Cardiovascular Therapeutics, 2017, Vol 35, Issue 2, pn/a
- ISSN
1755-5914
- Publication type
Article
- DOI
10.1111/1755-5922.12237