Antithrombotic management and long-term outcomes following percutaneous coronary intervention for acute coronary syndrome in Asia. (1st July 2020)

• Record Type: Journal Article
• Authors: Zhang, Shuning; Wang, Wei; Sawhney, Jitendra P.S.; Krittayaphong, Rungroj; Kim, Hyo-Soo; Nhan, Vo Thanh; Lee, Stephen W.-L.; Ong, Tiong Kiam; Chin, Chee Tang; Pocock, Stuart J.; Huo, Yong; Qian, Juying; Ge, Junbo
• Is Part Of: International journal of cardiology. Volume 310(2020)
• Page Start: 16
• Page End: 22
• Publication Date: 2020-07-01
• Subjects: ACS -- Prior PCI -- STEMI -- NSTEMI; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2020.01.008
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Background: Cardiovascular diseases account for approximately half of all deaths in Asia. The present analysis aimed to evaluate characteristics, antithrombotic management patterns (AMPs), and outcomes in patients with acute coronary syndrome (ACS) who underwent in-hospital percutaneous coronary intervention (PCI) and survived to hospital discharge, using data from the EPICOR Asia registry (NCT01361386 ). Methods: Two-year post-discharge follow-up data were analyzed from 8757 ACS PCI patients from EPICOR Asia (218 centers, eight countries). Major adverse cardiovascular events (MACE; death, non-fatal myocardial infarction [MI], non-fatal ischemic stroke), PCI characteristics, and AMPs were recorded. For MACE, time - to - event was analyzed using Cox regression. Results: Primary PCI was performed in 62.0% of ST-segment elevation MI (STEMI), 38.7% of non-STEMI (NSTEMI), and 24.2% of unstable angina (UA) patients. At 12 months, 88.1% of patients were on dual antiplatelet therapy (DAPT), with no differences by index event. Most (61.5%) still received DAPT at 2 years. Two-year incidences of mortality, composite MACE, and bleeding were 3.6%, 6.2%, and 6.6%, respectively. Risk of death and MACE was increased with STEMI and NSTEMI vs. UA. Patients from East Asia showed lower mortality and more bleeding vs. Southeast Asia/India. Conclusions: Many patients in EPICOR Asia underwent PCI and received DAPT up to 2 years post-discharge. These real-world findings improve our understanding of AMP impact on outcomes in Asian patients with ACS undergoing PCI. Highlights: In EPICOR Asia, primary PCI was performed in 8757 ACS survivors, mostly for STEMI. At 1 and 2 years post discharge, 88.1% and 61.5%, respectively, were on DAPT. Two-year risk of death and MACE was increased with STEMI and NSTEMI vs. UA. East Asia patients showed lower mortality and more bleeding vs. Southeast Asia/India.