Long‐term antithrombotic management patterns in Asian patients with acute coronary syndrome: 2‐year observations from the EPICOR Asia study. Issue 9 (2nd July 2020)

• Record Type: Journal Article
• Authors: Zheng, Bo; Huo, Yong; Lee, Stephen W.‐L.; Sawhney, Jitendra P. S.; Kim, Hyo‐Soo; Krittayaphong, Rungroj; Pocock, Stuart J.; Nhan, Vo T.; Alonso Garcia, Angeles; Chin, Chee Tang; Jiang, Jie; Jan, Stephen; Vega, Ana Maria; Hayashi, Nobuya; Ong, Tiong K.
• Is Part Of: Clinical cardiology. Volume 43:Issue 9(2020)
• Page Start: 999
• Page End: 1008
• Publication Date: 2020-07-02
• Subjects: acute coronary care antithrombotic management patterns -- acute coronary syndrome -- EPICOR -- observational; Cardiology -- Periodicals; 616.12005
• DOI: 10.1002/clc.23400
• Languages: English
• ISSNs: 0160-9289

Abstract

Abstract: Background: Despite guideline recommendations, dual antiplatelet therapy (DAPT) is frequently used for longer than 1 year after an acute coronary syndrome (ACS) event. In Asia, information on antithrombotic management patterns (AMPs), including DAPT post discharge, is sparse. This analysis evaluated real‐world AMPs up to 2 years post discharge for ACS. Hypothesis: There is wide variability in AMP use for ACS management in Asia. Methods: EPICOR Asia (NCT01361386) is a prospective observational study of patients discharged after hospitalization for an ACS in eight countries/regions in Asia, followed up for 2 years. Here, we describe AMPs used and present an exploratory analysis of characteristics and outcomes in patients who received DAPT for ≤12 months post discharge compared with >12 months. Results: Data were available for 12 922 patients; of 11 639 patients discharged on DAPT, 2364 (20.3%) received DAPT for ≤12 months and 9275 (79.7%) for >12 months, with approximately 60% still on DAPT at 2 years. Patients who received DAPT for >12 months were more likely to be younger, obese, lower Killip class, resident in India (vs China), and to have received invasive reperfusion. Clinical event rates during year 2 of follow‐up were lower in patients with DAPT >12 vs ≤12 months, but no causal association can be implied in this non‐randomized study. Conclusions: Most ACS patients remained on DAPT up to 1 year, in accordance with current guidelines, and over half remained on DAPT at 2 years post discharge. Patients not on DAPT at 12 months are a higher risk group requiring careful monitoring.