Clopidogrel vs. prasugrel vs. ticagrelor in patients with acute myocardial infarction complicated by cardiogenic shock: a pooled IABP-SHOCK II and CULPRIT-SHOCK trial sub-analysis
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| Title: | Clopidogrel vs. prasugrel vs. ticagrelor in patients with acute myocardial infarction complicated by cardiogenic shock: a pooled IABP-SHOCK II and CULPRIT-SHOCK trial sub-analysis |
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| Authors: | Orban, Martin, Kleeberger, Jan, Ouarrak, Taoufik, Freund, Anne, Feistritzer, Hans-Josef, Fuernau, Georg, Geisler, Tobias, Huber, Kurt, Dudek, Dariusz, Noc, Marko, Montalescot, Gilles, Neumer, Alexander, Haller, Paul, Clemmensen, Peter, Zeymer, Uwe, Desch, Steffen, Massberg, Steffen, Schneider, Steffen, Thiele, Holger, Hausleiter, Jörg |
| Contributors: | Sorbonne Université, Gestionnaire HAL 4 |
| Source: | Clin Res Cardiol |
| Publisher Information: | Springer Science and Business Media LLC, 2021. |
| Publication Year: | 2021 |
| Subject Terms: | Male, Ticagrelor, Myocardial Infarction, Shock, Cardiogenic, Hemorrhage, shock, ticagrelor, 03 medical and health sciences, Percutaneous Coronary Intervention, 0302 clinical medicine, cardiogenic, Humans, Prospective Studies, 10. No inequality, Cardiogenic shock, Aged, antagonists, Aged, 80 and over, 2. Zero hunger, clopidogrel, Original Paper, Intra-Aortic Balloon Pumping, Bleeding, Aged, 80 and over [MeSH], Aged [MeSH], Prasugrel Hydrochloride/adverse effects [MeSH], Clopidogrel, Prasugrel Hydrochloride/administration, Platelet Aggregation Inhibitors/administration, Shock, Cardiogenic/therapy [MeSH], Percutaneous Coronary Intervention [MeSH], Male [MeSH], Myocardial Infarction/complications [MeSH], Shock, Cardiogenic/mortality [MeSH], Myocardial Infarction/therapy [MeSH], Female [MeSH], Myocardial Infarction/mortality [MeSH], Follow-Up Studies [MeSH], Hemorrhage/chemically induced [MeSH], Humans [MeSH], Prasugrel, Prospective Studies [MeSH], Ticagrelor/administration, Clopidogrel/adverse effects [MeSH], Clopidogrel/administration, Ticagrelor/adverse effects [MeSH], Intra-Aortic Balloon Pumping/methods [MeSH], Middle Aged [MeSH], ADP-receptor antagonists, Platelet Aggregation Inhibitors/adverse effects [MeSH], Middle Aged, bleeding, prasugrel, 3. Good health, [SDV] Life Sciences [q-bio], ADP-receptor, Female, Prasugrel Hydrochloride, Platelet Aggregation Inhibitors, Follow-Up Studies |
| Description: | Aims The aim of this pooled sub-analysis of the Intraaortic Balloon Pump in Cardiogenic Shock II (IABP-SHOCK II) and Culprit Lesion Only PCI versus Multivessel PCI in Cardiogenic Shock (CULPRIT-SHOCK) trial was to compare the clinical outcome of patients with acute myocardial infarction complicated by cardiogenic shock treated either with clopidogrel or the newer, more potent ADP-receptor antagonists prasugrel or ticagrelor. Methods and results For the current analysis the primary endpoint was 1-year mortality and the secondary safety endpoint was moderate or severe bleedings until hospital discharge with respect to three different ADP-receptor antagonists. 856 patients were eligible for analysis. Of these, 507 patients (59.2%) received clopidogrel, 178 patients (20.8%) prasugrel and 171 patients (20.0%) ticagrelor as acute antiplatelet therapy. The adjusted rate of mortality after 1-year did not differ significantly between prasugrel and clopidogrel (hazard ratio [HR]: 0.81, 95% confidence interval [CI] 0.60–1.09, padj = 0.17) or between ticagrelor and clopidogrel treated patients (HR: 0.86, 95% CI 0.65–1.15, padj = 0.31). In-hospital bleeding events were significantly less frequent in patients treated with ticagrelor vs. clopidogrel (HR: 0.37, 95% CI 0.20 -0.69, padj = 0.002) and not significantly different in patients treated with prasugrel vs. clopidogrel (HR: 0.73, 95% CI 0.43 -1.24, padj = 0.24). Conclusion This pooled sub-analysis is the largest analysis on safety and efficacy of three oral ADP-receptor antagonists and shows that acute therapy with either clopidogrel, prasugrel or ticagrelor is no independent predictor of 1-year mortality. Treatment with ticagrelor seems independently associated with less in-hospital moderate and severe bleeding events compared to clopidogrel. This finding might be due to selection bias and should be interpreted with caution. Graphic abstract |
| Document Type: | Article Other literature type |
| File Description: | application/pdf |
| Language: | English |
| ISSN: | 1861-0692 1861-0684 |
| DOI: | 10.1007/s00392-021-01866-3 |
| Access URL: | https://link.springer.com/content/pdf/10.1007/s00392-021-01866-3.pdf https://pubmed.ncbi.nlm.nih.gov/33999281 https://www.ncbi.nlm.nih.gov/pubmed/33999281 https://europepmc.org/article/MED/33999281 https://link.springer.com/article/10.1007/s00392-021-01866-3 https://ruj.uj.edu.pl/xmlui/handle/item/278798 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8405498 https://pubmed.ncbi.nlm.nih.gov/33999281/ https://link.springer.com/article/10.1007/s00392-021-01866-3 https://doi.org/10.1007/s00392-021-01866-3 https://link.springer.com/article/10.1007/s00392-021-01866-3 https://ruj.uj.edu.pl/xmlui/handle/item/278798 https://repository.publisso.de/resource/frl:6447523 https://hal.sorbonne-universite.fr/hal-03242664v1/document https://doi.org/10.1007/s00392-021-01866-3 https://hal.sorbonne-universite.fr/hal-03242664v1 https://epub.ub.uni-muenchen.de/76482/ |
| Rights: | CC BY URL: http://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (http://creativecommons.org/licenses/by/4.0/) . |
| Accession Number: | edsair.doi.dedup.....57e9d6dcbb8d0ecbc1097a4a93b893db |
| Database: | OpenAIRE |
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Nájsť tento článok vo Web of Science | Abstract: | Aims The aim of this pooled sub-analysis of the Intraaortic Balloon Pump in Cardiogenic Shock II (IABP-SHOCK II) and Culprit Lesion Only PCI versus Multivessel PCI in Cardiogenic Shock (CULPRIT-SHOCK) trial was to compare the clinical outcome of patients with acute myocardial infarction complicated by cardiogenic shock treated either with clopidogrel or the newer, more potent ADP-receptor antagonists prasugrel or ticagrelor. Methods and results For the current analysis the primary endpoint was 1-year mortality and the secondary safety endpoint was moderate or severe bleedings until hospital discharge with respect to three different ADP-receptor antagonists. 856 patients were eligible for analysis. Of these, 507 patients (59.2%) received clopidogrel, 178 patients (20.8%) prasugrel and 171 patients (20.0%) ticagrelor as acute antiplatelet therapy. The adjusted rate of mortality after 1-year did not differ significantly between prasugrel and clopidogrel (hazard ratio [HR]: 0.81, 95% confidence interval [CI] 0.60–1.09, padj = 0.17) or between ticagrelor and clopidogrel treated patients (HR: 0.86, 95% CI 0.65–1.15, padj = 0.31). In-hospital bleeding events were significantly less frequent in patients treated with ticagrelor vs. clopidogrel (HR: 0.37, 95% CI 0.20 -0.69, padj = 0.002) and not significantly different in patients treated with prasugrel vs. clopidogrel (HR: 0.73, 95% CI 0.43 -1.24, padj = 0.24). Conclusion This pooled sub-analysis is the largest analysis on safety and efficacy of three oral ADP-receptor antagonists and shows that acute therapy with either clopidogrel, prasugrel or ticagrelor is no independent predictor of 1-year mortality. Treatment with ticagrelor seems independently associated with less in-hospital moderate and severe bleeding events compared to clopidogrel. This finding might be due to selection bias and should be interpreted with caution. Graphic abstract |
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| ISSN: | 18610692 18610684 |
| DOI: | 10.1007/s00392-021-01866-3 |