Extended dual antiplatelet therapy after acute coronary syndrome in Spain: Results from the EPICOR study

IntroductionReal-world, country-specific studies of dual antiplatelet therapy (DAPT) duration among survivors of acute coronary syndrome (ACS) are important for improving long-term prognosis. AimsTo investigate DAPT duration after hospital discharge for ACS in Spain. ResultsData from patients enroll...

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Detalles Bibliográficos
Autores: Bardaji, A, Leal, M, Arrarte, V, Garcia-Moll, X, de Isla, LP, Bueno, H
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2017
País:España
Institución:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositorio:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p6557
Acceso en línea:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=6557
http://hdl.handle.net/20.500.12105/11262
Access Level:acceso abierto
Palabra clave:Acute coronary syndrome
ADP Receptor antagonists
Antiplatelet agents
Coronary artery disease
Myocardial infarction
Secondary prevention
Descripción
Sumario:IntroductionReal-world, country-specific studies of dual antiplatelet therapy (DAPT) duration among survivors of acute coronary syndrome (ACS) are important for improving long-term prognosis. AimsTo investigate DAPT duration after hospital discharge for ACS in Spain. ResultsData 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 2years 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 2years (53.1%). Among patients who experienced any on-treatment bleeding event, almost two-thirds remained on DAPT at the end of follow-up. Patients >65years, diabetic, or those that were medically managed were more likely to continue with DAPT until 2years following discharge. At 2years, 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. ConclusionsMore 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.