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Clinical Outcomes of Ticagrelor in Korean Patients with Acute Myocardial Infarction without Highopen accessClinical Outcomes of Ticagrelor in Korean Patients with Acute Myocardial Infarction without High Bleeding Risk

Other Titles
Clinical Outcomes of Ticagrelor in Korean Patients with Acute Myocardial Infarction without High Bleeding Risk
Authors
Park, Keun-HoJeong, Myung HoKim, Hyun KukKi, Young-JaeKim, Sung SooChoi, Dong-HyunKoh, Young-YoupAhn, YoungkeunKim, Hyo-SooGwon, Hyeon-CheolRha, Seung-WoonHwang, Jin-Yong
Issue Date
1-Nov-2021
Publisher
대한의학회
Keywords
Hemorrhage; Myocardial Infarction; Percutaneous Coronary Intervention
Citation
Journal of Korean Medical Science, v.36, no.42, pp 1 - 16
Pages
16
Indexed
SCIE
SCOPUS
KCI
Journal Title
Journal of Korean Medical Science
Volume
36
Number
42
Start Page
1
End Page
16
URI
https://scholarworks.gnu.ac.kr/handle/sw.gnu/3015
DOI
10.3346/jkms.2021.36.e268
ISSN
1011-8934
1598-6357
Abstract
Background: Although ticagrelor is known to increase the bleeding risk compared to clopidogrel in East Asian patients, its clinical benefits in patients with acute myocardial infarction (AMI) without high bleeding risk (HBR) remains unknown. Methods: A total of 7,348 patients who underwent successful percutaneous coronary intervention (PCI) from the Korea Acute Myocardial Infarction Registry-National Institute of Health (KAMIR-NIH), between November 2011 and December 2015, were divided into two groups according to the Academic Research Consortium for HBR criteria (KAMIR-HBR, 2,469 patients; KAMIR-non HBR, 4,879 patients). We compared in-hospital major adverse cardiovascular events (MACEs, defined as a composite of cardiac death, non-fatal myocardial infarction, or stroke), and the thrombolysis in myocardial infarction (TIMI) major bleeding between ticagrelor and clopidogrel in the KAMIR-HBR and the KAMIR-non HBR groups, respectively. Results: After propensity score matching, ticagrelor had a higher incidence of in-hospital TIMI major bleeding than clopidogrel in all patients (odds ratio [OR], 1.683; 95% confidence interval [CI], 1.010-2.805; P = 0.046) and the KAMIR-HBR group (OR, 3.460; 95% CI, 1.374-8.714; P = 0.008). However, there was no significant difference in in-hospital TIMI major bleeding between ticagrelor and clopidogrel in the KAMIR-non HBR group (OR, 1.436; 95% CI, 0.722-2.855; P = 0.303). No differences were observed in the cumulative incidences of in-hospital and 6-month MACEs between ticagrelor and clopidogrel in both groups. Conclusions: The bleeding risk of ticagrelor was attenuated in Korean patients with AMI without HBR. Appropriate patient selection could reduce in-hospital bleeding complications associated with ticagrelor in Korean patients with AMI who underwent successful PCI.
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