One-Year Post-Discharge Resource Utilization and Treatment Patterns of Patients with Acute Coronary Syndrome Managed with Percutaneous Coronary Intervention and Treated with Ticagrelor or Prasugrel

Simeone, Jason C; Molife, Cliff; Marrett, Elizabeth; Frech‐Tamas, Feride; Effron, Mark B.; Nordstrom, Beth L.; Zhu, Yajun Emily; Keller, Stuart; Murphy, Brian R.; Nair, Kavita V.; Vetrovec, George W.; Page, Robert L.; McCollam, PL

doi:10.1007/s40256-015-0147-y

Cited by 23 publications

(19 citation statements)

References 35 publications

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“…Further, in the absence of a proper head‐to‐head study, no clear guidance is available on the selection of ticagrelor versus prasugrel . Meta‐analyses attempting to compare the efficacy of prasugrel and ticagrelor indirectly produced conflicting conclusions, and an observational study suffered from methodological inadequacy in comparing clinical outcomes . In addition, a recent prospective trial comparing the efficacy of ticagrelor and prasugrel did not enroll an adequate number of participants and was terminated prematurely .…”

mentioning

confidence: 99%

“…23,24 Meta-analyses attempting to compare the efficacy of prasugrel and ticagrelor indirectly produced conflicting conclusions, and an observational study suffered from methodological inadequacy in comparing clinical outcomes. [25][26][27] In addition, a recent prospective trial comparing the efficacy of ticagrelor and prasugrel did not enroll an adequate number of participants and was terminated prematurely. 28 To help fill this ongoing research gap and to provide further insight into the use of antiplatelet agents in the real world, we studied timeto-event estimates of the three antiplatelet medications from day 30 to day 365 following discharge from an ACS-PCI hospitalization using an insurance claims database.…”

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confidence: 99%

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Comparative Effectiveness of Oral Antiplatelet Agents in Patients with Acute Coronary Syndrome

Kim

Lee

Ardati³

et al. 2017

Pharmacotherapy

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OBJECTIVE In randomized controlled trials, prasugrel and ticagrelor reduced cardiovascular complications in patients with acute coronary syndrome (ACS) compared with clopidogrel. However, limited head-to-head comparisons have been conducted across the three antiplatelet agents using real-world data. The aim of this study was to compare clinical outcomes of three strategies during a 1-year period after percutaneous coronary intervention (PCI). METHODS Rates of all-cause and acute myocardial infarction (AMI) hospitalizations were compared retrospectively using an insurance claims database. Patients who filled a prescription for an oral antiplatelet agent between September 2011 and December 2013 for post ACS-PCI care were identified. Time to allcause and AMI hospitalization for a 365-day postdischarge period was compared using Cox proportional hazard models controlling for potential confounders within a propensity score matched cohort. RESULTS A matched cohort of 9504 clopidogrel, 7128 prasugrel, and 2376 ticagrelor patients was analyzed. The 1-year hazard ratio (HR) for the two newer agents versus clopidogrel was 0.84 (0.78-0.91). The HR for the newer agents versus clopidogrel of admission with AMI as the primary diagnosis was 0.78 (0.61-1.03), and for AMI as any diagnosis during a hospitalization was 0.88 (0.77-1.00). The HR of all-cause admission for ticagrelor versus prasugrel was 0.97 (0.84-1.13), and the HRs of AMI-related admission were not statistically significant between the two agents. Robustness checks across statistical methods to control for potential confounders did not influence the conclusion. CONCLUSION This real-world study demonstrated that use of the newer agents following PCI was associated with a decrease in all-cause and AMI-related hospitalizations. However, no significant difference was found in the rate of admission between ticagrelor versus prasugrel. Due to concerns regarding statistical power, future studies should examine larger cohorts to obtain more precise estimates for AMI hospitalization for ticagrelor and prasugrel.

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confidence: 99%

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Comparative Effectiveness of Oral Antiplatelet Agents in Patients with Acute Coronary Syndrome

Kim

Lee

Ardati³

et al. 2017

Pharmacotherapy

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“…Данные о приверженности к различным препаратам, входящим в ДАТТ, отличаются в разных странах. Так, по данным американских исследователей приверженность к прасугрелу больше, чем к тикагрелору [24]. По данным бельгийских исследователей, приверженность к клопидогрелу меньше, чем к тикагрелору и прасугрелу [21].…”

Section: результаты реальной клинической практикиunclassified

Dual antiplatelet therapy in patients with acute coronary syndrome. Results of actual clinical practice

Барбараш¹,

Кашталап²

2018

Russ J Cardiol

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ДАТТ-двойная антитромбоцитарная терапия, ИМ-инфаркт миокарда, ИМбпST-инфаркт миокарда без подъема сегмента ST, ИМпST-инфаркт миокарда с подъемом сегмента ST, ОКС-острый коронарный синдром, ОКСбпST-острый коронарный синдром без подъема сегмента ST, ОКСпSTострый коронарный синдром c подъемом сегмента ST, ОНМК-острое нарушение мозгового кровообращения, РКИ-рандомизированное клиническое исследование, ХБП-хроническая болезнь почек, ЧКВ-чрескожное коронарное вмешательство.

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“…To the best of our knowledge, thus far, only two studies 6,7 have focused on ticagrelor completion. A study conducted in Saskatchewan used a registry of patients initiated on ticagrelor, and 20.7% of the patients discontinued the use of ticagrelor before reaching 12 months of treatment.…”

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confidence: 99%

“…6 In an administrative data analysis conducted in the US, the mean number of days on ticagrelor was 150.2; however, the proportion of patients completing 12 months of treatment was not specifically reported. 7 None of these studies assessed the factors associated with completion. In addition, to the best of our knowledge, the level of treatment implementation by patients completing ticagrelor treatment has never been assessed.…”

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Treatment Completion and Implementation by Patients Initiating Ticagrelor

Grégoire

Poirier

Pérez

et al. 2019

J Popl Ther Clin Pharmacol

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BackgroundIn secondary prevention of adverse events and death following acute coronary syndrome, patients may benefit from adhering to a ticagrelor treatment.ObjectivesThe authors assessed the proportion of new ticagrelor users who completed 12 months of treatment, ex-plored the factors associated with treatment completion and, among the completers, evaluated the 12-month treatment implementation.MethodsA retrospective administrative health database inception cohort study was conducted in a population that included Quebec residents ≥18 years of age who initiated ticagrelor between January 1, 2012 and March 31, 2014. A patient still on ticagrelor at the end of the 12-month period after treatment initiation was considered to have completed the treatment. Factors associated with treatment completion were identified using log-binomial regression. Implementation was assessed using the proportion of days covered (PDC). ResultsOf the 3,600 patients, 2,235 (62.1%) completed 12 months of treatment. The patients who were more likely to complete their treatment included those who had visited a general practitioner, had a percutane-ous coronary intervention, used a statin or fibrate, and those who used an antihypertensive drug during the year preceding the ticagrelor treatment initiation. Older patients, those with atrial fibrillation, those who had ≥ 6 physician visits and those who used an anticoagulant were less likely to complete the 12-month treatment. The median PDC was 96.2%.ConclusionTreatment completion might be improved. Among patients who completed the treatment, implementation was high. The factors associated with completion could help to identify patients who might benefit from interventions that aim to optimize treatment completion.

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One-Year Post-Discharge Resource Utilization and Treatment Patterns of Patients with Acute Coronary Syndrome Managed with Percutaneous Coronary Intervention and Treated with Ticagrelor or Prasugrel

Cited by 23 publications

References 35 publications

Comparative Effectiveness of Oral Antiplatelet Agents in Patients with Acute Coronary Syndrome

Comparative Effectiveness of Oral Antiplatelet Agents in Patients with Acute Coronary Syndrome

Dual antiplatelet therapy in patients with acute coronary syndrome. Results of actual clinical practice

Treatment Completion and Implementation by Patients Initiating Ticagrelor

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