Safety and effectiveness of the new P2Y12r inhibitor agents vs clopidogrel in ACS patients according to the geographic area: East Asia vs Europe

被引：9

作者：

Giordana, Francesca ^{[1
]}

Montefusco, Antonio ^{[1
]}

D'Ascenzo, Fabrizio ^{[1
]}

Moretti, Claudio ^{[1
]}

Scarano, Silvia ^{[1
]}

Abu-Assi, Emad ^{[2
]}

Raposeiras-Roubin, Sergio ^{[2
]}

Henriques, Jose Paulo Simao ^{[3
]}

Saucedo, Jorge ^{[4
]}

Ramon Gonzalez-Juanatey, Jose ^{[5
]}

Wilton, Stephen B. ^{[6
]}

Kikkert, Wouter J. ^{[3
]}

Nunez-Gil, Ivan ^{[7
]}

Ariza-Sole, Albert ^{[8
]}

Song, Xiantao ^{[9
]}

Alexopoulos, Dimitrios ^{[10
]}

Liebetrau, Christoph ^{[11
]}

Kawaji, Tetsuma ^{[12
]}

Huczek, Zenon ^{[13
]}

Nie, Shao-Ping ^{[14
]}

Fujii, Toshiharu ^{[15
]}

Correia, Luis ^{[16
]}

Kawashiri, Masa-aki ^{[17
]}

Maria Garcia-Acuna, Jose ^{[2
]}

Southern, Danielle ^{[6
]}

Alfonso, Emilio ^{[7
]}

Terol, Belen ^{[7
]}

Garay, Alberto ^{[8
]}

Zhang, Dongfeng ^{[9
]}

Chen, Yalei ^{[9
]}

Xanthopoulou, Ioanna ^{[10
]}

Osman, Neriman ^{[11
]}

Moellmann, Helge ^{[11
]}

Shiomi, Hiroki ^{[12
]}

Kowara, Michal ^{[13
]}

Filipiak, Krzysztof ^{[13
]}

Wang, Xiao ^{[14
]}

Yan, Yan ^{[14
]}

Fan, Jing-Yao ^{[14
]}

Ikari, Yuji ^{[15
]}

Nakahayshi, Takuya ^{[17
]}

Sakata, Kenji ^{[17
]}

Yamagishi, Masakazu ^{[17
]}

Kalpak, Oliver ^{[18
]}

Kedev, Sasko ^{[18
]}

Gaita, F. ^{[1
]}

机构：

[1] Univ Turin, Div Cardiol, Citta Salute & Sci Hosp, I-10124 Turin, Italy

[2] Univ Hosp Alvaro Cunqueiro, Vigo, Spain

[3] Univ Amsterdam, Acad Med Ctr, NL-1012 WX Amsterdam, Netherlands

[4] NorthShore Univ Hosp, Chicago, IL USA

[5] Univ Clin Hosp Santiago De Compostela, Santiago De Compostela, Spain

[6] Libin Cardiovasc Inst Alberta, Calgary, AB, Canada

[7] San Carlos Hosp, Madrid, Spain

[8] Bellvitge Hosp, Barcelona, Spain

[9] Capital Med Univ, Beijing Anzhen Hosp, Beijing, Peoples R China

[10] Univ Patras Hosp, Athens, Greece

[11] Kerckhoff Heart & Thorax Ctr, Frankfurt, Germany

[12] Univ Clin Hosp, Kyoto, Japan

[13] Univ Clin Hosp, Warsaw, Poland

[14] Inst Heart Lung & Blood Vessel Dis, Beijing, Peoples R China

[15] Tokai Univ, Sch Med, Tokyo, Japan

[16] Hosp Sao Rafael, Salvador, BA, Brazil

[17] Kanazawa Univ, Grad Sch Med, Div Cardiovasc Med, Kanazawa, Ishikawa, Japan

[18] Univ Clin Cardiol, Skopje, North Macedonia

来源：

INTERNATIONAL JOURNAL OF CARDIOLOGY | 2016年 / 220卷

基金：

日本学术振兴会;

关键词：

Acute coronary syndrome; Clopidogrel; Ethnicity; Platelet inhibitor; Prasugrel; P2Y12; receptor; Ticagrelor; PERCUTANEOUS CORONARY INTERVENTION; HIGH-DOSE CLOPIDOGREL; PRASUGREL; 30; MG; ANTIPLATELET THERAPY; STENT THROMBOSIS; BLEEDING COMPLICATIONS; JAPANESE PATIENTS; HEALTHY CHINESE; ELUTING STENTS; RISK;

D O I：

10.1016/j.ijcard.2016.06.063

中图分类号：

R5 [内科学];

学科分类号：

100201 [内科学];

摘要：

Background: In the setting of the Acute Coronary Syndrome (ACS), differences in response to prasugrel and ticagrelor between East Asian and European patients have not been investigated yet. Methods: This is a sub-analysis of the "BleeMACS registry". Patients admitted for ACS and underwent PCI from between 2012 and 2014 were stratified first according to their provenance, Europe vs. East Asia (China and Japan), and then by country. The adjusted rate of 1-year serious bleeding - safety end-point-and 1-year death/re-infarction -effectiveness endpoint-of the new P2Y12r inhibitors were compared. Results: Data of 10004 patients in Europe and 2332 patients in East Asia were collected. At baseline prior stroke (6% vs 9%, p < 0.001, respectively) and type of ACS (59% vs 71% STEMI, 11% vs 21% Unstable Angina) were significantly different among the groups. At 1 year follow-up no difference in bleeding (3% vs 3%, p = 0.84) was found, while the between group incidence of death/re-infarctionwas significantly higher in the European centers (9% vs 5%, p < 0.001). At the multivariate analysis, ticagrelor decreases the risk of MACE (Europe: HR 0.5, CI 0.3-0.9; East Asia: HR 0.5, CI 0.2-0.9), despite of a higher risk of bleeding in Caucasians (HR 1.7, CI 1.1-2.6). Prasugrel reduces death/re-infarction (HR 0.4, CI 0.2-0.6), without increasing bleeding (HR 0.9, CI 0.5-1.3). Conclusions: In the setting of the ACS, the new anti-platelets drugs appear to be safe and efficacious at mid-term follow-up independently from the geographic area. Prasugrel seems to have the best risk-benefit, while ticagrelor appears safer in East Asians. (C) 2016 Elsevier Ireland Ltd. All rights reserved.

引用

页码：488 / 495

页数：8

共 36 条

[1]

Amsterdam E. A., 2014, AM COLL CARDIOLOGY A

[2]

Amsterdam EA, 2014, J AM COLL CARDIOL, V64, pE139, DOI [10.1016/j.jacc.2014.09.017, 10.1161/CIR.0000000000000134, 10.1016/j.jacc.2014.10.011, 10.1016/j.jacc.2014.09.016]

[3]

Pharmacokinetics and pharmacodynamics of single and multiple doses of prasugrel in healthy native Chinese subjects [J].

Cui, Yi-min ;

Wang, Zi-ning ;

Chen, Xiao-wen ;

Zhang, Hui-lin ;

Zhao, Xia ;

Zhou, Ying .

ACTA PHARMACOLOGICA SINICA, 2012, 33 (11) :1395-1400

[4]

CYP2C19*2 and*17 Alleles Have a Significant Impact on Platelet Response and Bleeding Risk in Patients Treated With Prasugrel After Acute Coronary Syndrome [J].

Cuisset, Thomas ;

Loosveld, Marie ;

Morange, Pierre Emmanuel ;

Quilici, Jacques ;

Moro, Pierre Julien ;

Saut, Noemie ;

Gaborit, Benedicte ;

Castelli, Christel ;

Beguin, Shirley ;

Grosdidier, Charlotte ;

Fourcade, Laurent ;

Bonnet, Jean-Louis ;

Alessi, Marie-Christine .

JACC-CARDIOVASCULAR INTERVENTIONS, 2012, 5 (12) :1280-1287

[5]

BleeMACS: rationale and design of the study [J].

D'Ascenzo, Fabrizio ;

Abu-Assi, Emad ;

Raposeiras-Roubin, Sergio ;

Simao Henriques, Jose Paulo ;

Saucedo, Jorge ;

Ramon Gonzalez-Juanatey, Jose ;

Wilton, Stephen B. ;

Kikkert, Wouter J. ;

Nunez-Gil, Ivan ;

Ariza-Sole, Albert ;

Song, Xiantao ;

Alexopoulos, Dimitrios ;

Liebetrau, Christoph ;

Kawaji, Tetsuma ;

Moretti, Claudio ;

Huczek, Zenon ;

Nie, Shao-Ping ;

Fujii, Toshiharu ;

Correia, Luis Claudio ;

Kawashiri, Masa-aki ;

Maria Garcia-Acuna, Jose ;

Southern, Danielle ;

Alfonso, Emilio ;

Terol, Belen ;

Garay, Alberto ;

Zhang, Dongfeng ;

Chen, Yalei ;

Xanthopoulou, Ioanna ;

Osman, Neriman ;

Moellmann, Helge ;

Shiomi, Hiroki ;

Giordana, Francesca ;

Scarano, Silvia ;

Gaita, Fiorenzo ;

Kowara, Michal ;

Filipiak, Krzysztof J. ;

Wang, Xiao ;

Yan, Yan ;

Fan, Jing-Yao ;

Ikari, Yuji ;

Nakahayshi, Takuya ;

Sakata, Kenji ;

Yamagishi, Masakazu ;

Kalpak, Oliver ;

Kedev, Sasko .

JOURNAL OF CARDIOVASCULAR MEDICINE, 2016, 17 (10) :744-749

[6]

Use and Misuse of Multivariable Approaches in Interventional Cardiology Studies on Drug-Eluting Stents: A Systematic Review [J].

D'Ascenzo, Fabrizio ;

Cavallero, Erika ;

Biondi-Zoccai, Giuseppe ;

Moretti, Claudio ;

Omede, Pierluigi ;

Bollati, Mario ;

Castagno, Davide ;

Modena, Maria Grazia ;

Gaita, Fiorenzo ;

Sheiban, Imad .

JOURNAL OF INTERVENTIONAL CARDIOLOGY, 2012, 25 (06) :611-621

[7]

Early and late coronary stent thrombosis of sirolimus-eluting and paclitaxel-eluting stents in routine clinical practice:: data from a large two-institutional cohort study [J].

Daemen, Joost ;

Wenaweser, Peter ;

Tsuchida, Keiichi ;

Abrecht, Linda ;

Sophia, Vaina ;

Morger, Cyrill ;

Kukreja, Neville ;

Jueni, Peter ;

Sianos, Georgios ;

Hellige, Gerrit ;

van Domburg, Ron T. ;

Hess, Otto M. ;

Boersma, Eric ;

Meier, Bernhard ;

Windecker, Stephan ;

Serruys, Patrick W. .

LANCET, 2007, 369 (9562) :667-678

[8]

Efficacy and safety analysis of new P2Y12 inhibitors versus clopidogrel in patients with percutaneous coronary intervention: a meta-analysis [J].

Gan, Xue-Dong ;

Wei, Bao-Zhu ;

Fang, Dong ;

Fang, Qi ;

Li, Kai-Yong ;

Ding, Shi-Lan-Ying ;

Peng, Song ;

Wan, Jing .

CURRENT MEDICAL RESEARCH AND OPINION, 2015, 31 (12) :2313-2323

[9]

Influence of CYP2C19*2 and *3 loss-of-function alleles on the pharmacodynamic effects of standard- and high-dose clopidogrel in East Asians undergoing percutaneous coronary intervention: the results of the ACCEL-DOUBLE-2N3 study [J].

Jeong, Y-H. ;

Abadilla, K. A. ;

Tantry, U. S. ;

Park, Y. ;

Koh, J-S. ;

Kwak, C. H. ;

Hwang, J-Y. ;

Gurbel, P. A. .

JOURNAL OF THROMBOSIS AND HAEMOSTASIS, 2013, 11 (06) :1194-1197

[10]

"East Asian Paradox": Challenge for the Current Antiplatelet Strategy of "One-Guideline-Fits-All Races" in Acute Coronary Syndrome [J].

Jeong, Young-Hoon .

CURRENT CARDIOLOGY REPORTS, 2014, 16 (05)

← 1 2 3 4 →