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논문 기본 정보

자료유형
학술저널
저자정보
Park Keun-Ho (Department of Internal Medicine Chosun University Hospital Gwangju Korea.) Jeong Myung Ho (Department of Cardiovascular Medicine Chonnam National University Hospital and Medical School Gwang) Kim Hyun Kuk (Department of Internal Medicine Chosun University Hospital Gwangju Korea.) Ki Young-Jae (Department of Internal Medicine Chosun University Hospital Gwangju Korea.) Kim Sung Soo (Department of Internal Medicine Chosun University Hospital Gwangju Korea.) Choi Dong-Hyun (Department of Internal Medicine Chosun University Hospital Gwangju Korea.) Koh Young-Youp (Department of Internal Medicine Chosun University Hospital Gwangju Korea.) Ahn Youngkeun (Department of Cardiovascular Medicine Chonnam National University Hospital and Medical School Gwang) Kim Hyo-Soo (Department of Internal Medicine Seoul National University Hospital Seoul Korea.) Gwon Hyeon-Cheol (Heart Vascular and Stroke Institute Samsung Medical Center Sungkyunkwan University School of Medici) Rha Seung-Woon (Cardiovascular Center Korea University Guro Hospital Seoul Korea.) Hwang Jin-Yong (Department of Internal Medicine Gyeongsang National University Hospital Jinju Korea.) KAMIR-NIH registry investigators (KAMIR-NIH registry investigators)
저널정보
대한의학회 Journal of Korean Medical Science Journal of Korean Medical Science Vol.36 No.42
발행연도
2021.11
수록면
1 - 16 (16page)
DOI
10.3346/jkms.2021.36.e268

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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.
#P2Y12 Receptor Inhibitors #Hemorrhage #Myocardial Infarction #Percutaneous Coronary Intervention

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참고문헌 (28)

참고문헌 신청
Urban P / 2019 / Defining high bleeding risk in patients undergoing percutaneous coronary intervention : a consensus document from the Academic Research Consortium for High Bleeding Risk / Eur Heart J 40(31):2632~2653 google schola Park KH / 2016 / Comparison of short-term clinical outcomes between ticagrelor versus clopidogrel in patients with acute myocardial infarction undergoing successful revascularization; from Korea Acute Myocardial Infarction Registry-National Institute of Health / Int J Cardiol 215:193~200 google schola Kang J / 2018 / Third-generation P2Y12 inhibitors in East Asian acute myocardial infarction patients : a nationwide prospective multicentre study / Thromb Haemost 118(3):591~600 google schola Park DW / 2019 / Clinically significant bleeding with ticagrelor versus clopidogrel in Korean patients with acute coronary syndromes intended for invasive management : a randomized clinical trial / Circulation 140(23):1865~1877 google schola Yun JE / 2019 / Safety and effectiveness of contemporary P2Y12inhibitors in an East Asian population with acute coronary syndrome : a nationwide population-based cohort study / J Am Heart Assoc 8(14):e012078 google schola

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