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KMID : 0368120170470060888
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Korean Circulation Journal
2017 Volume.47 No. 6 p.888 ~ p.897
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The Use Pattern and Clinical Impact of New Antiplatelet Agents Including Prasugrel and Ticagrelor on 30-day Outcomes after Acute Myocardial Infarction in Korea: Korean Health Insurance Review and Assessment Data
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Kim Choong-Ki
Shin Dong-Ho
Ahn Chul-Min
Kim Jung-Sun
Kim Byeong-Keuk
Ko Young-Guk
Choi Dong-Hoon
Hong Myeong-Ki
Park Ju-Hee
Lee Hye-Yeong
Choi Yoon-Jung
Choi Youn-Song
Oh Sang-Kwon
Jang Yang-Soo
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Abstract
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Background and Objectives: Despite the favorable efficacy of new antiplatelet agents demonstrated in randomized controlled trials, their clinical implications in Korea are unclear. The purpose of this study was to investigate trends in antiplatelet agent use for acute myocardial infarction (AMI) and their impact on 30-day clinical outcomes.
Methods: AMI patients undergoing percutaneous coronary intervention between 2010 and 2015 were assessed using claim data from the Health Insurance Review and Assessment Service.
Results: The use of new antiplatelet agents has rapidly increased since 2013 and has been preferred over clopidogrel (Plavix; Bristol-Myers Squibb/Sanofi Pharmaceuticals) since 2015. Both prasugrel (Effient; Eli Lilly and Company) (odds ratio [OR], 0.45; 95% confidence interval [CI], 0.31?0.67; p<0.001) and ticagrelor (Brilinta; AstraZeneca Pharmaceuticals LP) (OR, 0.84; 95% CI, 0.71?0.98; p=0.032) had an independent effect on lowering 30-day mortality in a weighted multivariable logistic regression model. However, new antiplatelet agents had no significant effect on other clinical outcomes including myocardial infarction, stroke, bleeding, and readmission within 30 days.
Conclusion: The use of new antiplatelet agents is rapidly increasing, and they have been used more commonly than clopidogrel since 2015. We demonstrated that new antiplatelet agents have a favorable effect on reducing 30-day mortality in AMI patients in Korea.
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KEYWORD
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Myocardial infarction, Prasugrel, Ticagrelor, Clopidogrel, Percutaneous coronary intervention
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