Contemporary use of ticagrelor in patients with acute coronary syndrome: insights from Swedish Web System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies (SWEDEHEART)
Aims The platelet inhibitor ticagrelor is strongly recommended during 12 months post-acute coronary syndrome (ACS) in European guidelines. We analysed clinical characteristics of patients given ticagrelor for ACS in the real world. Methods and results We studied the use of ticagrelor in patients adm...
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| Veröffentlicht in: | European heart journal. Cardiovascular pharmacotherapy 2016-01, Vol.2 (1), p.5-12 |
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| container_title | European heart journal. Cardiovascular pharmacotherapy |
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| creator | Sahlén, Anders Varenhorst, Christoph Lagerqvist, Bo Renlund, Henrik Wallentin, Lars James, Stefan K. Jernberg, Tomas |
| description | Aims
The platelet inhibitor ticagrelor is strongly recommended during 12 months post-acute coronary syndrome (ACS) in European guidelines. We analysed clinical characteristics of patients given ticagrelor for ACS in the real world.
Methods and results
We studied the use of ticagrelor in patients admitted for ACS in Sweden between 1 January 2012 and 31 December 2013 who were enrolled in the Swedish Web system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies (SWEDEHEART). Clinical characteristics were investigated for patients prescribed ticagrelor at discharge as well as for patients undergoing percutaneous coronary intervention who were prescribed ticagrelor. Independent factors associated with selecting ticagrelor were analysed in logistic regression. We found that 44.0% (n = 12 601) out of a total of 28 639 patients had been prescribed ticagrelor at discharge. After adjusting for age and sex, prior cardiovascular disease was less common in patients discharged on ticagrelor (myocardial infarction, ischaemic stroke, and peripheral vascular disease; P for all |
| doi_str_mv | 10.1093/ehjcvp/pvv034 |
| format | Article |
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The platelet inhibitor ticagrelor is strongly recommended during 12 months post-acute coronary syndrome (ACS) in European guidelines. We analysed clinical characteristics of patients given ticagrelor for ACS in the real world.
Methods and results
We studied the use of ticagrelor in patients admitted for ACS in Sweden between 1 January 2012 and 31 December 2013 who were enrolled in the Swedish Web system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies (SWEDEHEART). Clinical characteristics were investigated for patients prescribed ticagrelor at discharge as well as for patients undergoing percutaneous coronary intervention who were prescribed ticagrelor. Independent factors associated with selecting ticagrelor were analysed in logistic regression. We found that 44.0% (n = 12 601) out of a total of 28 639 patients had been prescribed ticagrelor at discharge. After adjusting for age and sex, prior cardiovascular disease was less common in patients discharged on ticagrelor (myocardial infarction, ischaemic stroke, and peripheral vascular disease; P for all <0.001). The risk of death as predicted by GRACE score and the risk of major bleeding as predicted by CRUSADE score were both lower in ticagrelor-treated patients vs. others (median 99 vs. 126 and median 23 vs. 25, respectively; P for both < 0.001). The intended treatment duration at discharge was 12 months in 82.5% of patients and <12 months in 9.3%.
Conclusion
Ticagrelor is preferentially being used in patients at lower risk. A minority of patients are recommended ticagrelor during <12 months.</description><identifier>ISSN: 2055-6837</identifier><identifier>ISSN: 2055-6845</identifier><identifier>EISSN: 2055-6845</identifier><identifier>DOI: 10.1093/ehjcvp/pvv034</identifier><identifier>PMID: 27533056</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Acute coronary syndrome ; Acute Coronary Syndrome - complications ; Acute Coronary Syndrome - mortality ; Acute Coronary Syndrome - surgery ; Adenosine - analogs & derivatives ; Adenosine - therapeutic use ; Aged ; Aged, 80 and over ; Cardiovascular Diseases - prevention & control ; Coronary Thrombosis - etiology ; Coronary Thrombosis - prevention & control ; Databases, Factual ; Evidence-Based Medicine ; Female ; Guideline Adherence ; Humans ; Male ; Medicin och hälsovetenskap ; Middle Aged ; P2Y12 antagonist ; Percutaneous Coronary Intervention ; Postoperative Complications - prevention & control ; Postoperative Hemorrhage - epidemiology ; Purinergic P2Y Receptor Antagonists - therapeutic use ; Risk Assessment ; Sweden - epidemiology ; Ticagrelor</subject><ispartof>European heart journal. Cardiovascular pharmacotherapy, 2016-01, Vol.2 (1), p.5-12</ispartof><rights>Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com 2015</rights><rights>Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c490t-7eaa11f7913824a2500890f8a1ccce7b1d55f1101d79cf2f0305bd57db64bff53</citedby><cites>FETCH-LOGICAL-c490t-7eaa11f7913824a2500890f8a1ccce7b1d55f1101d79cf2f0305bd57db64bff53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,552,780,784,885,1584,4024,27923,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27533056$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-308368$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:139785750$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Sahlén, Anders</creatorcontrib><creatorcontrib>Varenhorst, Christoph</creatorcontrib><creatorcontrib>Lagerqvist, Bo</creatorcontrib><creatorcontrib>Renlund, Henrik</creatorcontrib><creatorcontrib>Wallentin, Lars</creatorcontrib><creatorcontrib>James, Stefan K.</creatorcontrib><creatorcontrib>Jernberg, Tomas</creatorcontrib><title>Contemporary use of ticagrelor in patients with acute coronary syndrome: insights from Swedish Web System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies (SWEDEHEART)</title><title>European heart journal. Cardiovascular pharmacotherapy</title><addtitle>Eur Heart J Cardiovasc Pharmacother</addtitle><description>Aims
The platelet inhibitor ticagrelor is strongly recommended during 12 months post-acute coronary syndrome (ACS) in European guidelines. We analysed clinical characteristics of patients given ticagrelor for ACS in the real world.
Methods and results
We studied the use of ticagrelor in patients admitted for ACS in Sweden between 1 January 2012 and 31 December 2013 who were enrolled in the Swedish Web system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies (SWEDEHEART). Clinical characteristics were investigated for patients prescribed ticagrelor at discharge as well as for patients undergoing percutaneous coronary intervention who were prescribed ticagrelor. Independent factors associated with selecting ticagrelor were analysed in logistic regression. We found that 44.0% (n = 12 601) out of a total of 28 639 patients had been prescribed ticagrelor at discharge. After adjusting for age and sex, prior cardiovascular disease was less common in patients discharged on ticagrelor (myocardial infarction, ischaemic stroke, and peripheral vascular disease; P for all <0.001). The risk of death as predicted by GRACE score and the risk of major bleeding as predicted by CRUSADE score were both lower in ticagrelor-treated patients vs. others (median 99 vs. 126 and median 23 vs. 25, respectively; P for both < 0.001). The intended treatment duration at discharge was 12 months in 82.5% of patients and <12 months in 9.3%.
Conclusion
Ticagrelor is preferentially being used in patients at lower risk. A minority of patients are recommended ticagrelor during <12 months.</description><subject>Acute coronary syndrome</subject><subject>Acute Coronary Syndrome - complications</subject><subject>Acute Coronary Syndrome - mortality</subject><subject>Acute Coronary Syndrome - surgery</subject><subject>Adenosine - analogs & derivatives</subject><subject>Adenosine - therapeutic use</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cardiovascular Diseases - prevention & control</subject><subject>Coronary Thrombosis - etiology</subject><subject>Coronary Thrombosis - prevention & control</subject><subject>Databases, Factual</subject><subject>Evidence-Based Medicine</subject><subject>Female</subject><subject>Guideline Adherence</subject><subject>Humans</subject><subject>Male</subject><subject>Medicin och hälsovetenskap</subject><subject>Middle Aged</subject><subject>P2Y12 antagonist</subject><subject>Percutaneous Coronary Intervention</subject><subject>Postoperative Complications - prevention & control</subject><subject>Postoperative Hemorrhage - epidemiology</subject><subject>Purinergic P2Y Receptor Antagonists - therapeutic use</subject><subject>Risk Assessment</subject><subject>Sweden - epidemiology</subject><subject>Ticagrelor</subject><issn>2055-6837</issn><issn>2055-6845</issn><issn>2055-6845</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>D8T</sourceid><recordid>eNqFUk2P0zAQjRCIXZU9ckU-LhJh7ThuEm6lLRRpJaRtYY-WY08aL00c7KTV_mb-BFPabU8rTp6P996MRy-K3jL6kdGC30D9oLfdTbfdUp6-iC4TKkQ8zlPx8hTz7CK6CuGBUsrG-TjJ-evoIskE51SML6M_U9f20HTOK_9IhgDEVaS3Wq09bJwntiWd6i20fSA729dE6aEHop137Z4RHlvjXQOfEBnsukZYhTlZ7sDYUJN7KMnyMeAIUqHcvK1Vq6FBPaJaQ2awxTHdvxwHz7fWAPbjzyqAIVPlYb_BApTvycwGwDKC1GZQPfYnGvcwtl2T3pE70K5BIYONVQ1edRYCuV7ez2fzxXxyt3r_JnpVqU2Aq-M7in58ma-mi_j2-9dv08ltrNOC9nEGSjFWZQXjeZKqRFCaF7TKFdNaQ1YyI0TFGGUmK3SVVBQvWRqRmXKcllUl-CiKD7phB91Qys7bBm8lnbLyWPqFEUiB1IwjvngW33lnzqQnIuNFlosM-aPow7Pcmf05kc6v5TBITnOOZhhF1wc46v4eIPSysUHDZqNacEOQLGdJnidFkZ5_ob0LwUN10mZU7t0nD-6TB_ch_t1ReigbMCf0k9fOs93Q_UfrL5eZ688</recordid><startdate>201601</startdate><enddate>201601</enddate><creator>Sahlén, Anders</creator><creator>Varenhorst, Christoph</creator><creator>Lagerqvist, Bo</creator><creator>Renlund, Henrik</creator><creator>Wallentin, Lars</creator><creator>James, Stefan K.</creator><creator>Jernberg, Tomas</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>ACNBI</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>D8T</scope><scope>DF2</scope><scope>ZZAVC</scope></search><sort><creationdate>201601</creationdate><title>Contemporary use of ticagrelor in patients with acute coronary syndrome: insights from Swedish Web System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies (SWEDEHEART)</title><author>Sahlén, Anders ; Varenhorst, Christoph ; Lagerqvist, Bo ; Renlund, Henrik ; Wallentin, Lars ; James, Stefan K. ; Jernberg, Tomas</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c490t-7eaa11f7913824a2500890f8a1ccce7b1d55f1101d79cf2f0305bd57db64bff53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Acute coronary syndrome</topic><topic>Acute Coronary Syndrome - complications</topic><topic>Acute Coronary Syndrome - mortality</topic><topic>Acute Coronary Syndrome - surgery</topic><topic>Adenosine - analogs & derivatives</topic><topic>Adenosine - therapeutic use</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cardiovascular Diseases - prevention & control</topic><topic>Coronary Thrombosis - etiology</topic><topic>Coronary Thrombosis - prevention & control</topic><topic>Databases, Factual</topic><topic>Evidence-Based Medicine</topic><topic>Female</topic><topic>Guideline Adherence</topic><topic>Humans</topic><topic>Male</topic><topic>Medicin och hälsovetenskap</topic><topic>Middle Aged</topic><topic>P2Y12 antagonist</topic><topic>Percutaneous Coronary Intervention</topic><topic>Postoperative Complications - prevention & control</topic><topic>Postoperative Hemorrhage - epidemiology</topic><topic>Purinergic P2Y Receptor Antagonists - therapeutic use</topic><topic>Risk Assessment</topic><topic>Sweden - epidemiology</topic><topic>Ticagrelor</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sahlén, Anders</creatorcontrib><creatorcontrib>Varenhorst, Christoph</creatorcontrib><creatorcontrib>Lagerqvist, Bo</creatorcontrib><creatorcontrib>Renlund, Henrik</creatorcontrib><creatorcontrib>Wallentin, Lars</creatorcontrib><creatorcontrib>James, Stefan K.</creatorcontrib><creatorcontrib>Jernberg, Tomas</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>SWEPUB Uppsala universitet full text</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Freely available online</collection><collection>SWEPUB Uppsala universitet</collection><collection>SwePub Articles full text</collection><jtitle>European heart journal. Cardiovascular pharmacotherapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sahlén, Anders</au><au>Varenhorst, Christoph</au><au>Lagerqvist, Bo</au><au>Renlund, Henrik</au><au>Wallentin, Lars</au><au>James, Stefan K.</au><au>Jernberg, Tomas</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Contemporary use of ticagrelor in patients with acute coronary syndrome: insights from Swedish Web System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies (SWEDEHEART)</atitle><jtitle>European heart journal. Cardiovascular pharmacotherapy</jtitle><addtitle>Eur Heart J Cardiovasc Pharmacother</addtitle><date>2016-01</date><risdate>2016</risdate><volume>2</volume><issue>1</issue><spage>5</spage><epage>12</epage><pages>5-12</pages><issn>2055-6837</issn><issn>2055-6845</issn><eissn>2055-6845</eissn><abstract>Aims
The platelet inhibitor ticagrelor is strongly recommended during 12 months post-acute coronary syndrome (ACS) in European guidelines. We analysed clinical characteristics of patients given ticagrelor for ACS in the real world.
Methods and results
We studied the use of ticagrelor in patients admitted for ACS in Sweden between 1 January 2012 and 31 December 2013 who were enrolled in the Swedish Web system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies (SWEDEHEART). Clinical characteristics were investigated for patients prescribed ticagrelor at discharge as well as for patients undergoing percutaneous coronary intervention who were prescribed ticagrelor. Independent factors associated with selecting ticagrelor were analysed in logistic regression. We found that 44.0% (n = 12 601) out of a total of 28 639 patients had been prescribed ticagrelor at discharge. After adjusting for age and sex, prior cardiovascular disease was less common in patients discharged on ticagrelor (myocardial infarction, ischaemic stroke, and peripheral vascular disease; P for all <0.001). The risk of death as predicted by GRACE score and the risk of major bleeding as predicted by CRUSADE score were both lower in ticagrelor-treated patients vs. others (median 99 vs. 126 and median 23 vs. 25, respectively; P for both < 0.001). The intended treatment duration at discharge was 12 months in 82.5% of patients and <12 months in 9.3%.
Conclusion
Ticagrelor is preferentially being used in patients at lower risk. A minority of patients are recommended ticagrelor during <12 months.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>27533056</pmid><doi>10.1093/ehjcvp/pvv034</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 2055-6837 |
| ispartof | European heart journal. Cardiovascular pharmacotherapy, 2016-01, Vol.2 (1), p.5-12 |
| issn | 2055-6837 2055-6845 2055-6845 |
| language | eng |
| recordid | cdi_swepub_primary_oai_swepub_ki_se_503073 |
| source | MEDLINE; SWEPUB Freely available online; Oxford University Press Journals All Titles (1996-Current); PubMed Central |
| subjects | Acute coronary syndrome Acute Coronary Syndrome - complications Acute Coronary Syndrome - mortality Acute Coronary Syndrome - surgery Adenosine - analogs & derivatives Adenosine - therapeutic use Aged Aged, 80 and over Cardiovascular Diseases - prevention & control Coronary Thrombosis - etiology Coronary Thrombosis - prevention & control Databases, Factual Evidence-Based Medicine Female Guideline Adherence Humans Male Medicin och hälsovetenskap Middle Aged P2Y12 antagonist Percutaneous Coronary Intervention Postoperative Complications - prevention & control Postoperative Hemorrhage - epidemiology Purinergic P2Y Receptor Antagonists - therapeutic use Risk Assessment Sweden - epidemiology Ticagrelor |
| title | Contemporary use of ticagrelor in patients with acute coronary syndrome: insights from Swedish Web System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies (SWEDEHEART) |
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