Effectiveness and safety of P2Y12 inhibitors in patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention: a nationwide registry-based study

• Published in: European heart journal. Acute cardiovascular care 2022-09, Vol.11 (9), p.697-705
• Main Authors: Godtfredsen, Sissel J, Kragholm, Kristian H, Leutscher, Peter, Jørgensen, Steen Hylgaard, Christensen, Martin Kirk, Butt, Jawad H, Gislason, Gunnar, Køber, Lars, Fosbøl, Emil L, Sessa, Maurizio, Bhatt, Deepak L, Torp-Pedersen, Christian, Pareek, Manan
• Format: Article
• Language: English
• ISSN: 2048-8726; 2048-8734
• DOI: 10.1093/ehjacc/zuac095

AIMSTo compare the effectiveness and safety of clopidogrel, ticagrelor, and prasugrel in patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI). METHODS AND RESULTSNationwide, registry-based study of STEMI patients treated with primary PCI (2011-17) and subsequently with aspirin and a P2Y12 inhibitor. The effectiveness outcome was major adverse cardiovascular events (MACE) defined as a composite of recurrent myocardial infarction, repeat revascularization, stroke, or cardiovascular death at 12 months. The safety outcome was bleeding requiring hospitalization at 12 months. Multivariable logistic regression with average treatment effect modeling was used to calculate absolute and relative risks for outcomes standardized to the distributions of demographic characteristics of all included subjects. We included 10 832 patients; 1 697 were treated with clopidogrel, 7 508 with ticagrelor, and 1,627 with prasugrel. Median ages were 66, 63, and 59 years (P