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Clinical outcomes of adjusted-dose versus standard-dose prasugrel in East Asian patients with acute myocardial infarction.
Honda, Satoshi; Lee, Sangyeub; Cho, Kyung Hoon; Takegami, Misa; Nishihira, Kensaku; Kojima, Sunao; Asaumi, Yasuhide; Saji, Mike; Yamashita, Jun; Hibi, Kiyoshi; Takahashi, Jun; Sakata, Yasuhiko; Takayama, Morimasa; Sumiyoshi, Tetsuya; Ogawa, Hisao; Kimura, Kazuo; Sim, Doo Sun; Kim, Hyun Kuk; Kim, Weon; Ahn, Youngkeun; Jeong, Myung Ho; Yasuda, Satoshi.
Afiliación
  • Honda S; Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.
  • Lee S; Department of Cardiology, Chung-Ang University Hospital, Seoul, South Korea.
  • Cho KH; Department of Cardiology, Chonnam National University Hospital and Medical School, Gwangju, South Korea.
  • Takegami M; Department of Public Health and Health Policy, Graduated School of Medicine, University of Tokyo, Tokyo, Japan.
  • Nishihira K; Department of Cardiovascular Medicine, Miyazaki Medical Association Hospital, Miyazaki, Japan.
  • Kojima S; Department of Internal Medicine, Sakurajyuji Yatsushiro Rehabilitation Hospital, Kumamoto, Japan.
  • Asaumi Y; Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.
  • Saji M; Department of Cardiovascular Medicine, Toho University Faculty of Medicine, Tokyo, Japan.
  • Yamashita J; Department of Cardiology, Tokyo Medical University Hospital, Tokyo, Japan.
  • Hibi K; Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan.
  • Takahashi J; Department of Cardiovascular Medicine, Tohoku University, Sendai, Japan.
  • Sakata Y; Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.
  • Takayama M; Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan.
  • Sumiyoshi T; Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan.
  • Ogawa H; Kumamoto University, Kumamoto, Japan.
  • Kimura K; Yokosuka City Hospital, Yokosuka, Japan.
  • Sim DS; Department of Cardiology, Chonnam National University Hospital and Medical School, Gwangju, South Korea.
  • Kim HK; Department of Cardiology, Chosun University Hospital, Gwangju, South Korea.
  • Kim W; Division of Cardiology, Kyung Hee University Medical Center, Seoul, South Korea.
  • Ahn Y; Department of Cardiology, Chonnam National University Hospital and Medical School, Gwangju, South Korea.
  • Jeong MH; Department of Cardiology, Chonnam National University Hospital and Medical School, Gwangju, South Korea. Electronic address: myungho@chollian.net.
  • Yasuda S; Department of Cardiovascular Medicine, Tohoku University, Sendai, Japan. Electronic address: syasuda@cardio.med.tohoku.ac.jp.
Int J Cardiol ; 410: 132197, 2024 Sep 01.
Article en En | MEDLINE | ID: mdl-38823533
ABSTRACT

BACKGROUND:

The comparative efficacy and safety of adjusted- and standard-dose prasugrel in East Asian patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI) remain unclear. This study aimed to comparatively assess the ischaemic and bleeding outcomes of adjusted-dose (maintenance dose 3.75 mg) and standard-dose (maintenance dose 10 mg) prasugrel in East Asian patients with AMI undergoing PCI.

METHODS:

From a combined dataset sourced from nationwide AMI registries in Japan and South Korea (n = 17,118), patients treated with either adjusted- or standard-dose prasugrel were identified. Patients who did not undergo emergent PCI, those on oral anticoagulants, and those meeting the criteria of contraindication of prasugrel in South Korea (age ≥ 75 years, body weight < 60 kg, or history of stroke) were excluded. Major adverse cardiovascular events (MACE) and Thrombolysis in Myocardial Infarction (TIMI) major bleeding events were compared between the adjusted-dose (n = 1160) and standard-dose (n = 1086) prasugrel groups.

RESULTS:

Within the propensity-matched cohort (n = 702 in each group), no significant difference was observed in the in-hospital MACE between the adjusted- and standard-dose prasugrel groups (1.85% vs. 2.71%, odds ratio [OR] 0.68, 95% confidence interval [CI] 0.33-1.38, p = 0.286). However, the incidence of in-hospital major bleeding was significantly lower in the adjusted-dose prasugrel group than in the standard-dose group (0.43% vs. 1.71%, OR 0.25, 95% CI 0.07-0.88, p = 0.031). The cumulative 12-month incidence of MACE was equivalent in both groups (4.70% vs. 4.70%, OR 1.00, 95% CI 0.61-1.64, p = 1.000).

CONCLUSIONS:

Among East Asian patients with AMI undergoing PCI, those administered adjusted-dose prasugrel exhibited a lower risk of in-hospital bleeding events than those administered standard-dose prasugrel, while maintaining a comparable 1-year incidence of MACE.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Intervención Coronaria Percutánea / Clorhidrato de Prasugrel / Infarto del Miocardio Límite: Aged / Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: Int J Cardiol Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Países Bajos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Intervención Coronaria Percutánea / Clorhidrato de Prasugrel / Infarto del Miocardio Límite: Aged / Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: Int J Cardiol Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Países Bajos