Supplementary Material for: Contemporary Antiplatelet Treatment in Acute Coronary Syndrome Patients with Impaired Renal Function Undergoing Percutaneous Coronary Intervention
Davlouros P.
Xanthopoulou I.
Goudevenos J.
Hamilos M.
Vavuranakis E.
Sitafidis G.
Kanakakis I.
Deftereos S.
Alexopoulos D.
10.6084/m9.figshare.5249209.v1
https://karger.figshare.com/articles/journal_contribution/Supplementary_Material_for_Contemporary_Antiplatelet_Treatment_in_Acute_Coronary_Syndrome_Patients_with_Impaired_Renal_Function_Undergoing_Percutaneous_Coronary_Intervention/5249209
<p><b><i>Objectives:</i></b> To assess the clinical impact of impaired
renal function (IRF), in “real-world” acute coronary syndrome (ACS)
patients, receiving clopidogrel, prasugrel, or ticagrelor. <b><i>Methods:</i></b>
This was a prospective, observational, multicenter, cohort study of ACS
patients undergoing percutaneous coronary interventions (PCI) with IRF
(creatinine clearance <60 mL/min by Cockroft-Gault equation), who
were recruited into the Greek Antiplatelet Registry (GRAPE). Patients
were followed-up until 1 year for major adverse cardiovascular events
(MACE; a composite of death, nonfatal myocardial infarction, urgent
revascularization, and stroke) and BARC (Bleeding Academic Research
Consortium) bleeding. <b><i>Results:</i></b> Out of 2,047 registered
patients, there were 344 (16.8%) with IRF. At the 1-year follow-up, MACE
occurred in 18.6 and 6.2% of those patients with and without IRF,
respectively: adjusted hazard ratio (HR) = 2.13 (95% confidence
interval, CI 1.16-3.91), <i>p</i> = 0.02. IRF patients were also at
higher risk of death and BARC type ≥2 and ≥3 bleeding: adjusted HR =
3.55 (95% CI 1.73-7.27), <i>p</i> = 0.001; HR = 2.75 (95% CI 1.13-6.68), <i>p</i> = 0.03; and HR = 6.02 (95% CI 2.30-15.77), <i>p</i>
< 0.001, respectively. Combined MACE and BARC type ≥2 bleeding
occurred in 34.0 and 14.0% of those with and without IRF, respectively:
adjusted HR = 2.65 (95% CI 1.36-5.16), <i>p</i> = 0.004. At discharge, clopidogrel was more frequently prescribed in IRF patients (61.0 vs. 33.1%, <i>p</i> < 0.001). <b><i>Conclusions:</i></b>
Real-world ACS patients with IRF subjected to PCI demonstrate higher
thrombotic and bleeding risks than patients with normal renal function.</p>
2017-07-27 12:14:23
Cohort study
Percutaneous coronary intervention
Impaired renal function
Ticagrelor
Prasugrel
Clopidogrel