Zhang Shuning, Wang Wei, Sawhney Jitendra P S, Krittayaphong Rungroj, Kim Hyo-Soo, Nhan Vo Thanh, Lee Stephen W-L, Ong Tiong Kiam, Chin Chee Tang, Pocock Stuart J, Huo Yong, Qian Juying, Ge Junbo
Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China.
Sir Ganga Ram Hospital, New Delhi, India.
Int J Cardiol. 2020 Jul 1;310:16-22. doi: 10.1016/j.ijcard.2020.01.008. Epub 2020 Mar 17.
Cardiovascular diseases account for approximately half of all deaths in Asia. The present analysis aimed to evaluate characteristics, antithrombotic management patterns (AMPs), and outcomes in patients with acute coronary syndrome (ACS) who underwent in-hospital percutaneous coronary intervention (PCI) and survived to hospital discharge, using data from the EPICOR Asia registry (NCT01361386).
Two-year post-discharge follow-up data were analyzed from 8757 ACS PCI patients from EPICOR Asia (218 centers, eight countries). Major adverse cardiovascular events (MACE; death, non-fatal myocardial infarction [MI], non-fatal ischemic stroke), PCI characteristics, and AMPs were recorded. For MACE, time - to - event was analyzed using Cox regression.
Primary PCI was performed in 62.0% of ST-segment elevation MI (STEMI), 38.7% of non-STEMI (NSTEMI), and 24.2% of unstable angina (UA) patients. At 12 months, 88.1% of patients were on dual antiplatelet therapy (DAPT), with no differences by index event. Most (61.5%) still received DAPT at 2 years. Two-year incidences of mortality, composite MACE, and bleeding were 3.6%, 6.2%, and 6.6%, respectively. Risk of death and MACE was increased with STEMI and NSTEMI vs. UA. Patients from East Asia showed lower mortality and more bleeding vs. Southeast Asia/India.
Many patients in EPICOR Asia underwent PCI and received DAPT up to 2 years post-discharge. These real-world findings improve our understanding of AMP impact on outcomes in Asian patients with ACS undergoing PCI.
心血管疾病约占亚洲所有死亡人数的一半。本分析旨在利用亚太地区急性冠脉综合征注册研究（NCT01361386）的数据，评估住院期间接受经皮冠状动脉介入治疗（PCI）并存活至出院的急性冠脉综合征（ACS）患者的特征、抗栓治疗模式（AMPs）和预后。
对亚太地区急性冠脉综合征注册研究（218个中心，8个国家）的8757例ACS PCI患者出院后两年的随访数据进行分析。记录主要不良心血管事件（MACE；死亡、非致死性心肌梗死[MI]、非致死性缺血性卒中）、PCI特征和AMPs。对于MACE，使用Cox回归分析事件发生时间。
62.0%的ST段抬高型心肌梗死（STEMI）、38.7%的非ST段抬高型心肌梗死（NSTEMI）和24.2%的不稳定型心绞痛（UA）患者接受了直接PCI。在12个月时，88.1%的患者接受双联抗血小板治疗（DAPT），不同索引事件之间无差异。大多数患者（61.5%）在2年时仍接受DAPT。两年的死亡率、复合MACE和出血发生率分别为3.6%、6.2%和6.6%。与UA相比，STEMI和NSTEMI患者的死亡和MACE风险增加。与东南亚/印度相比，东亚患者的死亡率较低，但出血较多。
亚太地区急性冠脉综合征注册研究中的许多患者接受了PCI，并在出院后长达2年的时间内接受了DAPT。这些真实世界的研究结果有助于我们更好地理解AMPs对接受PCI的亚洲ACS患者预后的影响。
