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Longer-term oral antiplatelet use in stable post-myocardial infarction patients: Insights from the long Term rIsk, clinical manaGement and healthcare Resource utilization of stable coronary artery dISease (TIGRIS) observational study.

Publication ,  Journal Article
Goodman, SG; Nicolau, JC; Requena, G; Maguire, A; Blankenberg, S; Chen, JY; Granger, CB; Grieve, R; Pocock, SJ; Simon, T; Yasuda, S; Vega, AM ...
Published in: International journal of cardiology
June 2017

To describe contemporary patient characteristics and treatment patterns, including antithrombotic management, of post-myocardial infarction (MI) stable coronary artery disease (CAD) patients at high atherothrombotic risk from different geographical regions.Patients ≥50years with prior MI 1-3years ago and ≥1 risk factor (age ≥65years, diabetes, 2nd prior MI >1yr ago, multivessel CAD, creatinine clearance 15-<60ml/min) were enrolled by 369 physicians (96% cardiologists) in 25 countries (2013-14) in the prospective TIGRIS study (NCT01866904).9225 patients were enrolled (median 1.8years) post-MI: 52% with prior ST-elevation MI, median age 67years, 24% women, 67% Caucasian, 55% had ≥2 additional qualifying risk factors, 14% current smokers, 67% overweight/obese, 34% with blood pressure ≥140/90mmHg. 81% underwent percutaneous coronary intervention (PCI; 66% with drug-eluting stents) for the index MI. 75% of patients had been discharged on dual antiplatelet therapy (DAPT; acetylsalicylic acid [ASA]+ADP receptor inhibitor [ADPri]), mainly clopidogrel (75%). 63% had discontinued antiplatelet treatment (60% ADPri) around 1year, most commonly by physician recommendation (90%). At enrolment, 97% were taking an antithrombotic drug, most commonly ASA (88%), with 27% on DAPT (median duration 1.6years); continued DAPT >1year was highest (39%) in Asia-Pacific and lowest (12%) in Europe.Despite guideline recommendations, 1 in 4 post-MI patients did not receive DAPT for ~1year. In contrast to guideline recommendations supporting newer ADPris, clopidogrel was mainly prescribed. Prior to recent RCT data supporting DAPT >1year post-MI/PCI, >1 in 4 patients have continued on DAPT, though with substantial international variability.

Duke Scholars

Published In

International journal of cardiology

DOI

EISSN

1874-1754

ISSN

0167-5273

Publication Date

June 2017

Volume

236

Start / End Page

54 / 60

Related Subject Headings

  • Ticlopidine
  • ST Elevation Myocardial Infarction
  • Risk Factors
  • Practice Guidelines as Topic
  • Platelet Aggregation Inhibitors
  • Percutaneous Coronary Intervention
  • Outcome Assessment, Health Care
  • Middle Aged
  • Male
  • Long Term Adverse Effects
 

Citation

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ICMJE
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Goodman, S. G., Nicolau, J. C., Requena, G., Maguire, A., Blankenberg, S., Chen, J. Y., … TIGRIS Study Investigators, . (2017). Longer-term oral antiplatelet use in stable post-myocardial infarction patients: Insights from the long Term rIsk, clinical manaGement and healthcare Resource utilization of stable coronary artery dISease (TIGRIS) observational study. International Journal of Cardiology, 236, 54–60. https://doi.org/10.1016/j.ijcard.2017.02.062
Goodman, Shaun G., Jose C. Nicolau, Gema Requena, Andrew Maguire, Stefan Blankenberg, Ji Yan Chen, Christopher B. Granger, et al. “Longer-term oral antiplatelet use in stable post-myocardial infarction patients: Insights from the long Term rIsk, clinical manaGement and healthcare Resource utilization of stable coronary artery dISease (TIGRIS) observational study.International Journal of Cardiology 236 (June 2017): 54–60. https://doi.org/10.1016/j.ijcard.2017.02.062.
Goodman SG, Nicolau JC, Requena G, Maguire A, Blankenberg S, Chen JY, Granger CB, Grieve R, Pocock SJ, Simon T, Yasuda S, Vega AM, Brieger D, TIGRIS Study Investigators. Longer-term oral antiplatelet use in stable post-myocardial infarction patients: Insights from the long Term rIsk, clinical manaGement and healthcare Resource utilization of stable coronary artery dISease (TIGRIS) observational study. International journal of cardiology. 2017 Jun;236:54–60.
Journal cover image

Published In

International journal of cardiology

DOI

EISSN

1874-1754

ISSN

0167-5273

Publication Date

June 2017

Volume

236

Start / End Page

54 / 60

Related Subject Headings

  • Ticlopidine
  • ST Elevation Myocardial Infarction
  • Risk Factors
  • Practice Guidelines as Topic
  • Platelet Aggregation Inhibitors
  • Percutaneous Coronary Intervention
  • Outcome Assessment, Health Care
  • Middle Aged
  • Male
  • Long Term Adverse Effects