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Contemporary use of ticagrelor in patients with acute coronary syndrome: insights from Swedish Web System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies (SWEDEHEART)
Natl Heart Ctr Singapore, 5 Hosp Dr, Singapore 169609, Singapore.;Karolinska Inst, Karolinska Univ Hosp, Cardiol Sect, Dept Med, S-14186 Stockholm, Sweden..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
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2016 (English)In: EUROPEAN HEART JOURNAL-CARDIOVASCULAR PHARMACOTHERAPY, ISSN 2055-6837, Vol. 2, no 1, 5-12 p.Article in journal (Refereed) Published
Abstract [en]

The platelet inhibitor ticagrelor is strongly recommended during 12 months post-acute coronary syndrome (ACS) in European guidelines. We analysed clinical characteristics of patients given ticagrelor for ACS in the real world. We studied the use of ticagrelor in patients admitted for ACS in Sweden between 1 January 2012 and 31 December 2013 who were enrolled in the Swedish Web system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies (SWEDEHEART). Clinical characteristics were investigated for patients prescribed ticagrelor at discharge as well as for patients undergoing percutaneous coronary intervention who were prescribed ticagrelor. Independent factors associated with selecting ticagrelor were analysed in logistic regression. We found that 44.0% (n = 12 601) out of a total of 28 639 patients had been prescribed ticagrelor at discharge. After adjusting for age and sex, prior cardiovascular disease was less common in patients discharged on ticagrelor (myocardial infarction, ischaemic stroke, and peripheral vascular disease; P for all < 0.001). The risk of death as predicted by GRACE score and the risk of major bleeding as predicted by CRUSADE score were both lower in ticagrelor-treated patients vs. others (median 99 vs. 126 and median 23 vs. 25, respectively; P for both < 0.001). The intended treatment duration at discharge was 12 months in 82.5% of patients and < 12 months in 9.3%. Ticagrelor is preferentially being used in patients at lower risk. A minority of patients are recommended ticagrelor during < 12 months.

Place, publisher, year, edition, pages
2016. Vol. 2, no 1, 5-12 p.
Keyword [en]
Acute coronary syndrome, P2Y12 antagonist, Ticagrelor
National Category
Cardiac and Cardiovascular Systems
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URN: urn:nbn:se:uu:diva-308368DOI: 10.1093/ehjcvp/pvv034ISI: 000383330500003PubMedID: 27533056OAI: oai:DiVA.org:uu-308368DiVA: diva2:1049687
Available from: 2016-11-25 Created: 2016-11-25 Last updated: 2016-11-25Bibliographically approved

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Varenhorst, ChristophRenlund, HenrikWallentin, LarsJames, Stefan K.
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UCR-Uppsala Clinical Research CenterDepartment of Medical SciencesCardiology
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