MPC Member Publications

This database contains a listing of population studies publications written by MPC Members. Anyone can add a publication by an MPC student, faculty, or staff member to this database; new citations will be reviewed and approved by MPC administrators.

Full Citation

Title: Comparative Effectiveness of Ticagrelor, Prasugrel, and Clopidogrel for Secondary Prophylaxis in Acute Coronary Syndrome: A Propensity Score-Matched Cohort Study

Citation Type: Journal Article

Publication Year: 2023

ISSN: 1532-6535

DOI: 10.1002/CPT.2797

PMID: 36399019

Abstract: Comparative effectiveness evaluation of newer P2Y12 inhibitors (prasugrel and ticagrelor) compared with clopidogrel after acute coronary syndrome (ACS) is limited in real-world US populations. The objective of this study was to evaluate cardiovascular events based on ticagrelor, prasugrel, and clopidogrel use in a real-world patient setting. This retrospective cohort study used the IBM MarketScan database (January 1, 2013, to December 31, 2018) to create three propensity score-matched pairs: ticagrelor vs. clopidogrel (N = 21,719), prasugrel vs. clopidogrel (N = 11,513), and prasugrel vs. ticagrelor (N = 11,065). The primary outcome was a composite of myocardial ischemia, unstable angina, stroke, and heart failure hospitalization. These groups were compared in a time-to-event analysis for the primary outcome at 30, 90, and 180 days following P2Y12 inhibitors initiation after percutaneous coronary intervention. Compared with clopidogrel, ticagrelor use suggested a 10% reduction in the primary outcome at 90 days (hazard ratio (HR): 0.90, 95% confidence interval (CI): 0.82–0.99). There were no differences for all other matched pairs or follow-up combinations. In the subgroup analysis of females, the results suggested a risk reduction of 27% for prasugrel at 30 days (HR: 0.73, 95% CI: 0.53–1.00) and 17% for ticagrelor at 90 days (HR: 0.83, 95% CI: 0.70–0.98) when compared with clopidogrel. Among patients treated with bare-metal stents, the results suggested that prasugrel vs. ticagrelor was associated with a 55% and 33% reduced risk for the primary outcome at 30 days and 180 days, respectively. With limited evidence in the United States comparing these drugs, this study helps inform clinicians when choosing P2Y12 inhibitors after ACS.

Url: https://onlinelibrary.wiley.com/doi/full/10.1002/cpt.2797

Url: https://onlinelibrary.wiley.com/doi/abs/10.1002/cpt.2797

Url: https://ascpt.onlinelibrary.wiley.com/doi/10.1002/cpt.2797

User Submitted?: No

Authors: Kumar, Arun; Lutsey, Pamela L.; St Peter, Wendy L.; Schommer, Jon C.; Van't Hof, Jeremy R.; Rajpurohit, Abhijeet; Farley, Joel F.

Periodical (Full): Clinical Pharmacology & Therapeutics

Issue: 2

Volume: 113

Pages: 401-411

Countries:

IPUMS NHGIS NAPP IHIS ATUS Terrapop