Southern Saskatchewan Ticagrelor Registry experience

作者：Dehghani Payam^*; Chopra Varun; Bell Ali; Kelly Sheila; Zulyniak Lori; Booker Jeff; Zimmermann Rodney; Semchuk William; Cheema Asim N; Lavoie Andrea J

来源：Patient Preference and Adherence, 2014, 8: 1427-1435.

DOI：10.2147/PPA.S68423

• ticagrelor
• acute coronary syndrome
• registry
• adherence
• compliance
• antiplatelets

Background: As ticagrelor enters into clinical use for acute coronary syndrome, it is important to understand patient/physician behavior in terms of appropriate use, adherence, and event rates. %26lt;br%26gt;Methods: The Southern Saskatchewan Ticagrelor Registry is a prospective, observational, multicenter cohort study that identifies consecutive patients started on ticagrelor. We aimed to evaluate both on-and off-label use, identify characteristics of patients who prematurely stop ticagrelor, and describe patient/physician behavior contributing to inappropriate stoppage of this medication. %26lt;br%26gt;Results: From April 2012 to September 2013, 227 patients were initiated on ticagrelor, with a mean age of 62.2 +/- 12.1 years. The participants were 66% men and had a mean follow up of 157.4 +/- 111.7 days. Seventy-four patients (32.4%) had off-label indications. Forty-seven patients (20.7%) prematurely stopped ticagrelor and were more likely to be older, women, nonwhite, present with shock, and complain of dyspnea. Twenty-six of the 47 patients stopped ticagrelor inappropriately because of patient nonadherence (18 patients) and physician advice (eight patients). A composite outcome event of death from vascular causes, myocardial infarction, or stroke occurred in 8.8% of the entire cohort and was more likely to occur in those older then 65 years, those presenting with cardiogenic shock, and those who prematurely stopped ticagrelor. %26lt;br%26gt;Conclusion: In this real-world registry of patients started on ticagrelor, a third have off-label indications and a fifth prematurely stop the medication. Premature discontinuation was an independent predictor of major life-threatening bleeding and increased composite event rate of death from vascular causes, myocardial infarction, or stroke.

• 出版日期2014
• 单位Saskatchewan