Category Ranking
98%
Total Visits
921
Avg Visit Duration
2 minutes
Citations
20
Article Abstract
Background Prior reports indicate that the effect of P2Y inhibitors may be different in East Asian patients ("East Asian paradox"); therefore, understanding the outcomes associated with potent P2Y inhibitors in different populations is clinically important. Methods and Results In this observational cohort study using administrative healthcare data sets, we compared safety and effectiveness of contemporary P2Y inhibitors in patients with acute coronary syndrome. The primary safety outcomes were major and any bleeding, and the primary effectiveness outcomes were major cardiovascular events (a composite of cardiovascular death, myocardial infarction, or stroke) and all-cause mortality. Among 70 715 patients with acute coronary syndrome, 56 216 (79.5%) used clopidogrel, 11 402 (16.1%) used ticagrelor, and 3097 (4.4%) used prasugrel. The median follow-up period was 18.0 months (interquartile range: 9.6-26.4 months). In a propensity-matched cohort, compared with clopidogrel, ticagrelor was associated with a higher risk of any bleeding (hazard ratio: 1.23; 95% CI, 1.14-1.33) but a lower risk of mortality (hazard ratio: 0.76; 95% CI, 0.63-0.91). Prasugrel, compared with clopidogrel, was associated with higher risks of any bleeding (hazard ratio: 1.23; 95% CI, 1.06-1.43) and major bleeding (hazard ratio: 1.50; 95% CI, 1.01-2.21) but a similar risk of effectiveness outcomes. No significant difference was noted between ticagrelor and prasugrel with respect to key safety or effectiveness outcomes. Several sensitivity analyses showed similar results. Conclusions In East Asian patients with acute coronary syndrome, compared with clopidogrel, ticagrelor was associated with an increased risk of bleeding but a decreased risk of mortality. Prasugrel was associated with an increase of any bleeding without difference in effectiveness outcomes. The risks of bleeding and ischemic events were similar between ticagrelor and prasugrel.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6662138 | PMC |
| http://dx.doi.org/10.1161/JAHA.119.012078 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Hypoxic stress dysregulates functions of glioma-associated myeloid cells through epigenomic and transcriptional programs.
Cell Rep
September 2025
Laboratory of Molecular Neurobiology, Nencki Institute of Experimental Biology Polish Academy of Sciences, Pasteur St. 3, Warsaw 02-093, Poland; Laboratory of Tumour Hypoxia and Epigenomics, Nencki Institute of Experimental Biology Polish Academy of Sciences, Pasteur St. 3, Warsaw 02-093, Poland. El
Hypoxia is a key histopathological feature of glioblastoma, associated with tumor aggressiveness and therapy resistance. Glioma-associated microglia and macrophages (GAMs) are key players in the tumor microenvironment of glioblastoma and acquire immunosuppressive properties during tumor progression. We show that hypoxia alters key GAM identity genes, as it upregulates the expression of monocytic marker lectin galactoside-binding doluble 3 (Lgals3) and downregulates the homeostatic microglial markers purinergic receptor P2Y G-protein coupled 12 (P2ry12) and transmembrane protein 119 (Tmem119) in GAMs co-cultured with glioma cells and in glioblastoma patients' samples.
View Article and Find Full Text PDFBackground: In the presence of a potent P2Yinhibitor such as prasugrel, the additional clinical antithrombotic benefit of aspirin is unclear. The feasibility of prasugrel monotherapy without aspirin after percutaneous coronary intervention (PCI) has been demonstrated in chronic coronary syndrome, but is yet to be assessed in patients with non-ST elevation acute coronary syndrome (NSTE-ACS) and low anatomical complexity.
Methods And Results: ASET-Japan is a single-arm study investigating the safety of prasugrel 12-month monotherapy with a locally approved dose (loading 20 mg; maintenance 3.
Design, Synthesis and Anti-Inflammation Evaluation of -Acyl Tryptophan Derivatives as Promising P2YR Antagonists Against Lipopolysaccharide-Induced Acute Lung Injury.
Drug Des Devel Ther
August 2025
Henan Provincial Key Laboratory of Pediatric Hematology, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou University, Zhengzhou, Henan, People's Republic of China.
Purpose: The P2Y receptor (P2YR) is closely associated with several inflammatory diseases in humans. Although several P2YR antagonists have been reported to date, few have been successfully developed as therapeutic drugs, and none have entered clinical trials. We aimed to obtain P2YR antagonists with high antagonistic activity and druggability for further investigation into anti-inflammatory drugs.
View Article and Find Full Text PDFAntiplatelet Monotherapies for Long-Term Secondary Prevention Following Percutaneous Coronary Intervention.
J Clin Med
August 2025
Division of Cardiology, University of Florida College of Medicine, Jacksonville, FL 32209, USA.
In patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI), antiplatelet therapy is the cornerstone of treatment for secondary prevention. Although dual antiplatelet therapy (DAPT) consisting of aspirin and a P2Y inhibitor is the current standard of care, being, respectively, recommended for 6 and 12 months in patients with chronic and acute coronary syndrome without a need for oral anticoagulation, the continuous improvement in PCI technology and pharmacology have significantly reduced the need for long-term DAPT. Mounting evidence supports the administration of P2Y inhibitor monotherapy, particularly ticagrelor, after a short period of DAPT following PCI as a strategy to reduce bleeding without a trade-off in ischemic events compared to standard DAPT.
View Article and Find Full Text PDFShort DAPT After PCI for ACS: Which Monotherapy Is Better Between Aspirin or a P2Y Inhibitor?
JACC Cardiovasc Interv
August 2025
Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.