Open AccessCombined glycoprotein IIb/IIIa inhibitor therapy with ticagrelor for patients with acute coronary syndrome
Author(s) -
Zhi-Jiang Xie,
Shuanli Xin,
Chao Chang,
Haijing Zhou,
Xiufeng Zhao,
Feng-Hui Jiao,
Chuan Chen,
Tao Li
Publication year - 2021
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0246166
Subject(s) - ticagrelor , medicine , mace , acute coronary syndrome , myocardial infarction , cardiogenic shock , cardiology , stroke (engine) , combination therapy , thrombosis , clopidogrel , stent , percutaneous coronary intervention , mechanical engineering , engineering
This study was to compare the efficacy and safety of combined glycoprotein IIb/IIIa inhibitor (GPI) and ticagrelor versus ticagrelor in patients with acute coronary syndrome (ACS). An observational study was conducted using the Improving Care for Cardiovascular Disease in China-ACS project. Totally, 13,264 patients with ACS and received combination therapy or ticagrelor therapy were analyzed. The primary outcome was the composite of major cardiovascular events (MACE: all-cause mortality, myocardial infarction [MI], stent thrombosis, cardiogenic shock, and ischemic stroke), and secondary outcomes included all-cause mortality, MI, stent thrombosis, cardiogenic shock, and ischemic stroke. The multivariable adjusted analysis indicated that combination therapy was associated with an increased risk of major cardiovascular events (MACE) ( P = 0.001), any bleeding ( P <0.001), and major bleeding ( P = 0.005). Moreover, the multivariable adjusted for propensity score-matched (PSM) analysis suggested that combination therapy produced additional risk of MACE ( P = 0.014), any bleeding ( P <0.001), and major bleeding ( P = 0.005). Moreover, PSM analysis suggested that combination therapy was associated with greater risk of stent thrombosis ( P = 0.012) and intracranial bleeding ( P = 0.020). Combined GPI and ticagrelor therapies did not have any beneficial effects on MACE, stent thrombosis, intracranial bleeding, any bleeding, or major bleeding.