Background Prasugrel and ticagrelor are new antiplatelet agents developed for patients with Acute Coronary Syndrome (ACS) and high risk of thrombosis. Their benefits in terms of mortality and major cardiovascular events have been well established, but some concerns remain regarding their safety.
Purpose To analyse antiplatelet prescriptions focusing on new drugs and with a subgroup analysis (diabetes, renal function, age, weight, risk of haemorrhage).
Materials and methods A retrospective observational study was carried out in our healthcare area from January to June 2013. Patients included had ACS and required antiplatelet therapy. Demographic and clinical data were obtained from electronic medical records (Historia de Salud, PowerChart-Millennium and Intensive Care Unit programme). The CRUSADE scale was used to calculate the bleeding risk.
Results 379 patients were included (72.8% male, mean age 64.9 ± 12.8 years, 134 patients diagnosed with ST-Segment Elevation Myocardial Infarction and 245 with Non-ST Elevation Myocardial Infarction). During hospitalisation, 350 patients received clopidogrel and only 52 were treated with new drugs (29 with prasugrel and 23 ticagrelor); 37 of these received clopidogrel initially and then switched to a new drug. 9 deaths occurred during hospitalisation. At discharge, 280 patients continued with dual antiplatelet therapy (239 with clopidogrel and aspirin (AAS), 27 with prasugrel-AAS and 15 with ticagrelor-AAS), 81 with single treatment (64 with AAS and 17 with clopidogrel) and 9 interrupted the treatment. See Subgroup analysis on patients with dual therapy in Table 1.
Conclusions Use of new antiplatelet drugs in our healthcare area is still moderate. They are prescribed only in selected cases with low bleeding risk. The results show only a disposition towards prescribing prasugrel for diabetic patients according to the clinical trials results, but not in other subgroups that can benefit from new drugs.
No conflict of interest.
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