期刊
ATHEROSCLEROSIS
卷 331, 期 -, 页码 6-11出版社
ELSEVIER IRELAND LTD
DOI: 10.1016/j.atherosclerosis.2021.06.924
关键词
Ticagrelor; Clopidogrel; ST-elevation myocardial infarction; Percutaneous coronary intervention; Infection; Prognosis
资金
- National Science Foundation for Young Scientists of China [81800325, 81803327]
- Shuangqing Talent Program Project of Guangdong Provincial people's Hospital [KJ012019095, KJ012019084]
- High-level Hospital Construction Project [DFJH2020021]
The study compared the effects of ticagrelor and clopidogrel on infections among STEMI patients undergoing PCI, finding similar preventive effects on infections but slightly lower risks of in-hospital all-cause death and MACCE in the ticagrelor group.
Background and aims: Although ticagrelor exerts an antibacterial activity, its effect on infections in patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI) is unclear. We aimed to assess whether ticagrelor and clopidogrel affect infections in these patients during hospitalization. Methods: A total of 2116 consecutive patients with STEMI undergoing PCI were divided into the ticagrelor (n = 388) and clopidogrel (n = 1728) groups. The primary outcome was infection onset. Secondary outcomes were in-hospital all-cause death and major adverse cardiovascular and cerebrovascular events (MACCE). Propensity score analyses were conducted to test the robustness of the results. Results: Infections developed in 327 (15.4%) patients. There was no significant difference in infection between both groups (ticagrelor vs. clopidogrel: 13.1% vs. 16.0%, p = 0.164). Patients in the ticagrelor group had lower rates of in-hospital all-cause death and MACCE than patients in the clopidogrel group. Multivariate logistic regression analysis determined that ticagrelor and clopidogrel had a similar preventive effect on infections during hospitalization (adjusted odds ratio [OR] = 1.20; 95% confidence interval [CI] = 0.80-1.78, p = 0.380). Compared to the patients treated with clopidogrel, patients treated with ticagrelor had a slightly lower risk of other outcomes, but no statistical difference. Propensity score analyses demonstrated similar results for infections and other outcomes. Conclusions: Compared with clopidogrel treatment, ticagrelor treatment did not significantly alter the risk of infections during hospitalization among STEMI patients undergoing PCI, but was associated with a slightly lower risk of in-hospital all-cause death and MACCE.
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