Article date: September 2017
By: Patrick Blin, Caroline Dureau‐Pournin, Régis Lassalle, Jérémy Jové, Florence Thomas‐Delecourt, Cécile Droz‐Perroteau, Nicolas Danchin, Nicholas Moore in Volume 83, Issue 9, pages 2056-2065
Aims
The present study aims to describe real‐life outcomes in stable patients after‐myocardial infarction (MI) similar to those in the PEGASUS‐TIMI 54 trial (PEGASUS), which found long‐term benefits of ticagrelor in patients with a history of MI.
Methods
One‐year event‐free post‐MI patients were identified in the French claims database representative 1/97 sample (2005–2010) and followed for up to 3 years. A PEGASUS‐like (PL) population included patients with age ≥ 65 years, or age ≥ 50 and diabetes, renal dysfunction or prior MI, without stroke, end‐stage renal failure or oral anticoagulation. Outcomes were: a composite of all‐cause death or hospital admission for MI or stroke; individual events; major bleeding.
Results
There were 1585 post‐MI patients totalling 3926 person–years including 865 PL patients (2114 PY); 68% were male; mean age was 66 (standard deviation 15) in post‐MI, 74 (10) in PL. Outcomes per 100 person–years [95% confidence interval] were, respectively, in post‐MI and PL 6.3 [5.6–7.1] and 7.8 [6.7–8.9] for the composite outcome; 5.1 [4.4–5.8] and 6.5 [5.5–7.6] for death; 1.0 [0.7–1.3] and 1.0 [0.6–1.4] for MI; 0.6 [0.4–0.9] and 0.9 [0.5–1.2] for stroke; 1.3 [0.9–1.6] and 1.4 [0.9–1.9] for major bleeding. Event rates were stable over the 3 study years. Placebo patients in the PEGASUS‐TIMI54 Study were younger, more often male and had lower event rates, especially for all‐cause death and major bleeding.
Conclusions
Patients selected using the criteria described in PEGASUS were older with more comorbidities, resulting in higher all‐cause death and bleeding rates, but similar MI recurrence rates.
DOI: 10.1111/bcp.13291
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