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首页> 外文期刊>The American Journal of Cardiology >Ninety-Day Readmission and Long-Term Mortality in Medicare Patients (= 65 Years) Treated With Ticagrelor Versus Prasugrel After Percutaneous Coronary Intervention (from the Blue Cross Blue Shield of Michigan Cardiovascular Consortium)
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Ninety-Day Readmission and Long-Term Mortality in Medicare Patients (= 65 Years) Treated With Ticagrelor Versus Prasugrel After Percutaneous Coronary Intervention (from the Blue Cross Blue Shield of Michigan Cardiovascular Consortium)

机译：Medicare患者的90天升级和长期死亡率（＆ = 65岁）用冠状动脉介入后用TicagreloR与普拉布雷治疗（来自密歇根心血管联盟的蓝色交叉蓝盾）

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Ticagrelor and prasugrel were found to be superior to clopidogrel for the treatment of acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI); however, the comparative effectiveness of these 2 drugs remains unknown. We compared postdischarge outcomes among older patients treated with ticagrelor versus prasugrel after PCI for ACS. We linked clinical data from PCIs performed in older patients (age = 65) for ACS at 47 Michigan hospitals to Medicare fee-for-service claims from January 1, 2013, to December 31, 2014, to ascertain rates of 90-day readmission and long-term mortality. We used propensity score matching to adjust for the nonrandom use of ticagrelor and prasugrel at discharge. Logistic regression and Cox proportional hazards models were used to compare rates of 90-day readmission and long-term mortality, respectively. Patients discharged on ticagrelor (n = 1,243) were more frequently older, female, had a history of cerebrovascular disease, and presented with ST- or non-ST-elevation myocardial infarction compared with prasugrel (n = 1,014). After matching (n = 756 per group), there were no significant differences in the rates of 90-day readmission (16.7% ticagrelor vs 14.6% prasugrel; adjusted odds ratio 1.15, 95% confidence interval 0.86 to 1.55, p = 0.35) or 1-year mortality (5.4% ticagrelor vs 3.7% prasugrel; hazard ratio 1.3, 95% confidence interval 0.8 to 2.2, p = 0.31). In conclusion, we found no significant differences in the rates of 90-day readmission or longterm mortality between older patients treated with ticagrelor and patients treated with prasugrel after PCI for ACS. In the absence of randomized data to the contrary, these 2 treatments appear similarly effective. (C) 2017 Elsevier Inc. All rights reserved.
机译：发现TiCagrelor和Prasugrel优于氯吡格雷，用于治疗经皮冠状动脉介入（PCI）后急性冠状动脉综合征（ACS）;然而，这两种药物的比较有效性仍然未知。我们比较了在PCI对ACS的PCI后用TicagreloLor对普拉布雷治疗的老年患者的后收费结果。我们将来自老年患者（年龄＆ = 65）的PCIS的临床资料联系在2013年1月1日至2014年12月31日，以47密歇根州医院的ACS为医疗保险服务索赔，以确定90天的费率再入院和长期死亡率。我们使用倾向评分匹配来调整非random使用TicagreloLor和Prasugrel放电。物流回归和Cox比例危险模型分别比较了90天的阅览和长期死亡率。在TiCagreloLOR（n = 1,243）上的患者更频繁，女性，患有脑血管疾病的历史，并与PRASUGRL（n = 1,014）相比呈现ST或非ST-EXT-EXT-EXT-EXT-EXT-EXT-EXT-EXVATION心肌梗死。匹配后（每组n = 756），90天即将入院的速率没有显着差异（16.7％Ticagrelor vs 14.6％prasugrel;调整后的赔率比1.15,95％置信区间0.86至1.55，p = 0.35）或1年死亡率（5.4％Ticagrelor Vs 3.7％普拉什拉;危险比1.3,95％置信区间0.8至2.2，P = 0.31）。总之，我们发现，在治疗促粘剂和PCI后对ACS后普拉布雷治疗的患者治疗的患者的患者患者的90天休息或长期死亡率没有显着差异。在没有随机数据的情况下，这2种治疗似乎类似地有效。 （c）2017年Elsevier Inc.保留所有权利。

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