Risk of ischaemic and haemorrhagic stroke in Chinese undergoing percutaneous coronary intervention treated with potent P2Y12 inhibitor versus clopidogrel  

作　　者：Andrew Kei-Yan Ng Pauline Yeung Ng April Ip Kui Kai Lau Chung-Wah Siu 

机构地区：[1]Cardiac Medical Unit,Grantham Hospital,Hong Kong,Hong Kong [2]Department of Adult Intensive Care,Queen Mary Hospital,Hong Kong,Hong Kong [3]Department of Medicine,The University of Hong Kong,Hong Kong,Hong Kong [4]The State Key Laboratory of Brain and Cognitive Sciences,The University of Hong Kong,Hong Kong,Hong Kong

出　　处：《Stroke & Vascular Neurology》2022年第4期310-318,I0015-I0019,共14页卒中与血管神经病学（英文）

摘　　要：Background Stroke after acute coronary syndrome(ACS)can be devastating.It is uncertain whether the risks of ischaemic stroke or intracranial haemorrhage(ICH)are associated with different choices of P2Y12 inhibitors(potent P2Y12 inhibitors such as ticagrelor and prasugrel vs clopidogrel).Even though East Asians are known to have different thrombotic and haemorrhagic profiles from Caucasians,data on Chinese patients are sparse.Method This was a retrospective cohort study conducting in Chinese patients with ACS who underwent first-ever percutaneous coronary intervention from 14 hospitals in Hong Kong between 2010 and 2017.The primary efficacy endpoint was ischaemic stroke.The secondary efficacy endpoint was a composite outcome of thrombotic events including all-cause mortality,non-fatal myocardial infarction and ischaemic stroke.The primary safety endpoint was ICH.The secondary safety endpoint was a composite of major bleeding events.Results After adjustment of baseline characteristics by 1:1 propensity score matching,a total of 6220 patients(3110 on each group)were analysed.Compared with clopidogrel,potent P2Y12 inhibitors were associated with a lower risk of ischaemic stroke(HR 0.57;95%CI 0.37 to 0.87;p=0.008)and a lower risk of thrombotic events(HR 0.77;95%CI 0.66 to 0.90;p=0.001).Potent P2Y12 inhibitor was associated with similar risk of ICH(HR 0.65;95%CI 0.34 to 1.25,p=0.20)and major bleeding(HR 0.83;95%CI 0.68 to 1.01,p=0.069).Conclusions Potent P2Y12 inhibitors were associated with a lower adjusted risk of ischaemic stroke and thrombotic events,compared with clopidogrel.The risks of ICH and major bleeding were similar.

关 键 词：P2Y12 CORONARY haemorrhagic 

分 类 号：R541.4[医药卫生—心血管疾病] R743.3[医药卫生—内科学]