Antiplatelet Therapy during the First Year after Acute Coronary Syndrome in a Contemporary Italian Community of over 5 Million Subjects

Study type

• Study topic:
  Disease /health condition

  Human medicinal product
• Study type:
  Non-interventional study
• Scope of the study:
  Drug utilisation

  Healthcare resource utilisation
• Data collection methods:
  Secondary use of data

Non-interventional study

• Non-interventional study design:
  Cohort

Study drug and medical condition

• Name of medicine, other:
  Antiplatelets
• Study drug International non-proprietary name (INN) or common name:
  ACETYLSALICYLIC ACID

  CLOPIDOGREL

  PRASUGREL

  TICAGRELOR
• Anatomical Therapeutic Chemical (ATC) code:
  (B01AC04) clopidogrel

  clopidogrel

  (B01AC05) ticlopidine

  ticlopidine

  (B01AC06) acetylsalicylic acid

  acetylsalicylic acid

  (B01AC07) dipyridamole

  dipyridamole

  (B01AC22) prasugrel

  prasugrel

  (B01AC24) ticagrelor

  ticagrelor

  (B01AC30) combinations

  combinations
• Medical condition to be studied:
  Acute coronary syndrome

Population studied

• Age groups:
  All

  Paediatric Population (< 18 years)

  Preterm newborn infants (0 – 27 days)

  Term newborn infants (0 – 27 days)

  Infants and toddlers (28 days – 23 months)

  Children (2 to < 12 years)

  Adolescents (12 to < 18 years)

  Adult and elderly population (≥18 years)

  Adults (18 to < 65 years)

  Adults (18 to < 46 years)

  Adults (46 to < 65 years)

  Elderly (≥ 65 years)

  Adults (65 to < 75 years)

  Adults (75 to < 85 years)

  Adults (85 years and over)

Study design details

• Study design:
  Patients discharged (index date) with ACS diagnosis in 2017 were identified by an algorithm. Patients were characterized by revascularization rates at index date, APT at one month and one year and rehospitalizations and healthcare costs during follow-up.
• Main study objective:
  To investigate apparent discrepancies between guideline-recommended and real-world APT and the implications of such divergences for patients and healthcare systems.
• Setting:
  Inpatient and outpatient
• Summary results:
  From the 2017 ReS database, 7966 (1.46x1000 inhabitants) were discharged alive with an ACS diagnosis. Most were >69 years and male. Of these, 83% (6640/7966) received at least 1 recommended antiplatelet agent within one month (treated group): 23% (1870/7966) as single and 60% (4770/7966) as dual APT. Among the 53% undergoing revascularization, 81% received dual APT at one month. Of the 78% with the same APT at one year, 66% showed appropriate coverage. For subjects treated and untreated with APT at one month, one-year rehospitalization rates were 54% and 66%, respectively, and mean per capita costs were EUR 14,316 and EUR 16,552, respectively (hospitalization driving >80% of costs).

Documents

Study publications

Antiplatelet Therapy during the First Year after Acute Coronary Syndrome in a C…