Aspirin Combined With Ticagrelor or Clopidogrel in STEMI Patients With Diabetes Mellitus and Poor Glycemic Control Undergoing Primary PCI: A Multicenter Retrospective Cohort Study

Aspirin Combined With Ticagrelor or Clopidogrel in STEMI Patients With Diabetes Mellitus and Poor Glycemic Control Undergoing Primary PCI: A Multicenter Retrospective Cohort StudyDOI: 10.1002/ccd.70503 AbstractBackground: The safety and efficacy of aspirin combined with ticagrelor or clopidogrel remain unclear in ST-segment elevation myocardial infarction (STEMI) patients with Diabetes mellitus (DM) and poor glycemic control.Aims: This study aims to assess the efficacy and safety of ticagrelor versus clopidogrel-based dual antiplatelet therapy in STEMI patients with DM and poor glycemic control undergoing pPCI.Methods: We evaluated 2732 STEMI patients with DM and poor glycemic control who underwent primary percutaneous coronary intervention (pPCI) and were registered in the "Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome (CCC-ACS)" program between November 2014 and December 2019. Using propensity score matching (PSM) and cox proportional hazards regression, we compared the in-hospital risk of major adverse cardiovascular events (MACCE), TIMI bleeding events, and net adverse clinical events (NACE) between patients receiving aspirin combined with either ticagrelor or clopidogrel.Results: After PSM, the risk of in-hospital MACCE (HR = 0.545, 95% CI: 0.321-0.926, p = 0.025), Cardiac death (HR = 0.380, 95% CI: 0.149-0.971, p = 0.043) and NACE (HR = 0.728, 95% CI: 0.560-0.947, p = 0.018) was significantly lower in the ticagrelor group compared with the clopidogrel group(p < 0.05), while no significant difference was observed in the incidence of TIMI-bleeding events between the two groups (p > 0.05).Conclusion: Among STEMI patients with DM and poor glycemic control undergoing pPCI, ticagrelor use was associated with a low rate of MACCE, without an excessive risk of bleeding.Disclaimer:Lupin makes no representation or warranty of any kind, expressed or implied, regarding the accuracy, adequacy, validity, reliability, availability, or completeness of any scientific information shared by the HCP on the ­­­STAR UPDATE podcast. You should not allow the contents of this to substitute for your own medical judgment, which you should exercise in evaluating the information on this website.