TY - JOUR
T1 - Contemporary antiplatelet therapy and clinical outcomes of japanese patients with acute myocardial infarction ― results from the prospective Japan acute myocardial infarction registry (Jamir)
AU - JAMIR Investigators
AU - Yasuda, Satoshi
AU - Honda, Satoshi
AU - Takegami, Misa
AU - Nishihira, Kensaku
AU - Kojima, Sunao
AU - Asaumi, Yasuhide
AU - Suzuki, Makoto
AU - Kosuge, Masami
AU - Takahashi, Jun
AU - Sakata, Yasuhiko
AU - Takayama, Morimasa
AU - Sumiyoshi, Tetsuya
AU - Ogawa, Hisao
AU - Kimura, Kazuo
N1 - Funding Information:
This work was planned by the Japan Cardiovascular Research Foundation and is financially supported by Daiichi Sankyo Co., Ltd.
Funding Information:
Sankyo, and Bristol-Myers Squibb, and trust research/joint research funds from Takeda and Daiichi Sankyo; Dr. Takayama reports lecture fees from Daiichi Sankyo; Dr. Ogawa reports lecture fees and research grants from AstraZeneca, Bayer, Boehringer Ingelheim, Daiichi Sankyo, Pfizer, and Sanofi. No of the other authors have any conflicts of interest to declare.
Publisher Copyright:
© 2019, Japanese Circulation Society. All rights reserved.
PY - 2019
Y1 - 2019
N2 - Background: Antiplatelet therapy is the corner stone of treatment following acute myocardial infarction (AMI). Prasugrel, a new and potent antiplatelet agent, was recently introduced to clinical practice. We compared the clinical outcomes of patients with AMI treated with prasugrel with those treated with clopidogrel in real-world clinical practice in Japan. Methods and Results: The Japan AMI Registry (JAMIR) is a multicenter, nationwide, prospective registry enrolling patients with AMI from 50 institutes. Between December 2015 and May 2017, a total of 3,411 patients were enrolled. Among them, 3,069 patients were treated with either prasugrel (n=2,607) or clopidogrel (n=462) during hospitalization. Median follow-up period was 12 months. Prasugrel-treated patients were predominantly male, younger, more often showed ST-elevation AMI, and had fewer comorbidities. After adjustment using inverse probability of treatment weighting, the primary endpoint, defined as a composite of cardiovascular death, non-fatal MI and non-fatal stroke, was comparable between the prasugrel and clopidogrel groups (adjusted hazard ratio [HR] 1.07, 95% confidence interval [CI] 0.67–1.72), whereas the risk of major bleeding (BARC type 3 or 5 bleeding) was significantly lower in the prasugrel group (adjusted HR 0.62, 95% CI 0.39–0.99). Conclusions: The present real-world database of the JAMIR demonstrated that the potent P2Y12-inhibitor prasugrel showed comparable rates of 1-year ischemic events to clopidogrel, but the risk of bleeding was lower with prasugrel than with clopidogrel.
AB - Background: Antiplatelet therapy is the corner stone of treatment following acute myocardial infarction (AMI). Prasugrel, a new and potent antiplatelet agent, was recently introduced to clinical practice. We compared the clinical outcomes of patients with AMI treated with prasugrel with those treated with clopidogrel in real-world clinical practice in Japan. Methods and Results: The Japan AMI Registry (JAMIR) is a multicenter, nationwide, prospective registry enrolling patients with AMI from 50 institutes. Between December 2015 and May 2017, a total of 3,411 patients were enrolled. Among them, 3,069 patients were treated with either prasugrel (n=2,607) or clopidogrel (n=462) during hospitalization. Median follow-up period was 12 months. Prasugrel-treated patients were predominantly male, younger, more often showed ST-elevation AMI, and had fewer comorbidities. After adjustment using inverse probability of treatment weighting, the primary endpoint, defined as a composite of cardiovascular death, non-fatal MI and non-fatal stroke, was comparable between the prasugrel and clopidogrel groups (adjusted hazard ratio [HR] 1.07, 95% confidence interval [CI] 0.67–1.72), whereas the risk of major bleeding (BARC type 3 or 5 bleeding) was significantly lower in the prasugrel group (adjusted HR 0.62, 95% CI 0.39–0.99). Conclusions: The present real-world database of the JAMIR demonstrated that the potent P2Y12-inhibitor prasugrel showed comparable rates of 1-year ischemic events to clopidogrel, but the risk of bleeding was lower with prasugrel than with clopidogrel.
KW - Acute myocardial infarction
KW - Antiplatelet therapy
KW - Bleeding events
KW - Prasugrel
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U2 - 10.1253/circj.CJ-19-0145
DO - 10.1253/circj.CJ-19-0145
M3 - Article
C2 - 31204353
AN - SCOPUS:85070011095
VL - 83
SP - 1633
EP - 1643
JO - Circulation Journal
JF - Circulation Journal
SN - 1346-9843
IS - 8
ER -