Contemporary antiplatelet therapy and clinical outcomes of japanese patients with acute myocardial infarction ― results from the prospective Japan acute myocardial infarction registry (Jamir)

JAMIR Investigators

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)1633-1643
Number of pages11
JournalCirculation Journal
Volume83
Issue number8
DOIs
Publication statusPublished - 2019

Keywords

  • Acute myocardial infarction
  • Antiplatelet therapy
  • Bleeding events
  • Prasugrel

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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