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Clinical Drug Investigation

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07-02-2024 | Ticagrelor | Original Research Article

Effect of Ticagrelor versus Clopidogrel on All-Cause and Cardiovascular Mortality in Acute Coronary Syndrome Patients with Hyperuricemia

Authors: Shanshan Nie, Yuhang Zhao, Zeying Feng, Chan Zou, Fangfang Ding, Liying Gong, Hongwei Lu, Yu Cao, Guoping Yang

Published in: Clinical Drug Investigation | Issue 3/2024

Abstract

Background and Objective

The relationship between hyperuricemia and mortality in patients with acute coronary syndrome (ACS) is considerably controversial. Additionally, the strategy of dual antiplatelet therapy (DAPT) has not been evaluated in patients with ACS with hyperuricemia. This study aims to evaluate the impact of hyperuricemia on the prognosis of ACS and explore the efficacy of ticagrelor compared with clopidogrel in patients with hyperuricemia.

Methods

The study enrolled 4319 patients divided into hyperuricemia (HUA, n = 1060) and normouricemia (NUA, n = 3259) groups. The inverse probability of treatment weighting (IPTW)-adjusted Cox regression analysis was used to evaluate the impact of ticagrelor versus clopidogrel on all-cause and cardiovascular mortality.

Results

Hyperuricemia significantly increased the risk of all-cause death compared with patients with NUA at 7 days [adjusted hazard ratio (HR): 4.292, 95% confidence interval (CI) 1.727–10.67]; P = 0.002), 14 days (adjusted HR: 2.871, 95% CI 1.326–6.219; P = 0.0074), 30 days (adjusted HR: 2.168, 95% CI 1.056–4.453; P = 0.035), 3 months (adjusted HR: 2.018, 95% CI 1.152–3.533; P = 0.0144) and 1 year (adjusted HR: 1.702, 95% CI 1.137–2.548; P = 0.009). No significant difference was found between ticagrelor and clopidogrel in 1-year all-cause mortality [7.0% versus 5.5%, adjusted HR: 1.114 (95% CI 0.609–2.037), P = 0.725] among patients with concomitant hyperuricemia.

Conclusion

Hyperuricemia was independently related to an increased risk of all-cause and cardiovascular death in patients with ACS undergoing PCI. At 1-year follow-up, there were no significant differences between ticagrelor and clopidogrel concerning all-cause and cardiovascular death in patients with hyperuricemia.

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Title: Effect of Ticagrelor versus Clopidogrel on All-Cause and Cardiovascular Mortality in Acute Coronary Syndrome Patients with Hyperuricemia
Authors: Shanshan Nie
Yuhang Zhao
Zeying Feng
Chan Zou
Fangfang Ding
Liying Gong
Hongwei Lu
Yu Cao
Guoping Yang
Publication date: 07-02-2024
Publisher: Springer International Publishing
Keywords: Ticagrelor
Clopidogrel
Acute Coronary Syndrome
Published in: Clinical Drug Investigation / Issue 3/2024
Print ISSN: 1173-2563
Electronic ISSN: 1179-1918
DOI: https://doi.org/10.1007/s40261-024-01342-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Effect of Ticagrelor versus Clopidogrel on All-Cause and Cardiovascular Mortality in Acute Coronary Syndrome Patients with Hyperuricemia

Abstract

Background and Objective

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background and Objective

Methods

Results

Conclusion

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