Switching between thienopyridines in patients with acute myocardial infarction and quality of care - Aix-Marseille Université Accéder directement au contenu
Article Dans Une Revue Open heart Année : 2016

Switching between thienopyridines in patients with acute myocardial infarction and quality of care

Résumé

Objective - In acute coronary syndromes, switching between thienopyridines is frequent. The aims of the study were to assess the association between switching practices and quality of care. Methods - Registry study performed in 213 French public university, public non-academic and private hospitals. All consecutive patients admitted for acute myocardial infarction (MI; <48 hours) between 1/10/2010 and 30/11/2010 were eligible. Clinical and biological data were recorded up to 12 months follow-up. Results - Among 4101 patients receiving thienopyridines, a switch was performed in 868 (21.2%): 678 (16.5%) from clopidogrel to prasugrel and 190 (4.6%) from prasugrel to clopidogrel. Predictors of switch were ST segment elevation MI presentation, admission to a cardiology unit, previous percutaneous coronary intervention, younger age, body weight >60 kg, no history of stroke, cardiac arrest, anaemia or renal dysfunction. In patients with a switch, eligibility for prasugrel was >82% and appropriate use of a switch was 86% from clopidogrel to prasugrel and 20% from prasugrel to clopidogrel. Quality indicators scored higher in the group with a switch and also in centres where the switch rate was higher. Conclusions - As applied in the French Registry on Acute ST-elevation and non ST-elevation Myocardial Infarction (FAST-MI) registry, switching from one P2Y12 inhibitor to another led to a more appropriate prescription and was associated with higher scores on indicators of quality of care.

Dates et versions

hal-01465836 , version 1 (13-02-2017)

Identifiants

Citer

F. Schiele, Etienne Puymirat, Laurent Bonello, Nicolas Meneveau, Jean-Philippe Collet, et al.. Switching between thienopyridines in patients with acute myocardial infarction and quality of care. Open heart, 2016, 3 (1), pp.e000384. ⟨10.1136/openhrt-2015-000384⟩. ⟨hal-01465836⟩
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