Patterns and Outcomes of Dual Antiplatelet Therapy in Elderly Patients with Acute Coronary Syndrome at Maharaj Nakorn Chiang Mai Hospital
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Abstract
It is unclear whether antiplatelets are of benefit to older patients who are at high risk for both ischemia and bleeding. The aims of this study were to explore the prescription patterns of antiplatelet therapy and to evaluate efficacy and safety outcomes in elderly patients with acute coronary syndrome (ACS) at Maharaj Nakorn Chiang Mai Hospital. Methodology: This retrospective cohort study collected data from medical records of elderly patients aged 70 years or older with ACS who visited Maharaj Nakorn Chiang Mai Hospital between May 1st, 2020 and May 31st,2021. Pattern of dual antiplatelet therapy was the primary endpoint, while efficacy outcome (all-cause mortality, myocardial infarction and stroke) and safety outcome (Bleeding Academic Research Consortium (BARC) criteria) were the secondary ones. Data analysis included descriptive statistics (frequency, mean and standard deviation) and inferential statistics using Fisher’s exact test and independent t-test. Result: A total of 72 elderly patients with ACS were included, of whom 38 (66.7%) were prescribed aspirin with ticagrelor. The overall incidence of efficacy outcome was 2.78 %. The efficacy outcome occurred in 4.17% of patients who received aspirin with clopidogrel versus 2.08% of those who received aspirin with ticagrelor. There was no statistically significant difference in efficacy outcomes between the two groups (p-value = 1.000). The overall incidence of safety outcome was 11.11%. No significant difference in safety outcomes was observed between the clopidogrel group (4.17%) and the ticagrelor group (14.58%) (p-value = 0.255). Conclusion: The most common antiplatelet prescription patterns in elderly patients with ACS was aspirin with ticagrelor. There was no statistically significant difference in efficacy and safety outcome between aspirin- clopidogrel and aspirin- ticagrelor groups.
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