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P2Y12 Inhibitors Reduce Post-PCI Risk of Death

New treatment seems particularly beneficial for STEMI patients

THURSDAY, Aug. 26 (HealthDay News) -- New P2Y12 inhibitors are associated with improved outcomes after percutaneous coronary intervention (PCI) compared with clopidogrel, and appear especially beneficial for ST-segment elevation myocardial infarction (STEMI) patients, according to research published online Aug. 25 in the Journal of the American College of Cardiology.

Anne Bellemain-Appaix, M.D., of the Assistance Publique-Hôpitaux de Paris, and colleagues studied data from eight randomized, placebo-controlled trials, including a total of 48,599 patients, that compared new P2Y12 inhibitors with clopidogrel to determine the effectiveness of the former in improving clinical outcomes after PCI. Ninety-four percent of the patients had acute coronary syndrome, and 84 percent underwent PCI.

The researchers found that new P2Y12 inhibitors decreased mortality significantly for the whole cohort (odds ratio [OR], 0.83), for any PCI (OR, 0.85), and for PCI for STEMI (OR, 0.78). In PCI patients, new P2Y12 inhibitors significantly decreased major adverse cardiac events and stent thrombosis by 18 and 40 percent, respectively. The researchers observed a significant increase in major bleeding with P2Y12 inhibitors for any PCI, but they found no difference in bleeding complications in PCI for STEMI, and there were similar outcomes in primary PCI for STEMI.

"New P2Y12 inhibitors decrease mortality after PCI compared with clopidogrel. The risk/benefit ratio is particularly favorable in PCI for STEMI patients," the authors write.

Several authors disclosed financial relationships with pharmaceutical and/or medical device companies.

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