Why the study?
In patients undergoing recent PCI, poor adherence to antiplatelet agents may increase the risk of stent thrombosis and death.
What are the rates and predictors of adherence to P2Y12 receptor inhibitors in patients after PCI with drug-eluting stents?
What are the rates and predictors of adherence to P2Y12 receptor inhibitors in patients after PCI with drug-eluting stents?
A substantial proportion of patients exhibit low to moderate adherence to P2Y12 inhibitors early after PCI, highlighting the need for adherence monitoring, particularly in smokers and those with prior cardiovascular disease.
May support adherence monitoring post-PCI; leaves open whether targeting smoking and preexisting CVD improves P2Y12 inhibitor adherence.
Introduction/Objectives: In patients who have undergone recent percutaneous coronary intervention (PCI), poor adhesion to antiplatelet agents may increase the risk of stent thrombosis and death. We aimed to investigate the adherence to different P2Y12 receptor inhibitors after PCI with drug-eluting stent in stable and unstable patients and to evaluate the factors associated with low adherence. Method: In a prospective study conducted between 2014 and 2018, the 8-item Morisky scale was applied at 30 days and 6 months post-PCI to measure P2Y12 receptor inhibitors adherence. Also, we describe the characteristics of patients using different platelet receptor P2Y12 inhibitors. Regression models were used to identify predictors of poor adherence. Results: A total of 214 patients were included (65 ± 12 years, 81% man, 61% acute coronary syndromes). Patients in the clopidogrel group were older than those in the prasugrel (68 ± 12 vs 59 ± 11 years, P < .01, respectively) or ticagrelor group (68 ± 12 vs 62 ± 12 years, P < .01). Patients with low/moderate adherence at 30 days and 6 months represented, respectively, 19.8% and 27.5% of our sample. Current smokers and preexisting cardiovascular disease at presentation were associated with lower adherence at 30 days. Conclusions: We found substantial rates of moderate and low adherence to P2Y12 receptor inhibitors early after PCI. Current smokers and preexisting cardiovascular disease at presentation were associated with a lower likelihood of adherence. These results highlight the need of monitoring adherence to medical treatment after PCI.
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Morita et al. (2020) studied this question.
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