P2Y12 Inhibitor Selection and Ischemic Outcomes in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention: A Real-World Registry Analysis

Figures

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  FIG. 1. Flow chart of the study population.

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  FIG. 2. Covariate balance before and after inverse probability of treatment weighting (IPTW). IPTW substantially improved covariate balance, with most variables achieving an absolute standardized mean difference <0.10 after weighting. Abbreviations are as defined in Table 1.

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  FIG. 3. Weighted cumulative incidence curves for ischemic clinical outcomes after inverse probability of treatment weighting (IPTW). Weighted cumulative incidence curves are shown for (A) major adverse cardiovascular events and (B) target vessel failure according to P2Y12 inhibitor type in the ACS population.

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  FIG. 4. Subgroup analyses for major adverse cardiovascular events (MACE) according to ischemic- and bleeding-risk features. Forest plots show the association between ticagrelor use and MACE compared with clopidogrel across prespecified subgroups. (A) Subgroup analysis according to high ischemic-risk features, including diabetes mellitus, left ventricular ejection fraction (LVEF) <40%, anemia, ST-segment elevation myocardial infarction (STEMI), multivessel disease, and complex percutaneous coronary intervention (PCI). (B) Subgroup analysis according to high bleeding-risk features, including age ≥75 years, estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2, eGFR <30 mL/min/1.73 m2, hemoglobin <11 g/dL, and previous stroke. Hazard ratios (HR) and 95% confidence interval (CI) are for ticagrelor versus clopidogrel. p-values for interaction were calculated using Cox proportional hazards models including treatment group, subgroup, and treatment-by-subgroup interaction terms.