Keywords : Antiplatelettherapy
Factors Influencing Post-Myocardial Infarction Patients' Utilisation of Dual Antiplatelet Medication over the Long Term: Findings from the Tigris Registry
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 7, Pages 486-494
Background: To outline the current patient profiles and treatment regimens, including antithrombotic care, for post-myocardial infarction (MI) stable coronary artery disease (CAD) patients from various geographical locations who are at high atherothrombotic risk.
Materials and Methods: 25 medical professionals (96% cardiologists) from india (2021-2022) enrolled patients 50 years old with prior MI 1-3 years ago and 1 risk factor (age 65, diabetes, second prior MI>1 yr ago, multivessel CAD, creatinine clearance 15–60 mL/min) in the prospective TIGRIS trial.
Results: 225 post-MI patients were enrolled (median 1.8 years): 52% with prior ST-elevation MI, median age 67, 24% women, 67% caucasian, 55% with 2 additional risk factors, 14% current smokers, 67% overweight/obese, 34% with blood pressure 140/90 mm Hg. 81% of MI patients had PCI (66% with drug-eluting stents). 75% of patients were discharged on dual antiplatelet treatment, mostly clopidogrel (75%). 63% had stopped antiplatelet therapy (1 year) on doctor's advice (90%). At enrollment, 97% were taking an antithrombotic medication, most commonly ASA (88%), with 27% on DAPT (median duration 1.6 years); highest (39%) in Asia-Pacific and lowest (12%) in Europe.
Conclusion: 1 in 4 post-MI patients didn't undergo DAPT for 1 year, despite guidelines. Contrary to guidelines favouring newer ADPris, clopidogrel was given. Prior to current RCT results supporting DAPT>1 year post-MI/PCI, >1 in 4 patients continued on DAPT, despite international variation.