Department of Cardiology, Peking University First Hospital, Beijing, China
National Center for Cardiovascular Diseases, Fuwai Hospital, Beijing, China
Department of Cardiology, Zhongshan Hospital Affiliated to Fudan University, Guangzhou, China
Department of Cardiology, the General Hospital of Shenyang Military, Shenyang, China
Department of Cardiology, Guangdong General Hospital, Guangzhou, China
Department of Cardiology, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
Department of Cardiology, the Second Affiliated Hospital of Harbin Medical University, Harbin, China
Funds:
Editorial assistance was provided by Isuru Wijesoma from MediTech Media (Singapore), which was funded by Astra-Zeneca in accordance with Good Publication Practice (GPP3) guidelines
Objective To describe the long-term antithrombotic management patterns (AMPs) and clinical outcomes of Chinese patients with acute coronary syndrome (ACS). Methods This was an observational, multicenter, longitudinal cohort extension study of Chinese patients who had completed the EPICOR Asia 2-year follow-up study post-hospitalization for an ACS event. Changes in AMP and clinical outcomes for up to 5 years post-ACS event were evaluated. Results Overall, 2334 patients with ACS were enrolled at 49 sites. The mean age was 61.6 years and 76.3% were men. By study end, 2093 patients completed the 3-year follow-up. At baseline (2 years post-ACS event), 72.4% of patents received one antiplatelet (AP) medication, with aspirin being the preferred one. A small proportion of patients (21.5%) was treated with two or more APs (2+ AP), and even fewer patients (6.1%) did not receive any AP medication at baseline. Upon study completion, the proportion of patients without AP therapy increased to 13.6%, while the percentage of patients on one AP and 2+ AP decreased to 69.3% and 17.1%, respectively. Numerically, a higher incidence of clinical events (composite of all-cause mortality, myocardial infarction, stroke) was observed for the 2+ AP (13.2%) subgroup than for the no AP (10.5%) and one AP (8.6%) subgroups. Furthermore, the 2+ AP subgroup exhibited the greatest number of bleeding events, outpatient visits, and hospitalization rates. Unlike myocardial infarction or stroke, bleeding events prompted an adjustment in AMP. Conclusion Most patients in China received at least one AP medication up to 5 years after an ACS event.