Table 5.
Outcomes of Ticagrelor Versus Clopidogrel According to DM/CKD Status, With Poor Glycemic Control Defined by HbA1c and CKD Defined by the Creatinine‐Cystatin C CKD‐EPI Equation
| DM/CKD Subgroup | Ticagrelor Patients (N) | Clopidogrel Patients (N) | Ticagrelor Event Rate, N (%) | Clopidogrel Event Rate, N (%) | HR (95% CI) | P Value Interaction |
|---|---|---|---|---|---|---|
| Cardiovascular death/MI/stroke | 0.265 | |||||
| DM+/CKD+ | 633 | 631 | 105 (22.66) | 158 (36.57) | 0.68 (0.53–0.88) | |
| DM−/CKD+ | 344 | 390 | 49 (19.68) | 74 (27.22) | 0.77 (0.54–1.11) | |
| DM+/CKD− | 2841 | 2886 | 267 (11.79) | 313 (13.64) | 0.87 (0.74–1.03) | |
| DM−/CKD− | 2877 | 2797 | 191 (8.31) | 201 (8.99) | 0.92 (0.76–1.13) | |
| Cardiovascular death | 0.257 | |||||
| DM+/CKD+ | 633 | 631 | 57 (11.52) | 98 (20.70) | 0.63 (0.45–0.87) | |
| DM−/CKD+ | 344 | 390 | 25 (9.42) | 40 (13.63) | 0.74 (0.45–1.23) | |
| DM+/CKD− | 2841 | 2886 | 103 (4.34) | 112 (4.62) | 0.96 (0.73–1.25) | |
| DM−/CKD− | 2877 | 2797 | 57 (2.39) | 64 (2.75) | 0.87 (0.61–1.24) | |
| MI | 0.734 | |||||
| DM+/CKD+ | 633 | 631 | 53 (11.28) | 77 (17.53) | 0.71 (0.50–1.00) | |
| DM−/CKD+ | 344 | 390 | 29 (11.57) | 40 (14.61) | 0.84 (0.52–1.36) | |
| DM+/CKD− | 2841 | 2886 | 165 (7.24) | 192 (8.31) | 0.87 (0.71–1.08) | |
| DM−/CKD− | 2877 | 2797 | 124 (5.36) | 134 (5.97) | 0.89 (0.70–1.14) | |
| All‐cause death | 0.481 | |||||
| DM+/CKD+ | 633 | 631 | 68 (13.75) | 106 (22.39) | 0.70 (0.51–0.95) | |
| DM−/CKD+ | 344 | 390 | 28 (10.55) | 44 (14.99) | 0.74 (0.46–1.20) | |
| DM+/CKD− | 2841 | 2886 | 113 (4.76) | 125 (5.15) | 0.94 (0.73–1.21) | |
| DM−/CKD− | 2877 | 2797 | 64 (2.68) | 81 (3.48) | 0.77 (0.56–1.07) | |
| Stroke | 0.293 | |||||
| DM+/CKD+ | 633 | 631 | 15 (3.08) | 12 (2.57) | 1.33 (0.62–2.85) | |
| DM−/CKD+ | 344 | 390 | 5 (1.90) | 6 (2.06) | 0.95 (0.29–3.12) | |
| DM+/CKD− | 2841 | 2886 | 33 (1.40) | 41 (1.70) | 0.82 (0.52–1.30) | |
| DM−/CKD− | 2877 | 2797 | 29 (1.22) | 17 (0.73) | 1.67 (0.92–3.05) | |
| Major bleeding | 0.143 | |||||
| DM+/CKD+ | 633 | 631 | 74 (20.61) | 74 (20.51) | 1.03 (0.75–1.42) | |
| DM−/CKD+ | 344 | 390 | 43 (23.41) | 43 (19.59) | 1.12 (0.74–1.71) | |
| DM+/CKD− | 2841 | 2886 | 307 (16.44) | 322 (16.72) | 0.97 (0.83–1.14) | |
| DM−/CKD− | 2877 | 2797 | 272 (14.15) | 212 (10.97) | 1.28 (1.07–1.54) | |
| Non‐CABG‐related major bleeding | 0.782 | |||||
| DM+/CKD+ | 633 | 631 | 48 (12.89) | 40 (10.69) | 1.29 (0.84–1.96) | |
| DM−/CKD+ | 344 | 390 | 23 (12.06) | 21 (9.15) | 1.36 (0.75–2.45) | |
| DM+/CKD− | 2841 | 2886 | 93 (4.71) | 87 (4.23) | 1.12 (0.84–1.50) | |
| DM−/CKD− | 2877 | 2797 | 95 (4.71) | 66 (3.29) | 1.39 (1.02–1.91) | |
The model is adjusted for age, sex, BMI, heart rate, prior myocardial infarction, hypertension, dyslipidemia, angina pectoris, smoking status, previous PCI or CABG, type of ACS, and randomized treatment. ACS indicates acute coronary syndrome; BMI, body mass index; CABG, coronary artery bypass graft; CKD, chronic kidney disease; CKD‐EPI, chronic kidney disease epidemiology collaboration; DM, diabetes mellitus; HR, hazard ratio; MI, myocardial infarction; PCI, percutaneous coronary intervention.