Table 3. Major Adverse Coronary Events Within 1 Year After Percutaneous Coronary Intervention for Acute Coronary Syndrome Based on Adherence, Persistence, and Switching of Study P2Y12 Inhibitor.
| Characteristic | MACE, No./Total No. (%) | HR (95% CI)a | ||
|---|---|---|---|---|
| Full Cohort (N = 11 185) | Clopidogrel Group (n = 7109) | Ticagrelor Group (n = 4076) | Ticagrelor vs Clopidogrel | |
| Adherence | ||||
| MRA ≥80% | 881/8584 (10.3) | 550/5256 (10.5) | 311/3328 (9.9) | 1.00 (0.86-1.16) |
| MRA <80% | 366/2601 (14.1) | 278/1853 (15.0) | 88/748 (11.8) | 0.88 (0.68-1.14) |
| MRA ≥80% vs <80%, HR (95% CI)a | 0.79 (0.69-0.90)b | 0.77 (0.66-0.89)b | 0.86 (0.67-1.11) | NA |
| Persistence | ||||
| Yes | 697/6765 (10.3) | 433/4186 (10.3) | 264/2579 (10.2) | 1.02 (0.87-1.20) |
| No | 550/4420 (12.4) | 395/2923 (13.5) | 155/1497 (10.4) | 0.89 (0.73-1.09) |
| Persistent vs nonpersistent, HR (95% CI)a | 0.90 (0.80-1.01) | 0.85 (0.74-0.98)b | 1.01 (0.81-1.24) | NA |
| Switchc | ||||
| Yes | NA | 6/92 (6.5) | 47/521 (9.0) | 1.49 (0.62-3.61) |
| No | NA | 752/6947 (10.8) | 322/3505 (9.2) | 0.98 (0.86-1.12) |
| Switch vs no switch, HR (95% CI)a | NA | 0.56 (0.25-1.25) | 0.88 (0.65-1.20) | NA |
Abbreviations: HR, hazard ratio; MACE, major adverse coronary event; MRA, medication refill adherence; NA, not applicable.
a
Adjusted for age, sex, prior percutaneous coronary intervention, diabetes, hyperlipidemia, coronary anatomy, drug-eluting stent, hemoglobin, creatinine, and proton pump inhibitor use.
b
Statistically significant results.
c
Excludes switches occurring after MACE event.