Prospective Registry of Antithrombotic Therapy in Acute Coronary Syndromes (EPICOR)

Marcelo Trivi, Alejandro Lakowski, Cecilia Zeballos, Ernesto Duronto, Lilia Lobo Márquez, Carlos Rapallo, Juan Fuselli, Gerardo Zapata

Abstract


Objectives: To present the two-year follow-up results of the EPICOR study Argentine cohort, a prospective, international,observational, multicenter registry designed to determine the use of antithrombotic therapy patterns in the routine clinicalpractice of patients with acute coronary syndrome (ACS).Methods: The study enrolled a total of 438 consecutive patients with ST-segment elevation myocardial infarction (STEMI,41%) or non-ST-segment elevation ACS (NSTE ACS, 59%) discharged alive from public, private, and community hospitals.Mean age was 62 years, 76% of patients were male, 71% hypertensive, 64% smokers, 19% diabetic and 40% had history ofprevious cardiovascular disease.Results: Overall mortality was 4.8% at 1 year and 7.3% at 2 years. Use of dual antiplatelet therapy was 80% at one year and53% at 2 years (p<0.0001), with no differences between those with or without ST-segment elevation. The 2-year incidence ofischemic and major bleeding events was 15.3% and 1.8%, respectively.Conclusions: Beyond the one-year administration recommended by the guidelines, a high percentage of persistent dual antiplatelettherapy was observed at 2 years, with a low incidence of major bleeding events, suggesting a clinical risk-benefit selection.

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