Ticagrelor and the risk of infections during hospitalization in patients with ST-elevation myocardial infarction undergoing percutaneous coronary intervention

作者：Lian, Xing-Ji; Dai, Yi-Ning; Xue, Jin-Hua; Zeng, Li-Huan; Wang, Li-Tao; Xue, Ling; Chen, Ji-Yan; Tan, Ning; He, Peng-Cheng^*; Liu, Yuan-Hui^*; Duan, Chong-Yang^*

来源：Atherosclerosis, 2021, 331: 6-11.

DOI：10.1016/j.atherosclerosis.2021.06.924

• Ticagrelor
• Clopidogrel
• ST-elevation myocardial infarction
• Percutaneous coronary intervention
• Infection
• Prognosis

Background and aims: Although ticagrelor exerts an antibacterial activity, its effect on infections in patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI) is unclear. We aimed to assess whether ticagrelor and clopidogrel affect infections in these patients during hospitalization. @@@ Methods: A total of 2116 consecutive patients with STEMI undergoing PCI were divided into the ticagrelor (n = 388) and clopidogrel (n = 1728) groups. The primary outcome was infection onset. Secondary outcomes were in-hospital all-cause death and major adverse cardiovascular and cerebrovascular events (MACCE). Propensity score analyses were conducted to test the robustness of the results. @@@ Results: Infections developed in 327 (15.4%) patients. There was no significant difference in infection between both groups (ticagrelor vs. clopidogrel: 13.1% vs. 16.0%, p = 0.164). Patients in the ticagrelor group had lower rates of in-hospital all-cause death and MACCE than patients in the clopidogrel group. Multivariate logistic regression analysis determined that ticagrelor and clopidogrel had a similar preventive effect on infections during hospitalization (adjusted odds ratio [OR] = 1.20; 95% confidence interval [CI] = 0.80-1.78, p = 0.380). Compared to the patients treated with clopidogrel, patients treated with ticagrelor had a slightly lower risk of other outcomes, but no statistical difference. Propensity score analyses demonstrated similar results for infections and other outcomes. @@@ Conclusions: Compared with clopidogrel treatment, ticagrelor treatment did not significantly alter the risk of infections during hospitalization among STEMI patients undergoing PCI, but was associated with a slightly lower risk of in-hospital all-cause death and MACCE.

• 单位
  广东省心血管病研究所; 南方医科大学; 广东省人民医院; 1; 中山大学