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Updated: Feb 9, 2026
Acute Myocardial Infarction in Rats
Published on: February 16, 2011
Ticagrelor Use in Acute Myocardial Infarction: Insights From the National Cardiovascular Data Registry
Sukhdeep S Basra1, Tracy Y Wang2, DaJuanicia N Simon2
1Center for Advanced Heart Failure, University of Texas Health Science Center at Houston, TX.
Insights
Ticagrelor use increased in acute myocardial infarction patients, with most receiving low-dose aspirin. Factors influencing ticagrelor and high-dose aspirin use were identified.
Area of Science:
- Cardiology
- Pharmacology
- Clinical Research
Background:
- Ticagrelor, a P2Y12 inhibitor, offers superior efficacy over clopidogrel but may have reduced efficacy with high-dose aspirin.
- Understanding current prescribing trends and patient factors is crucial for optimizing antiplatelet therapy.
Purpose of the Study:
- To evaluate temporal trends in P2Y12 inhibitor prescription, specifically ticagrelor, in acute myocardial infarction (AMI) patients.
- To identify factors associated with ticagrelor use and high-dose aspirin prescription at discharge.
Main Methods:
- Analysis of the ACTION Registry-Get With The Guidelines (GWTG) database (October 2013-December 2014) including 167,455 AMI patients.
- Examined temporal trends and independent factors for ticagrelor use and high-dose aspirin use among patients discharged on ticagrelor and aspirin.
Main Results:
- Ticagrelor prescription at discharge significantly increased (12% to 16.7%), while prasugrel and clopidogrel use decreased.
- Younger age, white race, and invasive management were associated with ticagrelor use over clopidogrel.
- High-dose aspirin was prescribed to 3.1% of patients on ticagrelor, with factors like diabetes and prior myocardial infarction associated with its use.
Conclusions:
- A modest but significant increase in ticagrelor use was observed in AMI patients.
- High adherence to low-dose aspirin use at discharge was noted, suggesting appropriate management of dual antiplatelet therapy.
Background:
Ticagrelor is a P2Y12 receptor inhibitor with superior clinical efficacy compared with clopidogrel. However, it is associated with reduced efficacy when combined with a high-dose aspirin.
Methods And Results:
Patients in the acute coronary treatment and intervention outcomes network (ACTION) Registry-Get With The Guidelines (GWTG) with acute myocardial infarction from October 2013 through December 2014 were included in the study (167 455 patients; 622 sites). We evaluated temporal trends in the prescription of P2Y12 inhibitors, and identified factors associated with ticagrelor use at discharge. Among patients discharged on ticagrelor and aspirin (21 262 patients), we evaluated the temporal trends and independent factors associated with high-dose aspirin prescription at discharge. Ticagrelor prescription at discharge increased significantly from 12% to 16.7% (P<0.0001). Decreases in prasugrel and clopidogrel use at discharge (15.7%-13.9% and 54.2%-51.1%, respectively, P<0.0001) were also observed. Independent factors associated with preferential ticagrelor prescription at discharge over clopidogrel included younger age, white race, home ticagrelor use, invasive management, and in-hospital re-infarction and stroke (P<0.0001 for all), whereas older age, female sex, prior stroke, home ticagrelor use, and in-hospital stroke (P<0.0001 for all) were associated with preferential ticagrelor prescription at discharge over prasugrel. High-dose aspirin was used in 3.1% of patients discharged on ticagrelor. Independent factors associated with high-dose aspirin prescription at discharge included home aspirin use, diabetes mellitus, previous myocardial infarction, previous coronary artery bypass graft, ST-segment-elevation myocardial infarction, cardiogenic shock, and geographic region (P=0.01).
Conclusions:
Our contemporary analysis shows a modest but significant increase in the use of ticagrelor and a high rate of adherence to the use of low-dose aspirin at discharge.
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