Long-term antithrombotic management patterns in Asian patients with acute coronary syndrome: 2-year observations from...

Area of Science:

• Cardiology
• Clinical Research
• Pharmacology

Background:

• Dual antiplatelet therapy (DAPT) is recommended post-acute coronary syndrome (ACS), but real-world adherence and duration in Asia are understudied.
• Antithrombotic management patterns (AMPs) following ACS discharge vary significantly across Asian regions.
• This study addresses the sparse data on long-term DAPT use in Asian ACS populations.

Purpose of the Study:

• To evaluate real-world antithrombotic management patterns (AMPs) up to two years post-discharge for acute coronary syndrome (ACS) in Asia.
• To describe the characteristics and outcomes of patients receiving DAPT for different durations after ACS.
• To identify potential factors influencing prolonged DAPT use in Asian ACS patients.

Main Methods:

• Prospective observational study (EPICOR Asia) including 12,922 patients discharged after ACS from eight Asian countries/regions.
• Follow-up extended to two years, analyzing antithrombotic management patterns (AMPs).
• Exploratory analysis compared patients on DAPT for ≤12 months versus >12 months post-discharge.

Main Results:

• Of 11,639 patients on DAPT at discharge, 20.3% received it for ≤12 months and 79.7% for >12 months.
• Approximately 60% of patients remained on DAPT at the two-year follow-up.
• Patients on DAPT >12 months were younger, more likely to be obese, lower Killip class, from India, and received invasive reperfusion.

Conclusions:

• The majority of ACS patients in Asia continue DAPT for at least one year, aligning with guidelines.
• Over half of ACS patients remain on DAPT at two years post-discharge.
• Patients discontinuing DAPT at 12 months represent a higher-risk group requiring vigilant monitoring.