Use of antiplatelet agents in patients after myocardial infarction followed up in Moscow outpatient clinics. Results of a non-interventional prospective study

Abstract

Aim. To assess the rate of adverse cardiovascular events (a combination of non-fatal myocardial infarction (MI), non-fatal stroke, cardiovascular death) within 12 months after MI in patients who were followed up in outpatient clinics in Moscow after the hospital discharge, as well as its association with antiplatelet therapy.Material and methods. This observational multicenter, open-label, prospective study that consecutively included patients after MI and came for further treatment and observation to the clinic after the hospital discharge, subject to providing informed consent. Data were obtained at four scheduled visits (an inclusion visit and 3 follow-up visits — 3, 6 and 12 months after the event). An analysis was carried out in the context of various antiplatelet therapy.Results. The study included 1576 patients in 27 Moscow clinics (mean age, 62,2±11,1 years; men — 69%; ST-segment elevation MI — 57,7%, non-ST elevation MI — 42,3%). At the time of study inclusion, 47,2% of patients received dual antiplatelet therapy with clopidogrel, 4,2% — prasugrel, 48,6% — ticagrelor, with a mean duration of 11,2 months. Incidence of adverse cardiovascular events over 12-month follow-up rate was low and amounted to 3,4% (cumulative incidence, 0,038). This indicator was significantly lower in the subgroup of patients who underwent percutaneous coronary intervention compared with patients who received conservative therapy for MI (p=0,0002).Conclusion. The study demonstrated a low incidence of adverse cardiovascular events over 12 months in patients followed up in outpatient clinics in Moscow after an MI, while percutaneous coronary intervention for MI was associated with a lower incidence of adverse cardiovascular events compared with conservative therapy.