Dyspnea in patients treated with P2Y12receptor antagonists: insights from the GReek AntiPlatElet (GRAPE) registry.
In 'real life' acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI) and receiving contemporary antiplatelet treatment, data on dyspnea occurrence and impact on persistence with treatment are scarce. In a prospective, multicenter, cohort study, ACS patients undergoing PCI were recruited into the GReekAntiPlatElet (GRAPE) registry. During 1-year follow up, overall, 249/1989 (12.5%) patients reported dyspnea, more frequently at 1-month and decreasing thereafter. Multivariate analysis showed that ticagrelor administration (n = 738) at discharge was associated with the occurrence of dyspnea: Odds ratio 2.46 (95% confidence interval, CI, 1.87-3.25), p < 0.001. Older age, lower hematocrit, and prior bleeding event were also associated with dyspnea reports. Persistence, switching, and cessation rates were 68.3%, 20.9%, and 10.8% vs 76.7%, 12.5%, and 10.9% among patients reporting dyspnea compared with those who did not, p for trend = 0.002. In conclusion, in ACS patients undergoing PCI and treated with a P2Y12receptor antagonist, dyspnea occurs commonly, particularly when ticagrelor is administered. Non-persistence with antiplatelet agents at discharge is more frequently observed among dyspnea-reporters.
a Department of Cardiology , Patras University Hospital , Patras , Greece.|b Department of Cardiology , Attikon University Hospital, Athens, Greece , Athens , Greece.
Dimitrios
D
Alexopoulos
a Department of Cardiology , Patras University Hospital , Patras , Greece.
Ioanna
I
Xanthopoulou
a Department of Cardiology , Patras University Hospital , Patras , Greece.
Angelos
A
Perperis
c Department of Cardiology , Ioannina University Hospital , Ioannina , Greece.
John
J
Goudevenos
d Department of Cardiology , Iraklion University Hospital , Iraklion , Greece.
Michalis
M
Hamilos
e Department of Cardiology , Larissa University Hospital, Larissa , Greece.
George
G
Sitafidis
f Department of Clinical Therapeutics , "Alexandra" University Hospital , Athens , Greece.
Ioannis
I
Kanakakis
g 1st University Department of Cardiology, Ippokration Hospital , Athens , Greece.
Manolis
M
Vavouranakis
b Department of Cardiology , Attikon University Hospital, Athens, Greece , Athens , Greece.|h Department of Cardiology , Athens General Hospital "G. Gennimatas" , Athens , Greece.
George
G
Giannopoulos
a Department of Cardiology , Patras University Hospital , Patras , Greece.
Nikolaos
N
Barampoutis
b Department of Cardiology , Attikon University Hospital, Athens, Greece , Athens , Greece.|h Department of Cardiology , Athens General Hospital "G. Gennimatas" , Athens , Greece.
Spyridon
S
Deftereos
b Department of Cardiology , Attikon University Hospital, Athens, Greece , Athens , Greece.
John
J
Lekakis
D054058:Acute Coronary Syndrome / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery; D000241:Adenosine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D004417:Dyspnea; D005260:Female; D006115:Greece; D006400:Hematocrit; D006470:Hemorrhage / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D062645:Percutaneous Coronary Intervention; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D000068799:Prasugrel Hydrochloride / Q000008:administration & dosage / Q000009:adverse effects*; D011446:Prospective Studies; D058921:Purinergic P2Y Receptor Antagonists / Q000008:administration & dosage / Q000009:adverse effects*; D012042:Registries; D012307:Risk Factors; D000077486:Ticagrelor; D013988:Ticlopidine / Q000008:administration & dosage / Q000009:adverse effects*
D010975:Platelet Aggregation Inhibitors; D058921:Purinergic P2Y Receptor Antagonists; D000068799:Prasugrel Hydrochloride; D000077486:Ticagrelor; D000241:Adenosine; D013988:Ticlopidine
Acute coronary syndrome; P2Y12 receptor antagonist; dyspnea; persistence