title: Outcomes in patients after myocardial infarction similar to those of the PEGASUS-TIMI 54 trial: A cohort study in the French national claims database.
abstract: OBJECTIVE
  The present study aims to describe real-life outcomes in stable patients after-myocardial infarction (MI) similar to those in the PEGASUS-TIMI 54 trial (PEGASUS), which found long-term benefits of ticagrelor in patients with a history of MI.
  
  
  METHODS
  One-year event-free post-MI patients were identified in the French claims database representative 1/97 sample (2005-2010) and followed for up to 3 years. A PEGASUS-like (PL) population included patients with age ≥ 65 years, or age ≥ 50 and diabetes, renal dysfunction or prior MI, without stroke, end-stage renal failure or oral anticoagulation. Outcomes were: a composite of all-cause death or hospital admission for MI or stroke; individual events; major bleeding.
  
  
  RESULTS
  There were 1585 post-MI patients totalling 3926 person-years including 865 PL patients (2114 PY); 68% were male; mean age was 66 (standard deviation 15) in post-MI, 74 (10) in PL. Outcomes per 100 person-years [95% confidence interval] were, respectively, in post-MI and PL 6.3 [5.6-7.1] and 7.8 [6.7-8.9] for the composite outcome; 5.1 [4.4-5.8] and 6.5 [5.5-7.6] for death; 1.0 [0.7-1.3] and 1.0 [0.6-1.4] for MI; 0.6 [0.4-0.9] and 0.9 [0.5-1.2] for stroke; 1.3 [0.9-1.6] and 1.4 [0.9-1.9] for major bleeding. Event rates were stable over the 3 study years. Placebo patients in the PEGASUS-TIMI54 Study were younger, more often male and had lower event rates, especially for all-cause death and major bleeding.
  
  
  CONCLUSIONS
  Patients selected using the criteria described in PEGASUS were older with more comorbidities, resulting in higher all-cause death and bleeding rates, but similar MI recurrence rates.
authors.affiliation: Bordeaux PharmacoEpi, INSERM CIC1401, Université de Bordeaux, 33076, Bordeaux, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Blin
authors.affiliation: Bordeaux PharmacoEpi, INSERM CIC1401, Université de Bordeaux, 33076, Bordeaux, France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Dureau-Pournin
authors.affiliation: Bordeaux PharmacoEpi, INSERM CIC1401, Université de Bordeaux, 33076, Bordeaux, France.
authors.forename: Régis
authors.initials: R
authors.lastname: Lassalle
authors.affiliation: Bordeaux PharmacoEpi, INSERM CIC1401, Université de Bordeaux, 33076, Bordeaux, France.
authors.forename: Jérémy
authors.initials: J
authors.lastname: Jové
authors.affiliation: AstraZeneca, 92400, Courbevoie, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Thomas-Delecourt
authors.affiliation: Bordeaux PharmacoEpi, INSERM CIC1401, Université de Bordeaux, 33076, Bordeaux, France.
authors.forename: Cécile
authors.initials: C
authors.lastname: Droz-Perroteau
authors.affiliation: Hôpital Européen Georges Pompidou, 75015, Paris, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Danchin
authors.affiliation: Bordeaux PharmacoEpi, INSERM CIC1401, Université de Bordeaux, 33076, Bordeaux, France.|INSERM U1219, 33076, Bordeaux, France.
authors.forename: Nicholas
authors.identifier: http://orcid.org/0000-0003-1212-2817
authors.initials: N
authors.lastname: Moore
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use*; D016208:Databases, Factual; D048909:Diabetes Complications / Q000188:drug therapy; D005260:Female; D005602:France; D006470:Hemorrhage / Q000139:chemically induced / Q000150:complications; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000188:drug therapy; D008297:Male; D009203:Myocardial Infarction / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors
keywords: coronary disease; epidemiology; haemorrhage; myocardial infarction; secondary prevention; stroke