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Long-term risk, clinical management, and healthcare resource utilization of stable patients with coronary artery disease and post-myocardial infarction in Greece-TIGREECE study

Background: In light of the scarcity of evidence, TIGREECE evaluated the clinical management and long-term outcomes of patients at high risk for an atherothrombotic event who have suffered a myocardial infarction (MI), managed by cardiologists/internists in routine hospital and private office settings in Greece.

Methods: TIGREECE, a multicenter, 3-year prospective cohort study, enrolled patients ≥50 years old, with a history of MI 1-3 years before enrollment, and with at least one of the following risk factors: age ≥65 years, diabetes mellitus requiring medication, second prior MI, multivessel coronary artery disease, and creatinine clearance 15-60 mL/min. The primary outcome was a composite of MI, unstable angina with urgent revascularization, stroke, or all-cause death.

Results: Between 05-June-2014 and 25-July-2015, 305 eligible consented patients (median age: 67.3 years; 81.3% males; 14.8% active smokers; 80.7% overweight/obese) were enrolled; 52.5% had ≥2 qualifying risk factors. The median time from the index MI [ST-segment elevation myocardial infarction (STEMI) in 51.1%, non-STEMI in 33.1%] to enrollment was 1.7 years. Of the patients, 65.9% had been discharged on dual antiplatelet therapy. At enrollment, 94.4% were receiving antiplatelets: 60.0% single [acetylsalicylic acid (ASA): 43.3%; clopidogrel: 15.7%], 34.4% dual (ASA+clopidogrel: 31.8%) therapy. The Kaplan-Meier estimated 3-year primary composite event rate was 9.3% (95% CI: 6.4-13.0) and the ischemic composite event rate was 6.7% (95% CI: 4.2-9.9).

Conclusions: Study results indicate that in the routine care of Greece one in ten patients experience a recurring CV event or death, mainly of ischemic origin, 1-3 years post-MI.

Comments:

The study TIGREECE found that one in ten patients at high risk for an atherothrombotic event experience a recurring cardiovascular event or death, mainly of ischemic origin, 1-3 years post-myocardial infarction in the routine care of Greece.

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S1415 Clopidogrel (SR-25990C) Bisulfate Clopidogrel (SR-25990C) Bisulfate is an oral, thienopyridine class antiplatelet agent.

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P2 Receptor