Safety and effectiveness of tegoprazan in patients treated with dual antiplatelet therapy after drug-eluting stent implantation for acute myocardial infarction
Abstract
Abstract Background Data on the interactions between P2Y12 inhibitors and tegoprazan are limited. This study compared the effects of tegoprazan and proton-pump inhibitors (PPIs) on clinical outcomes in patients receiving dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) with drug-eluting stents (DES) for acute myocardial infarction (AMI). Methods Using the nationwide claims-based databases of the National Health Insurance Service (NHIS) from March 2019 to September 2022, we retrospectively analyzed 21,276 patients treated with either tegoprazan (n = 2,075) or PPIs (n = 19,201) combination with DAPT after PCI for AMI. The primary safety outcomes were gastrointestinal bleeding and major bleeding at one year, while the primary effectiveness outcomes included myocardial infarction and stroke. Net adverse clinical evpents (NACE), defined as composite of major bleeding, myocardial infarction and stroke, were also assessed. Results The mean age was 65.2 ± 12.6 years and 75.8% were male. In a propensity-matched cohort, compared with PPIs, tegoprazan was associated with a lower risk of gastrointestinal bleeding (hazard ratio [HR] 0.72, 95% confidence interval [CI] 0.54-0.98, P=0.04) and major bleeding (HR 0.69, 95% CI 0.49-0.98, P=0.04), while the risks of myocardial infarction (HR 0.83, 95% CI 0.53-1.31, P=0.43) and stroke (HR 0.95, 95% CI 0.47-1.94, P=0.89) were similar. NACE was lower in the tegoprazan group (HR 0.75, 95% CI 0.58-0.97, P=0.03).…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 21,276 participants or records.
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