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Risk of infectious events in acute myocardial infarction patients treated with ticagrelor or clopidogrel

  • Cheng-Han Lee
    Affiliations
    Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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  • Hui-Wen Lin
    Affiliations
    Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan

    Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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  • Nan-Yao Lee
    Affiliations
    Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan

    Center for Infection Control, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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  • Sheng-Hsiang Lin
    Correspondence
    Corresponding author at: Institute of Clinical Medicine and Biostatistics Consulting Center, National Cheng Kung University Hospital, 138 Sheng Li Road, Tainan, Taiwan.
    Affiliations
    Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan

    Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan

    Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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  • Yi-Heng Li
    Correspondence
    Corresponding author at: Department of Internal Medicine, National Cheng Kung University Hospital, 138 Sheng Li Road, Tainan, Taiwan.
    Affiliations
    Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Published:November 13, 2020DOI:https://doi.org/10.1016/j.ejim.2020.10.016
      Ticagrelor is an oral direct-acting antiplatelet agent that inhibits P2Y12 receptor activation. The PLATO study showed that ticagrelor significantly reduced the composite outcome of vascular death, myocardial infarction (MI) or stroke compared to clopidogrel in patients with acute coronary syndrome (ACS) [
      • Wallentin L.
      • Becker R.C.
      • Budaj A.
      • et al.
      Ticagrelor versus clopidogrel in patients with acute coronary syndromes.
      ]. Post hoc analysis of the PLATO study demonstrated a lower mortality rate of pneumonia and sepsis in the ticagrelor group [
      • Storey R.F.
      • James S.K.
      • Siegbahn A.
      • et al.
      Lower mortality following pulmonary adverse events and sepsis with ticagrelor compared to clopidogrel in the PLATO study.
      ]. Moreover, a recent study found that ticagrelor possessed direct bactericidal activity against gram positive cocci (GPC) [
      • Lancellotti P.
      • Musumeci L.
      • Jacques N.
      • et al.
      Antibacterial activity of ticagrelor in conventional antiplatelet dosages against antibiotic-resistant gram positive bacteria.
      ]. In mice, the conventional oral antiplatelet dosage of ticagrelor (3 mg/kg loading dose, then 1.5 mg/kg twice daily) could inhibit the growth and dissemination of Staphylococcus aureus [
      • Lancellotti P.
      • Musumeci L.
      • Jacques N.
      • et al.
      Antibacterial activity of ticagrelor in conventional antiplatelet dosages against antibiotic-resistant gram positive bacteria.
      ]. The present study was to assess whether ticagrelor treatment in patients with acute MI would be associated with fewer severe infectious events that need admission compared with clopidogrel users during follow-up after discharge.

      Keywords

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