Safety and efficacy of tegoprazan in patients treated with dual antiplatelet therapy after coronary stenting for acute myocardial infarction

초록

This study compared the efficacy and safety of tegoprazan versus proton-pump inhibitors (PPIs) for gastrointestinal (GI) protection in patients receiving dual antiplatelet therapy (DAPT) after undergoing percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI). Using a Korean Nationwide database (March 2019 to September 2022), 21,276 patients treated with tegoprazan (n = 2,075) or PPIs (n = 19,201) in combination with DAPT after PCI for AMI were analyzed. The primary efficacy endpoint was GI bleeding at 1 year, and the primary safety endpoint was major adverse cardiac and cerebrovascular events (MACCE), defined as a composite of myocardial infarction or stroke. In the crude cohort, tegoprazan was associated with a lower risk of GI bleeding and major bleeding with similar MACCEs rates at 1 year compared to PPIs. After propensity-score matching, tegoprazan was consistently associated with lower risks of GI 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), without increasing the risk of MACCEs (HR 0.86, 95% CI 0.59-1.26, P = 0.45) at 1 year. In patients with AMI treated with DAPT, tegoprazan was associated with a significantly lower GI bleeding risk versus PPIs, without increasing ischemic events.

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