Platelets (Oct 2017)

Dyspnea in patients treated with P2Y12 receptor antagonists: insights from the GReek AntiPlatElet (GRAPE) registry

  • Dimitrios Alexopoulos,
  • Ioanna Xanthopoulou,
  • Angelos Perperis,
  • John Goudevenos,
  • Michalis Hamilos,
  • George Sitafidis,
  • Ioannis Kanakakis,
  • Manolis Vavouranakis,
  • George Giannopoulos,
  • Nikolaos Barampoutis,
  • Spyridon Deftereos,
  • John Lekakis

DOI
https://doi.org/10.1080/09537104.2016.1265919
Journal volume & issue
Vol. 28, no. 7
pp. 691 – 697

Abstract

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In ‘real life’ acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI) and receiving contemporary antiplatelet treatment, data on dyspnea occurrence and impact on persistence with treatment are scarce. In a prospective, multicenter, cohort study, ACS patients undergoing PCI were recruited into the GReekAntiPlatElet (GRAPE) registry. During 1-year follow up, overall, 249/1989 (12.5%) patients reported dyspnea, more frequently at 1-month and decreasing thereafter. Multivariate analysis showed that ticagrelor administration (n = 738) at discharge was associated with the occurrence of dyspnea: Odds ratio 2.46 (95% confidence interval, CI, 1.87–3.25), p < 0.001. Older age, lower hematocrit, and prior bleeding event were also associated with dyspnea reports. Persistence, switching, and cessation rates were 68.3%, 20.9%, and 10.8% vs 76.7%, 12.5%, and 10.9% among patients reporting dyspnea compared with those who did not, p for trend = 0.002. In conclusion, in ACS patients undergoing PCI and treated with a P2Y12 receptor antagonist, dyspnea occurs commonly, particularly when ticagrelor is administered. Non-persistence with antiplatelet agents at discharge is more frequently observed among dyspnea-reporters.

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