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For this purpose 571 consecutive ACS patients receiving ticagrelor (n\u2009=\u2009258, 45%) or prasugrel (n\u2009=\u2009313, 55%) undergoing PCI were enrolled in this prospective, observational, multicenter ATLANTIS-SWITCH substudy. Predictors of premature discontinuation or switch of antiplatelet therapy and their association with major adverse cardiovascular events and TIMI bleeding events were evaluated. Premature stop\/switch was found in 72 (12.6%) patients: 34 (5.9%) stopped and 38 (6.7%) switched the ADP blocker. Ticagrelor treated patients were significantly more likely to stop\/switch therapy as compared to prasugrel (15.9% vs. 9.2%, <jats:italic>p<\/jats:italic>\u2009=\u20090.016). We identified 4 independent predictors for stop\/switch of ADP blocker: major surgery, need for oral anticoagulation (OAC), TIMI major bleeding and drug intolerance. TIMI major bleeding was a driver of stop\/switch actions and occurred in 4.3% vs 0.2% in patients with vs without stop\/switch (<jats:italic>p<\/jats:italic>\u2009=\u20090.001). The majority of stop\/switch actions (75%) were physicians driven decisions. Importantly, stop\/switch of therapy was not associated with increased risk of MACE (<jats:italic>p<\/jats:italic>\u2009=\u20090.936). In conclusion premature switch\/stop of ADP blockers appears to be safe when mainly driven by physician\u2019s decision and clinical indication.<\/jats:p>","DOI":"10.1038\/s41598-019-44673-7","type":"journal-article","created":{"date-parts":[[2019,6,3]],"date-time":"2019-06-03T10:22:43Z","timestamp":1559557363000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Incidence, predictors, and prognosis of premature discontinuation or switch of prasugrel or ticagrelor: the ATLANTIS - SWITCH study"],"prefix":"10.1038","volume":"9","author":[{"given":"Max-Paul","family":"Winter","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dirk","family":"von Lewinski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Markus","family":"Wallner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florian","family":"Pr\u00fcller","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ewald","family":"Kolesnik","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8284-2994","authenticated-orcid":false,"given":"Christian","family":"Hengstenberg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jolanta M.","family":"Siller-Matula","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2019,6,3]]},"reference":[{"key":"44673_CR1","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1186\/1471-2261-14-100","volume":"14","author":"T Thim","year":"2014","unstructured":"Thim, T. et al. 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The author declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing Interests"}}],"article-number":"8194"}}