{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T11:08:56Z","timestamp":1785150536915,"version":"3.55.0"},"reference-count":50,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2022,8,11]],"date-time":"2022-08-11T00:00:00Z","timestamp":1660176000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,9,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>To compare the effectiveness and safety of clopidogrel, ticagrelor, and prasugrel in patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>Nationwide, registry-based study of STEMI patients treated with primary PCI (2011\u201317) and subsequently with aspirin and a P2Y12 inhibitor. The effectiveness outcome was major adverse cardiovascular events (MACE) defined as a composite of recurrent myocardial infarction, repeat revascularization, stroke, or cardiovascular death at 12 months. The safety outcome was bleeding requiring hospitalization at 12 months. Multivariable logistic regression with average treatment effect modeling was used to calculate absolute and relative risks for outcomes standardized to the distributions of demographic characteristics of all included subjects. We included 10\u2009832 patients; 1 697 were treated with clopidogrel, 7 508 with ticagrelor, and 1,627 with prasugrel. Median ages were 66, 63, and 59 years (P\u2009&amp;lt;\u20090.001). Standardized relative risks of MACE were 0.75 for ticagrelor vs. clopidogrel (95% confidence interval [CI], 0.64\u20130.83), 0.84 for prasugrel vs. clopidogrel (95% CI, 0.73\u20130.94), and 1.12 for prasugrel vs. ticagrelor (95% CI, 1.00\u20131.24). Standardized relative risks of bleeding were 0.77 for ticagrelor vs. clopidogrel (95% CI, 0.59\u20130.93), 0.89 for prasugrel vs. clopidogrel (95% CI, 0.64\u20131.15), and 1.17 for prasugrel vs. ticagrelor (95% CI, 0.89\u20131.45).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Ticagrelor and prasugrel were associated with lower risks of MACE after STEMI than clopidogrel, and ticagrelor was associated with a marginal reduction compared with prasugrel. The risk of bleeding was lower with ticagrelor compared with clopidogrel, but did not significantly differ between ticagrelor and prasugrel.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjacc\/zuac095","type":"journal-article","created":{"date-parts":[[2022,8,11]],"date-time":"2022-08-11T11:58:42Z","timestamp":1660219122000},"page":"697-705","source":"Crossref","is-referenced-by-count":3,"title":["Effectiveness and safety of P2Y12 inhibitors in patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention: a nationwide registry-based study"],"prefix":"10.1093","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1049-9285","authenticated-orcid":false,"given":"Sissel J","family":"Godtfredsen","sequence":"first","affiliation":[{"name":"Department of Cardiology, Aalborg University Hospital , Hobrovej 18-22, 9000 Aalborg , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristian H","family":"Kragholm","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Aalborg University Hospital , Hobrovej 18-22, 9000 Aalborg , Denmark"},{"name":"Department of Clinical Medicine, Aalborg University , S\u00f8ndre Skovvej 15, 9000 Aalborg , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Leutscher","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Aalborg University , S\u00f8ndre Skovvej 15, 9000 Aalborg , Denmark"},{"name":"Centre for Clinical Research, North Denmark Regional Hospital , Bispensgade 37, 9800 Hj\u00f8rring , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steen Hylgaard","family":"J\u00f8rgensen","sequence":"additional","affiliation":[{"name":"Centre for Clinical Research, North Denmark Regional Hospital , Bispensgade 37, 9800 Hj\u00f8rring , Denmark"},{"name":"Department of Cardiology, North Denmark Regional Hospital , Bispensgade 37, 9800 Hj\u00f8rring , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin Kirk","family":"Christensen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Aalborg University Hospital , Hobrovej 18-22, 9000 Aalborg , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jawad H","family":"Butt","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Copenhagen University Hospital Rigshospitalet , Inge Lehmanns Vej 7, 2100 Copenhagen , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0548-402X","authenticated-orcid":false,"given":"Gunnar","family":"Gislason","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Copenhagen University Hospital , Gentofte Hospitalsvej 1, 2900 Hellerup , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6635-1466","authenticated-orcid":false,"given":"Lars","family":"K\u00f8ber","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Copenhagen University Hospital Rigshospitalet , Inge Lehmanns Vej 7, 2100 Copenhagen , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emil L","family":"Fosb\u00f8l","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Copenhagen University Hospital Rigshospitalet , Inge Lehmanns Vej 7, 2100 Copenhagen , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Sessa","sequence":"additional","affiliation":[{"name":"Department of Drug Design and Pharmacology, University of Copenhagen , Jagtvej 160 Building 22, 2100 Copenhagen , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepak L","family":"Bhatt","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital Heart & Vascular Center and Harvard Medical School , 70 Francis St., Boston, MA 02115 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2892-6131","authenticated-orcid":false,"given":"Christian","family":"Torp-Pedersen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Aalborg University , S\u00f8ndre Skovvej 15, 9000 Aalborg , Denmark"},{"name":"Department of Cardiology and Clinical Epidemiology, North Zealand Hospital , Dyrehavevej 29, 3400 Hiller\u00f8d , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0867-5825","authenticated-orcid":false,"given":"Manan","family":"Pareek","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Copenhagen University Hospital , Gentofte Hospitalsvej 1, 2900 Hellerup , Denmark"},{"name":"Brigham and Women\u2019s Hospital Heart & Vascular Center and Harvard Medical School , 70 Francis St., Boston, MA 02115 , USA"},{"name":"Department of Cardiology and Clinical Epidemiology, North Zealand Hospital , Dyrehavevej 29, 3400 Hiller\u00f8d , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,8,11]]},"reference":[{"key":"2022092919583884400_zuac095-B1","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1056\/NEJMoa010746","article-title":"Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation","volume":"345","author":"The Clopidogrel in Unstable Angina to Prevent Recurrent Events Trial Investigators","year":"2001","journal-title":"N Engl J Med"},{"key":"2022092919583884400_zuac095-B2","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1056\/NEJMoa010746","article-title":"Addition of clopidogrel to aspirin and fibrinolytic therapy for myocardial 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