{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T08:28:00Z","timestamp":1759480080319,"version":"3.37.3"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2022,1,12]],"date-time":"2022-01-12T00:00:00Z","timestamp":1641945600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,11,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>To establish the safety and efficacy of different dual antiplatelet therapy (DAPT) combinations in patients with acute coronary syndrome (ACS) according to their baseline ischaemic and bleeding risk estimated with a machine learning derived model [machine learning-based prediction of adverse events following an acute coronary syndrome (PRAISE) score].<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>Incidences of death, re-acute myocardial infarction (re-AMI), and Bleeding Academic Research Consortium 3\u20135 bleeding with aspirin plus different P2Y12 inhibitors (clopidogrel or potent P2Y12 inhibitors: ticagrelor or prasugrel) were appraised among patients of the PRAISE data set grouped in four subcohorts: low-to-moderate ischaemic and bleeding risk; low-to-moderate ischaemic risk and high bleeding risk; high ischaemic risk and low-to-moderate bleeding risk; and high ischaemic and bleeding risk. Hazard ratios (HRs) for the outcome measures were derived with inverse probability of treatment weighting adjustment. Among patients with low-to-moderate bleeding risk, clopidogrel was associated with higher rates of re-AMI in those at low-to-moderate ischaemic risk [HR 1.69, 95% confidence interval (CI) 1.16\u20132.51; P = 0.006] and increased risk of death (HR 3.2, 1.45\u20134.21; P = 0.003) and re-AMI (HR 2.23, 1.45\u20133.41; P &amp;lt; 0.001) in those at high ischaemic risk compared with prasugrel or ticagrelor, without a difference in the risk of major bleeding. Among patients with high bleeding risk, clopidogrel showed comparable risk of death, re-AMI, and major bleeding vs. potent P2Y12 inhibitors, regardless of the baseline ischaemic risk.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Among ACS patients with non-high risk of bleeding, the use of potent P2Y12 inhibitors is associated with a lower risk of death and recurrent ischaemic events, without bleeding excess. Patients deemed at high bleeding risk may instead be safely addressed to a less intensive DAPT strategy with clopidogrel.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjqcco\/qcac002","type":"journal-article","created":{"date-parts":[[2022,1,7]],"date-time":"2022-01-07T20:11:01Z","timestamp":1641586261000},"page":"881-891","source":"Crossref","is-referenced-by-count":8,"title":["Safety and efficacy of different P2Y12 inhibitors in patients with acute coronary syndromes stratified by the PRAISE risk score: a multicentre study"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5404-3968","authenticated-orcid":false,"given":"Giuseppe","family":"Patti","sequence":"first","affiliation":[{"name":"Division of Cardiology, Maggiore della Carit\u00e0 Hospital, University of Eastern Piedmont , Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabrizio","family":"D'Ascenzo","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University of Turin A.O.U. Citt\u00e0 della Salute e della Scienza di Torino , Corso Bramante 85, 10126 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4915-9501","authenticated-orcid":false,"given":"Ovidio","family":"De Filippo","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University of Turin A.O.U. Citt\u00e0 della Salute e della Scienza di Torino , Corso Bramante 85, 10126 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0019-0273","authenticated-orcid":false,"given":"Francesco","family":"Bruno","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University of Turin A.O.U. 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