{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T02:35:48Z","timestamp":1789698948860,"version":"4.0.1"},"reference-count":61,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2020,9,9]],"date-time":"2020-09-09T00:00:00Z","timestamp":1599609600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Eur J Clin Investigation"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To investigate the long\u2010term clinical benefit of dual antiplatelet therapy with potent P2Y12 inhibitors compared to clopidogrel in patients with acute coronary syndrome (ACS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this prospective multicenter observational study, we enrolled 708 patients with ACS treated with clopidogrel (n\u00a0=\u00a0137), ticagrelor (n\u00a0=\u00a0260) or prasugrel (n\u00a0=\u00a0311). Major adverse cardiac events (MACE; over 1\u00a0year) and long\u2010term mortality (median: 5.6\u00a0years; interquartile range [IQR] 4.9\u20106.5\u00a0years) were assessed. Multiple electrode aggregometry (MEA) was used to measure adenosine diphosphate (ADP)\u2010 and arachidonic acid (AA)\u2010induced platelet aggregation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Type of P2Y12 inhibitor emerged as an independent predictor of long\u2010term mortality and MACE: patients treated with potent platelet inhibitors prasugrel or ticagrelor were at lower risk for long\u2010term mortality (adjusted hazard ratio [HR]\u00a0=\u00a00.44; 95% CI: 0.22\u20100.92; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.028) or MACE (adjusted HR\u00a0=\u00a00.38; 95% CI: 0.20\u20100.73; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.004) than those treated with clopidogrel independent from clinical risk factors. In contrast, the efficacy of clopidogrel decreased with increasing severity of ACS: platelet aggregation was 37% higher in patients with ST segment elevation myocardial infarction (STEMI) and 25% higher in patients with non\u2010ST elevation myocardial infarction (non\u2010STEMI) compared to patients with unstable angina (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.039). Patients with diabetes achieved less potent ADP\u2010 and AA\u2010induced platelet inhibition under clopidogrel, compared to patients without diabetes (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.045; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.030, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In the setting of ACS, treatment with ticagrelor or prasugrel reduced long\u2010term mortality and 1\u2010year MACE as compared to clopidogrel.<\/jats:p><\/jats:sec>","DOI":"10.1111\/eci.13304","type":"journal-article","created":{"date-parts":[[2020,6,7]],"date-time":"2020-06-07T17:40:16Z","timestamp":1591551616000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Ticagrelor and prasugrel are independent predictors of improved long\u2010term survival in ACS patients"],"prefix":"10.1111","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0232-4311","authenticated-orcid":false,"given":"Gloria M.","family":"Gager","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacology Medical University of Vienna Vienna Austria"},{"name":"Department of Internal Medicine II Division of Cardiology Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernd","family":"Jilma","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2945-9742","authenticated-orcid":false,"given":"Max\u2010Paul","family":"Winter","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II Division of Cardiology Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Hengstenberg","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II Division of Cardiology Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene M.","family":"Lang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II Division of Cardiology Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aurel","family":"Toma","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II Division of Cardiology Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Pr\u00fcller","sequence":"additional","affiliation":[{"name":"Clinical Institute of Medical and Chemical Laboratory Diagnostics Medical University of Graz Graz Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Wallner","sequence":"additional","affiliation":[{"name":"Department of Cardiology Medical University of Graz Graz Austria"},{"name":"Cardiovascular Research Center Lewis Katz School of Medicine Temple University Philadelphia PA USA"},{"name":"Center for Biomarker Research in Medicine CBmed GmbH Graz Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ewald","family":"Kolesnik","sequence":"additional","affiliation":[{"name":"Department of Cardiology Medical University of Graz Graz Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk","family":"von Lewinski","sequence":"additional","affiliation":[{"name":"Department of Cardiology Medical University of Graz Graz Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jolanta M.","family":"Siller\u2010Matula","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II Division of Cardiology Medical University of Vienna Vienna Austria"},{"name":"Department of Experimental and Clinical Pharmacology Centre for Preclinical Research and Technology (CEPT) Medical University of Warsaw Warsaw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,9,9]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx175"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.07.012"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.14689"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/cpt.1616"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-019-44673-7"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.2147\/TCRM.S152369"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.3109\/09537104.2015.1095874"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vph.2016.01.003"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/2048872615585516"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0706482"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0904327"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1080\/09537104.2018.1445836"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx393"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv320"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy394"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/FJC.0000000000000451"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2012.04639.x"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0039-1683421"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2362.2009.02234.x"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2009.03699.x"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.685313"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehr204"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2016.10.084"},{"key":"e_1_2_8_25_1","first-page":"259","article-title":"Personalized antiplatelet therapy with P2Y12 receptor inhibitors: benefits and pitfalls","volume":"11","author":"Winter M\u2010P","year":"2015","journal-title":"Post\u0119py Kardiol Interwencyjnej"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1160\/TH14-03-0238"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0102701"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2018.09.011"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1908973"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2019.00176"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/eci.13102"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.119.012530"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-016-0028-x"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.2459\/JCM.0000000000000869"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2014.08.143"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1159\/000442939"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1160\/TH17-02-0087"},{"key":"e_1_2_8_38_1","article-title":"L and Ryan K. Pharmacogenomic polygenic response score predicts ischaemic events and cardiovascular mortality in clopidogrel\u2010treated patients","author":"Lewis JP","year":"2019","journal-title":"Eur Heart J Cardiovasc Pharmacother"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1002\/cpt.1492"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1080\/03007995.2018.1510385"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjcvp\/pvw044"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1042\/CS20140310"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2015.05.085"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv744"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2014.07.239"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm7110442"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13613-018-0366-x"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.1111\/bcp.13053"},{"key":"e_1_2_8_49_1","doi-asserted-by":"publisher","DOI":"10.2337\/diabetes.54.8.2430"},{"key":"e_1_2_8_50_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-015-0182-7"},{"key":"e_1_2_8_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2010.03.013"},{"key":"e_1_2_8_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.07.068"},{"key":"e_1_2_8_53_1","doi-asserted-by":"publisher","DOI":"10.1177\/0091270009343005"},{"key":"e_1_2_8_54_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00392-010-0179-x"},{"key":"e_1_2_8_55_1","doi-asserted-by":"publisher","DOI":"10.1111\/eci.13001"},{"key":"e_1_2_8_56_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2020.108008"},{"key":"e_1_2_8_57_1","doi-asserted-by":"publisher","DOI":"10.21037\/cdt.2018.05.09"},{"key":"e_1_2_8_58_1","doi-asserted-by":"publisher","DOI":"10.1177\/2048872618802783"},{"key":"e_1_2_8_59_1","doi-asserted-by":"publisher","DOI":"10.1160\/TH13-05-0384"},{"key":"e_1_2_8_60_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2012.01.016"},{"key":"e_1_2_8_61_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-019-1428-0"},{"key":"e_1_2_8_62_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1908077"}],"container-title":["European Journal of Clinical Investigation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/eci.13304","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/eci.13304","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/eci.13304","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,4]],"date-time":"2023-09-04T05:28:00Z","timestamp":1693805280000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/eci.13304"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,9]]},"references-count":61,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2020,11]]}},"alternative-id":["10.1111\/eci.13304"],"URL":"https:\/\/doi.org\/10.1111\/eci.13304","archive":["Portico"],"relation":{},"ISSN":["0014-2972","1365-2362"],"issn-type":[{"value":"0014-2972","type":"print"},{"value":"1365-2362","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9,9]]},"assertion":[{"value":"2020-03-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-05-27","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-09-09","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e13304"}}