{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T03:27:13Z","timestamp":1789270033495,"version":"build-2803163510"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"14","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,7,16]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Prior reports indicate that the effect of P2Y\n              <jats:sub>12<\/jats:sub>\n              inhibitors may be different in East Asian patients (\u201cEast Asian paradox\u201d); therefore, understanding the outcomes associated with potent P2Y\n              <jats:sub>12<\/jats:sub>\n              inhibitors in different populations is clinically important.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              In this observational cohort study using administrative healthcare data sets, we compared safety and effectiveness of contemporary P2Y\n              <jats:sub>12<\/jats:sub>\n              inhibitors in patients with acute coronary syndrome. The primary safety outcomes were major and any bleeding, and the primary effectiveness outcomes were major cardiovascular events (a composite of cardiovascular death, myocardial infarction, or stroke) and all\u2010cause mortality. Among 70\u00a0715 patients with acute coronary syndrome, 56\u00a0216 (79.5%) used clopidogrel, 11\u00a0402 (16.1%) used ticagrelor, and 3097 (4.4%) used prasugrel. The median follow\u2010up period was 18.0\u00a0months (interquartile range: 9.6\u201326.4\u00a0months). In a propensity\u2010matched cohort, compared with clopidogrel, ticagrelor was associated with a higher risk of any bleeding (hazard ratio: 1.23; 95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              , 1.14\u20131.33) but a lower risk of mortality (hazard ratio: 0.76; 95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              , 0.63\u20130.91). Prasugrel, compared with clopidogrel, was associated with higher risks of any bleeding (hazard ratio: 1.23; 95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              , 1.06\u20131.43) and major bleeding (hazard ratio: 1.50; 95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              , 1.01\u20132.21) but a similar risk of effectiveness outcomes. No significant difference was noted between ticagrelor and prasugrel with respect to key safety or effectiveness outcomes. Several sensitivity analyses showed similar results.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">In East Asian patients with acute coronary syndrome, compared with clopidogrel, ticagrelor was associated with an increased risk of bleeding but a decreased risk of mortality. Prasugrel was associated with an increase of any bleeding without difference in effectiveness outcomes. The risks of bleeding and ischemic events were similar between ticagrelor and prasugrel.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.119.012078","type":"journal-article","created":{"date-parts":[[2019,7,16]],"date-time":"2019-07-16T19:19:32Z","timestamp":1563304772000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":57,"title":["Safety and Effectiveness of Contemporary P2Y\n            <sub>12<\/sub>\n            Inhibitors in an East Asian Population With Acute Coronary Syndrome: A Nationwide Population\u2010Based Cohort Study"],"prefix":"10.1161","volume":"8","author":[{"given":"Ji Eun","family":"Yun","sequence":"first","affiliation":[{"name":"Division for Healthcare Technology Assessment Research National Evidence\u2010based Healthcare Collaborating Agency Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun Jung","family":"Kim","sequence":"additional","affiliation":[{"name":"Division for Healthcare Technology Assessment Research National Evidence\u2010based Healthcare Collaborating Agency Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji Jeong","family":"Park","sequence":"additional","affiliation":[{"name":"Division for Healthcare Technology Assessment Research National Evidence\u2010based Healthcare Collaborating Agency Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sehee","family":"Kim","sequence":"additional","affiliation":[{"name":"Division for Healthcare Technology Assessment Research National Evidence\u2010based Healthcare Collaborating Agency Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keunhui","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Insurance Benefits National Health Insurance Service Wonju 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