{"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":1785150536133,"version":"3.55.0"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"18","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,9,17]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Current guidelines recommend the new\u2010generation P2Y12\u2010inhibitor ticagrelor for patients with acute\n              <jats:styled-content style=\"fixed-case\">ST<\/jats:styled-content>\n              \u2010segment\u2013elevation myocardial infarctions (\n              <jats:styled-content style=\"fixed-case\">STEMIs<\/jats:styled-content>\n              ). The aim of the present study was to assess efficacy and safety of ticagrelor for elderly patients with\n              <jats:styled-content style=\"fixed-case\">STEMI<\/jats:styled-content>\n              (\u226575\u00a0years) in an\n              <jats:italic>all\u2010comers<\/jats:italic>\n              <jats:styled-content style=\"fixed-case\">STEMI<\/jats:styled-content>\n              registry.\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              Patients with\n              <jats:styled-content style=\"fixed-case\">STEMI<\/jats:styled-content>\n              , aged \u226575\u00a0years, treated with primary percutaneous coronary intervention and documented in the Bremen\n              <jats:styled-content style=\"fixed-case\">STEMI<\/jats:styled-content>\n              Registry between 2006 and 2017 entered analysis. The primary efficacy outcome, major adverse cardiac and cerebrovascular events, was defined as a composite of death, myocardial reinfarction, and stroke. The safety outcome was defined as any significant bleeding event within 1\u00a0year. To estimate benefit\/risk ratio, net adverse clinical events (major adverse cardiac and cerebrovascular events+bleedings) were calculated. Outcomes were estimated in propensity score\u2013matched cohorts to adjust for possible confounders. Of a total of 7466 patients with\n              <jats:styled-content style=\"fixed-case\">STEMI<\/jats:styled-content>\n              , 1087, aged \u226575\u00a0years, were selected, of which 552 (51%) received clopidogrel and 535 (49%) received ticagrelor, with similar age (80.9\u00b14.6 versus 80.9\u00b14.6\u00a0years) and sex (51% versus 50% female) distributions between treatment arms. The primary efficacy outcome occurred in 32.4% of patients treated with clopidogrel versus 25.5% treated with ticagrelor (\n              <jats:italic>P<\/jats:italic>\n              =0.015), with the 1\u2010year mortality rate at 26.8% versus 21.1% (\n              <jats:italic>P<\/jats:italic>\n              =0.035). Because there was no difference in the safety outcome (clopidogrel versus ticagrelor, 4.9% versus 5.1%; not significant), net adverse clinical events were higher for clopidogrel than for ticagrelor: 37.3% versus 30.6% (\n              <jats:italic>P<\/jats:italic>\n              =0.028). In a propensity score\u2013matched model, the advantage for ticagrelor on major adverse cardiac and cerebrovascular events remained significant (hazard ratio, 0.69; 95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              , 0.49\u20100.97;\n              <jats:italic>P<\/jats:italic>\n              =0.03), whereas 1\u2010year\u2010mortality (hazard ratio, 0.89; 95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              , 0.67\u20131.27;\n              <jats:italic>P<\/jats:italic>\n              =0.5) and 1\u2010year bleeding events (hazard ratio, 1.1; 95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              , 0.4\u20132.3;\n              <jats:italic>P<\/jats:italic>\n              =0.8) did not differ.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              These results from propensity score\u2013matched registry data show that for elderly patients with\n              <jats:styled-content style=\"fixed-case\">STEMI,<\/jats:styled-content>\n              ticagrelor compared with clopidogrel was associated with a reduction in major adverse cardiac and cerebrovascular events without a significant increase in bleeding events within 1\u00a0year.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.119.012530","type":"journal-article","created":{"date-parts":[[2019,9,5]],"date-time":"2019-09-05T09:00:24Z","timestamp":1567674024000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":43,"title":["Efficacy and Safety of Ticagrelor in Comparison to Clopidogrel in Elderly Patients With ST\u2010Segment\u2013Elevation Myocardial Infarctions"],"prefix":"10.1161","volume":"8","author":[{"given":"Johannes","family":"Schmucker","sequence":"first","affiliation":[{"name":"Bremer Institut f\u00fcr Herz\u2010 und Kreislaufforschung am Klinikum Links der Weser Bremen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Fach","sequence":"additional","affiliation":[{"name":"Bremer Institut f\u00fcr Herz\u2010 und Kreislaufforschung am Klinikum Links der Weser Bremen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis Alberto","family":"Mata Marin","sequence":"additional","affiliation":[{"name":"Bremer Institut f\u00fcr Herz\u2010 und Kreislaufforschung am Klinikum Links der Weser Bremen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tina","family":"Retzlaff","sequence":"additional","affiliation":[{"name":"Bremer Institut f\u00fcr Herz\u2010 und Kreislaufforschung am Klinikum Links der Weser Bremen 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