Objective:Ticagrelor on Health Outcomes in diabEtes Mellitus patients Intervention Study(THEMIS)filled an important data gap by showing a significant reduction of ischemic cardiovascular events in a ticagrelor plus as...Objective:Ticagrelor on Health Outcomes in diabEtes Mellitus patients Intervention Study(THEMIS)filled an important data gap by showing a significant reduction of ischemic cardiovascular events in a ticagrelor plus aspirin cohort compared with placebo plus aspirin cohort among patients with coronary artery disease(CAD)and type 2 diabetes mellitus(T2DM)but without a history of myocardial infarction.This study aims to evaluate the applicability of the THEMIS results in a real-world clinical setting in China.Methods:This retrospective,observational cohort study used data from the Optimal antiPlatelet Therapy for Chinese patients with Coronary Artery Disease(OPT-CAD)study which enrolled participants who were hospitalized between November 2012 and December 2013.The 24-month cumulative incidence of major adverse cardiovascular event(MACE),major bleeding,and all-cause death in patients with T2DM and CAD(T2DM-CAD),T2DM and stable CAD(SCAD)(T2DM-SCAD),and T2DM and SCAD without prior myocardial infarction or stroke(THEMIS-like)were analyzed.Results:Data from 13,296 patients with CAD were included;the T2DM-CAD,T2DM-SCAD,and THEMIS-like cohorts comprised 3,344(25.2%),949(7.1%),and 509(3.8%)patients,respectively.The corresponding 24-month cumulative incidence of major bleeding was 38(1.1%),16(1.7%),and 8(1.6%),and that of MACEs was 250(7.5%),87(9.2%),and 29(5.7%),and all-cause death was 181(5.4%),84(8.9%),29(5.7%),respectively.The risk of MACE in the THEMIS-like cohort was approximate to that in the THEMIS trial(7.7%vs.8.5%in ticagrelor and placebo group,respectively).Conclusion:The incidence of MACE was substantial in the THEMIS-like cohort,suggesting that cardiovascular risk for future events correlates with the presence of cardiovascular disease across the CAD risk continuum.展开更多
基金supported by grants from the National Key Research and Development Program of China(2022YFC2503500 and 2022YFC2503504)and a research grant AstraZeneca。
文摘Objective:Ticagrelor on Health Outcomes in diabEtes Mellitus patients Intervention Study(THEMIS)filled an important data gap by showing a significant reduction of ischemic cardiovascular events in a ticagrelor plus aspirin cohort compared with placebo plus aspirin cohort among patients with coronary artery disease(CAD)and type 2 diabetes mellitus(T2DM)but without a history of myocardial infarction.This study aims to evaluate the applicability of the THEMIS results in a real-world clinical setting in China.Methods:This retrospective,observational cohort study used data from the Optimal antiPlatelet Therapy for Chinese patients with Coronary Artery Disease(OPT-CAD)study which enrolled participants who were hospitalized between November 2012 and December 2013.The 24-month cumulative incidence of major adverse cardiovascular event(MACE),major bleeding,and all-cause death in patients with T2DM and CAD(T2DM-CAD),T2DM and stable CAD(SCAD)(T2DM-SCAD),and T2DM and SCAD without prior myocardial infarction or stroke(THEMIS-like)were analyzed.Results:Data from 13,296 patients with CAD were included;the T2DM-CAD,T2DM-SCAD,and THEMIS-like cohorts comprised 3,344(25.2%),949(7.1%),and 509(3.8%)patients,respectively.The corresponding 24-month cumulative incidence of major bleeding was 38(1.1%),16(1.7%),and 8(1.6%),and that of MACEs was 250(7.5%),87(9.2%),and 29(5.7%),and all-cause death was 181(5.4%),84(8.9%),29(5.7%),respectively.The risk of MACE in the THEMIS-like cohort was approximate to that in the THEMIS trial(7.7%vs.8.5%in ticagrelor and placebo group,respectively).Conclusion:The incidence of MACE was substantial in the THEMIS-like cohort,suggesting that cardiovascular risk for future events correlates with the presence of cardiovascular disease across the CAD risk continuum.
