People that suffer a heart attack need emergency treatment to improve blood flow, treat complications and prevent future problems. To prevent future blood clots, patients are prescribed dual antiplatelet therapy. One of those medications is aspirin. The second type is a type of antiplatelet agent called P2Y12 inhibitors.

There are 3 P2Y12 inhibitors: clopidogrel, prasugrel and ticagrelor. Some studies have shown that ticagrelor is “stronger” than clopidogrel and a little better at decreasing complications of blood clots. However, ticagrelor can slightly increase bleeding. Our study aims to determine which type of P2Y12 inhibitors has the lowest risk of blot clots and death.

For our study, we will look at historical health records in Manitoba. We will look at every person who suffered a heart attack and who has been prescribed ticagrelor or clopidogrel and check whether they died or had to go to the hospital because of blood clots. From there, we will see if there are differences in those outcomes between the two types of medications. Patients are not identified to protect their privacy, but we can link records of prescriptions, hospital visits, and emergency department visits to a unique person.

We will share our findings with doctors and patients so we can help improve patient quality of life. Additionally, our findings have the potential to help the healthcare system be more efficient by lowering the number of times people need to go to the hospital or emergency room because of a blood clot event.

Panel Writeup

The burden of cardiovascular disease in Canada

A heart attack occurs when the flow of blood to the heart is blocked. A heart attack, also called a myocardial infarction, can be fatal, but treatment has improved dramatically over the years. Chest pain or discomfort is the most common symptom of a heart attack in both men and women.

Cardiovascular disease (CVD) has a large impact on the health of Canadians. Heart disease is the second leading cause of death in Canada. According to the Canadian Chronic Disease Surveillance System (CCDSS) about one in 12 Canadian adults aged 20 and over live with diagnosed heart disease. The prevalence of diagnosed heart disease increases as people age and is higher among men than women in all age groups. Cardiovascular disease contributes as much as $22.2 billion to health care costs each year.

Most Canadians have at least one risk factor for CVD. Reducing risk factors before the first heart attack or stroke can prevent or postpone 33 per cent of all deaths. A large percentage of the population is at risk of developing CVD or experiencing a second heart attack, stroke, or other CVD-related crisis. Treatment options for heart attack include lifestyle management, medications, and procedures such as percutaneous coronary intervention or coronary artery bypass graft surgery. Both primary and secondary prevention efforts must attain priority to decrease the incidence of fatal and non-fatal heart disease in the population.