1. Time‐dependent benefits of pre‐treatment with new oral P2Y12‐inhibitors in patients addressed to primary PCI for acute ST‐elevation myocardial infarction
- Author
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Ottavio Di Cillo, Francesco Bartolomucci, Stefano Favale, Valeria Paradies, Francesco Paolo Bianchi, Alessandro Santo Bortone, Eliano Pio Navarese, D. Zanna, Francesco Addabbo, Nicola Signore, Gaetano Contegiacomo, Alessandro Cafaro, Martino Pepe, and Cinzia Forleo
- Subjects
medicine.medical_specialty ,Prasugrel ,business.industry ,medicine.medical_treatment ,Percutaneous coronary intervention ,General Medicine ,030204 cardiovascular system & hematology ,medicine.disease ,Loading dose ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Conventional PCI ,Cardiology ,Medicine ,Radiology, Nuclear Medicine and imaging ,030212 general & internal medicine ,Myocardial infarction ,Onset of action ,Cardiology and Cardiovascular Medicine ,business ,Ticagrelor ,TIMI ,medicine.drug - Abstract
OBJECTIVES The aim of this observational study was to determine the benefits of the novel, orally delivered P2Y12 -inhibitors (Is) in terms of angiographic endpoints and in relation to the time of the loading dose (LD) administration. BACKGROUND The goal of ST-elevation myocardial infarction (STEMI) treatment is timely reperfusion. The P2Y12 -Is prasugrel and ticagrelor have improved the angiographic outcome of primary percutaneous coronary intervention (pPCI) and patients' prognosis. However, their onset of action is impaired in STEMI and delayed by their oral administration. METHODS The 328 eligible patients with STEMI consecutively referred for pPCI were divided into three groups depending on the interval of "P2Y12 -I LD administration-to-balloon time": Group 2 included patients that received P2Y12 -I LD at least 60 min prior to pPCI, Group 1 within 60 min prior to pPCI, and Group 0 at the moment of pPCI. Angiographic, clinical, and biochemical parameters were evaluated. Pre- and post-pPCI TIMI flow grade (TFG) and ST resolution (STR) were used as outcome measures to determine efficacy and optimal timing of pretreatment. RESULTS Pre-pPCI TFG improved with increasing P2Y12 -I LD administration-to-balloon time; pre-PCI TFG 0/1 was 74.5% in Group 0, 65.5% in Group 1 and 54.9% in Group 2 (P
- Published
- 2018
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