dc.contributor.author |
Bagai A |
|
dc.contributor.author |
Goodman SG |
|
dc.contributor.author |
Cantor WJ |
|
dc.contributor.author |
Vicaut E |
|
dc.contributor.author |
Bolognese L |
|
dc.contributor.author |
Cequier A |
|
dc.contributor.author |
Chettibi M |
|
dc.contributor.author |
Hammett CJ |
|
dc.contributor.author |
Huber K |
|
dc.contributor.author |
Janzon M |
|
dc.contributor.author |
Lapostolle F |
|
dc.contributor.author |
Lassen JF |
|
dc.contributor.author |
Merkely, Béla Péter |
|
dc.contributor.author |
Storey RF |
|
dc.contributor.author |
Ten Berg JM |
|
dc.contributor.author |
Zeymer U |
|
dc.contributor.author |
Diallo A |
|
dc.contributor.author |
Hamm CW |
|
dc.contributor.author |
Tsatsaris A |
|
dc.contributor.author |
El Khoury J |
|
dc.contributor.author |
Van't Hof AW |
|
dc.contributor.author |
Montalescot G |
|
dc.date.accessioned |
2018-06-15T07:43:38Z |
|
dc.date.available |
2018-06-15T07:43:38Z |
|
dc.date.issued |
2018 |
|
dc.identifier.citation |
pagination=56-64;
journalVolume=196;
journalTitle=AMERICAN HEART JOURNAL; |
|
dc.identifier.uri |
http://repo.lib.semmelweis.hu//handle/123456789/5350 |
|
dc.identifier.uri |
doi:10.1016/j.ahj.2017.10.021 |
|
dc.description.abstract |
BACKGROUND: Among patients with STEMI in the ATLANTIC study, pre-hospital administration of ticagrelor improved post-PCI ST-segment resolution and 30-day stent thrombosis. We investigated whether this clinical benefit with pre-hospital ticagrelor differs by ischemic duration. METHODS: In a post hoc analysis we compared absence of ST-segment resolution post-PCI and stent thrombosis at 30 days between randomized treatment groups (pre- versus in-hospital ticagrelor) stratified by symptom onset to first medical contact (FMC) duration [</=1 hour (n = 773), >1 to </=3 hours (n = 772), and >3 hours (n = 311)], examining the interaction between randomized treatment strategy and duration of symptom onset to FMC for each outcome. RESULTS: Patients presenting later after symptom onset were older, more likely to be female, and have higher baseline risk. Patients with symptom onset to FMC >3 hours had the greatest improvement in post-PCI ST-segment elevation resolution with pre- versus in-hospital ticagrelor (absolute risk difference: </=1 hour, 2.9% vs. >1 to </=3 hours, 3.6% vs. >3 hours, 12.2%; adjusted p for interaction = 0.13), while patients with shorter duration of ischemia had greater improvement in stent thrombosis at 30 days with pre- versus in-hospital ticagrelor (absolute risk difference: </=1 hour, 1.3% vs. >1 hour to </=3 hours, 0.7% vs. >3 hours, 0.4%; adjusted p for interaction = 0.55). Symptom onset to active ticagrelor administration was independently associated with stent thrombosis at 30 days (adjusted OR 1.89 per 100 minute delay, 95%CI 1.20-2.97, P < .01), but not post-PCI ST-segment resolution (P = .41). CONCLUSIONS: The effect of pre-hospital ticagrelor to reduce stent thrombosis was most evident when given early within 3 hours after symptom onset, with delay in ticagrelor administration after symptom onset associated with higher rate of stent thrombosis. These findings re-emphasize the need for early ticagrelor administration in primary PCI treated STEMI patients. |
|
dc.relation.ispartof |
urn:issn:0002-8703 |
|
dc.title |
Duration of ischemia and treatment effects of pre- versus in-hospital ticagrelor in patients with ST-segment elevation myocardial infarction: Insights from the ATLANTIC study. |
|
dc.type |
Journal Article |
|
dc.date.updated |
2018-05-05T23:17:51Z |
|
dc.language.rfc3066 |
en |
|
dc.identifier.mtmt |
3332929 |
|
dc.identifier.pubmed |
29421015 |
|
dc.contributor.department |
SE/AOK/K/Városmajori Szív- és Érgyógyászati Klinika |
|
dc.contributor.department |
SE/AOK/K/VAROSMAJOR_SZÍVÉRGYÓGY/Kardiológia Központ - Kardiológiai Tanszék |
|
dc.contributor.institution |
Semmelweis Egyetem |
|