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Prehospital Ticagre...
Prehospital Ticagrelor in ST-Segment Elevation Myocardial Infarction
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- Montalescot, Gilles (författare)
- University of Paris 06, France
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- van t Hof, Arnoud W. (författare)
- Isala Clin, Netherlands
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- Lapostolle, Frederic (författare)
- Hop Avicenne, France
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- Silvain, Johanne (författare)
- University of Paris 06, France
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- Flensted Lassen, Jens (författare)
- Aarhus University Hospital, Denmark
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- Bolognese, Leonardo (författare)
- Azienda Osped Arezzo, Italy
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- Cantor, Warren J. (författare)
- University of Toronto, Canada
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- Cequier, Angel (författare)
- University of Barcelona, Spain
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- Chettibi, Mohamed (författare)
- Centre Hospital University of Franz Fanon, Algeria
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- Goodman, Shaun G. (författare)
- University of Toronto, Canada
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- Hammett, Christopher J. (författare)
- Royal Brisbane and Womens Hospital, Australia
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- Huber, Kurt (författare)
- Wilhelminenspital Stadt Wien, Austria
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- Janzon, Magnus (författare)
- Östergötlands Läns Landsting,Linköpings universitet,Avdelningen för kardiovaskulär medicin,Hälsouniversitetet,Kardiologiska kliniken US
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- Merkely, Bela (författare)
- Semmelweis University, Hungary
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- Storey, Robert F. (författare)
- University of Sheffield, England
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- Zeymer, Uwe (författare)
- Klinikum Stadt Ludwigshafen, Germany; Institute Herzinfarktforsch Ludwigshafen, Germany
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- Stibbe, Olivier (författare)
- Brigade Sapeurs Pompiers Paris, France
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- Ecollan, Patrick (författare)
- CHU Pitie Salpetriere, France
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- Heutz, Wim M. J. M. (författare)
- Regionale Ambulance Voorziening, Netherlands
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- Swahn, Eva (författare)
- Östergötlands Läns Landsting,Linköpings universitet,Avdelningen för kardiovaskulär medicin,Hälsouniversitetet,Kardiologiska kliniken US
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- Collet, Jean-Philippe (författare)
- University of Paris 06, France
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- Willems, Frank F. (författare)
- Rijnstate Ziekenhuis, Netherlands
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- Baradat, Caroline (författare)
- AstraZeneca, France
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- Licour, Muriel (författare)
- AstraZeneca, France
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- Tsatsaris, Anne (författare)
- AstraZeneca, France
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- Vicaut, Eric (författare)
- Hop Lariboisiere, France
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- Hamm, Christian W. (författare)
- Kerckhoff Heart Centre, Germany
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(creator_code:org_t)
- Massachusetts Medical Society, 2014
- 2014
- Engelska.
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Ingår i: New England Journal of Medicine. - : Massachusetts Medical Society. - 0028-4793 .- 1533-4406. ; 371:11, s. 1016-1027
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- BACKGROUND The direct-acting platelet P2Y(12) receptor antagonist ticagrelor can reduce the incidence of major adverse cardiovascular events when administered at hospital admission to patients with ST-segment elevation myocardial infarction (STEMI). Whether prehospital administration of ticagrelor can improve coronary reperfusion and the clinical outcome is unknown. METHODS We conducted an international, multicenter, randomized, double-blind study involving 1862 patients with ongoing STEMI of less than 6 hours duration, comparing prehospital (in the ambulance) versus in-hospital (in the catheterization laboratory) treatment with ticagrelor. The coprimary end points were the proportion of patients who did not have a 70% or greater resolution of ST-segment elevation before percutaneous coronary intervention (PCI) and the proportion of patients who did not have Thrombolysis in Myocardial Infarction flow grade 3 in the infarct-related artery at initial angiography. Secondary end points included the rates of major adverse cardiovascular events and definite stent thrombosis at 30 days. RESULTS The median time from randomization to angiography was 48 minutes, and the median time difference between the two treatment strategies was 31 minutes. The two coprimary end points did not differ significantly between the prehospital and in-hospital groups. The absence of ST-segment elevation resolution of 70% or greater after PCI (a secondary end point) was reported for 42.5% and 47.5% of the patients, respectively. The rates of major adverse cardiovascular events did not differ significantly between the two study groups. The rates of definite stent thrombosis were lower in the prehospital group than in the in-hospital group (0% vs. 0.8% in the first 24 hours; 0.2% vs. 1.2% at 30 days). Rates of major bleeding events were low and virtually identical in the two groups, regardless of the bleeding definition used. CONCLUSIONS Prehospital administration of ticagrelor in patients with acute STEMI appeared to be safe but did not improve pre-PCI coronary reperfusion.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
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Montalescot, Gil ...
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van t Hof, Arnou ...
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Lapostolle, Fred ...
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Silvain, Johanne
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Flensted Lassen, ...
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Bolognese, Leona ...
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visa fler...
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Cantor, Warren J ...
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Cequier, Angel
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Chettibi, Mohame ...
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Goodman, Shaun G ...
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Hammett, Christo ...
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Huber, Kurt
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Janzon, Magnus
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Merkely, Bela
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Storey, Robert F ...
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Zeymer, Uwe
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Stibbe, Olivier
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Ecollan, Patrick
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Heutz, Wim M. J. ...
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Swahn, Eva
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Collet, Jean-Phi ...
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Willems, Frank F ...
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Baradat, Carolin ...
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Licour, Muriel
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Tsatsaris, Anne
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Vicaut, Eric
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Hamm, Christian ...
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