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Pre-hospital admini...
Pre-hospital administration of ticagrelor in diabetic patients with ST-elevation myocardial infarction undergoing primary angioplasty : A sub-analysis of the ATLANTIC trial
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- Fabris, Enrico (author)
- Cardiology Department, Isala Heart Center, Zwolle, the Netherlands, , Cardiovascular Department, University of Trieste, Trieste, Italy
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- Van't Hof, Arnoud (author)
- Cardiology Department, Isala Heart Center, Zwolle, the Netherlands, Maastricht University Medical Center, Maastricht, the Netherlands, Zuyderland Hospital, Heerlen, the Netherlands
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- Hamm, Christian W (author)
- Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany
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- Lapostolle, Frédéric (author)
- SAMU 93 Hôpital Avicenne, Bobigny, France
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- Lassen, Jens Flensted (author)
- Department of Cardiology B, Aarhus University Hospital, Aarhus, Denmark
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- Goodman, Shaun G (author)
- Canadian Heart Research Centre, Division of Cardiology, St. Michael's Hospital, University of Toronto, Toronto, Canada
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- Ten Berg, Jurriën M (author)
- Department of Cardiology, St. Antonius Hospital Nieuwegein, Nieuwegein, the Netherlands
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- Bolognese, Leonardo (author)
- Cardiovascular and Neurological Department, Azienda Ospedaliera Arezzo, Arezzo, Italy
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- Cequier, Angel (author)
- Heart Disease Institute, Hospital Universitario de Bellvitge, University of Barcelona, Spain
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- Chettibi, Mohamed (author)
- Centre Hospito-universitaire Frantz Fanon, Blida, Algeria
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- Hammett, Christopher J (author)
- Department of Cardiology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
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- Huber, Kurt (author)
- 3rd Department of Medicine, Cardiology and Intensive Care Medicine, Wilhelminen hospital and Sigmund Freud University, Medical School, Vienna, Austria.
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- Janzon, Magnus (author)
- Linköpings universitet,Avdelningen för kardiovaskulär medicin,Medicinska fakulteten,Region Östergötland, Kardiologiska kliniken US
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- Merkely, Béla (author)
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
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- Storey, Robert F (author)
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
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- Zeymer, Uwe (author)
- Klinikum Ludwigshafen and Institut für Herzinfarktforschung, Ludwigshafen, Germany
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- Cantor, Warren J (author)
- Southlake Regional Health Centre, University of Toronto, Ontario, Canada
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- Kerneis, Mathieu (author)
- Sorbonne Université, ACTION Study Group, Hospital Pitie-Salpetriere (AP-HP), Paris, France
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- Diallo, Abdourahmane (author)
- Hospital Lariboisiere, ACTION Study Group, Paris, France
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- Vicaut, Eric (author)
- Hospital Lariboisiere, ACTION Study Group, Paris, France
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- Montalescot, Gilles (author)
- Sorbonne Université, ACTION Study Group, Hospital Pitie-Salpetriere (AP-HP), Paris, France
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(creator_code:org_t)
- 2018-10-09
- 2019
- English.
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In: Catheterization and cardiovascular interventions. - : John Wiley & Sons. - 1522-1946 .- 1522-726X. ; 93:7, s. E369-E377
- Related links:
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https://doi.org/10.1...
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https://urn.kb.se/re...
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Abstract
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- OBJECTIVE: We investigated, in the contemporary era of ST-elevation myocardial infarction (STEMI) treatment, the influence of diabetes mellitus (DM) on cardiovascular outcomes, and whether pre-hospital administration of ticagrelor may affect these outcomes in a subgroup of STEMI patients with DM.BACKGROUND: DM patients have high platelet reactivity and a prothrombotic condition which highlight the importance of an effective antithrombotic regimen in this high-risk population.METHODS: In toal 1,630 STEMI patients enrolled in the ATLANTIC trial who underwent primary percutaneous coronary intervention (PCI) were included. Multivariate analysis was used to explore the association of DM with outcomes and potential treatment-by-diabetes interaction was tested.RESULTS: A total of 214/1,630 (13.1%) patients had DM. DM was an independent predictor of poor myocardial reperfusion as reflected by less frequent ST-segment elevation resolution (≥70%) after PCI (OR 0.59, 95% CI 0.43-0.82, P < 0.01) and was an independent predictor of the composite 30-day outcomes of death/new myocardial infarction (MI)/urgent revascularization/definite stent thrombosis (ST) (OR 2.80, 95% CI 1.62-4.85, P < 0.01), new MI or definite acute ST (OR 2.46, 95% CI 1.08-5.61, P = 0.03), and definite ST (OR 10.00, 95% CI 3.54-28.22, P < 0.01). No significant interaction between pre-hospital ticagrelor vs in-hospital ticagrelor administration and DM was present for the clinical, electrocardiographic and angiographic outcomes as well as for thrombolysis in myocardial infarction major bleeding.CONCLUSIONS: DM remains independently associated with poor myocardial reperfusion and worse 30-day clinical outcomes. No significant interaction was found between pre-hospital vs in-hospital ticagrelor administration and DM status. Further approaches for the treatment of DM patients are needed.CLINICAL TRIAL REGISTRATION: clinicaltrials.gov identifier: NCT01347580.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- STEMI
- antithrombotic drug
- diabetes mellitus
- ticagrelor
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Fabris, Enrico
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Van't Hof, Arnou ...
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Hamm, Christian ...
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Lapostolle, Fréd ...
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Lassen, Jens Fle ...
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Goodman, Shaun G
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Ten Berg, Jurrië ...
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Bolognese, Leona ...
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Cequier, Angel
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Chettibi, Mohame ...
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Hammett, Christo ...
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Huber, Kurt
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Janzon, Magnus
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Merkely, Béla
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Storey, Robert F
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Zeymer, Uwe
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Cantor, Warren J
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Kerneis, Mathieu
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Diallo, Abdourah ...
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Vicaut, Eric
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Montalescot, Gil ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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Catheterization ...
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Linköping University