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  • Collet, Jean-PhilippeSorbonne Université Paris 6, ACTION Study Group, Hôpital Pitié-Salpêtrière (AP-HP), Paris, France (författare)

Impact of age on the effect of pre-hospital P2Y12 receptor inhibition in primary percutaneous coronary intervention for ST-segment elevation myocardial infarction : the ATLANTIC-Elderly analysis

  • Artikel/kapitelEngelska2018

Förlag, utgivningsår, omfång ...

  • Toulouse, France :Europa Digital & Publishing,2018
  • printrdacarrier

Nummerbeteckningar

  • LIBRIS-ID:oai:DiVA.org:liu-155885
  • https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-155885URI
  • https://doi.org/10.4244/EIJ-D-18-00182DOI

Kompletterande språkuppgifter

  • Språk:engelska
  • Sammanfattning på:engelska

Ingår i deldatabas

Klassifikation

  • Ämneskategori:ref swepub-contenttype
  • Ämneskategori:art swepub-publicationtype

Anmärkningar

  • AIMS: The aim of the study was to examine the main results of the ATLANTIC trial in patients with ST-elevation myocardial infarction (STEMI), randomised to pre- versus in-hospital ticagrelor, according to age.METHODS AND RESULTS: Patients were evaluated by age class (<75 vs. ≥75 years) for demographics, prior cardiovascular history, risk factors, management, and outcomes. Elderly patients (≥75 years; 304/1,862) were more likely to be women, diabetic, lean, with a prior history of myocardial infarction and CABG, and with comorbidities (p<0.01 for all). Elderly patients presented more frequently with acute heart failure and less frequently had thromboaspiration, a stent implanted (p<0.01) and an aggressive antithrombotic regimen. Elderly patients had lower rates of pre- and post-PCI ≥70% ST-segment elevation resolution (43.9% vs. 51.6%; p=0.035), of pre- and post-PCI TIMI 3 flow (17.1% vs. 27.5%, p=0.0002), and a higher rate of the composite of death/MI/stroke/urgent revascularisation (9.9% vs. 2.9%; OR 3.67, 95% CI [2.27; 5.93], p<0.0001) and mortality (8.5% vs. 1.5%; OR 6.45, 95% CI [2.75; 15.11], p<0.0001). There was a non-significant trend towards more frequent major bleedings among elderly patients (TIMI major 2.3% vs. 1.1%; OR 2.13, 95% CI [0.88; 5.18], p=0.095). There was no significant interaction between time of ticagrelor administration (pre-hospital versus in-lab) and class of age for all outcomes.CONCLUSIONS: Elderly patients, who represented one sixth of the patients randomised in the ATLANTIC trial, had less successful mechanical reperfusion and a sixfold increase in mortality at 30 days, probably due to comorbidities and possible undertreatment. The effect of early ticagrelor was consistent irrespective of age.

Ämnesord och genrebeteckningar

Biuppslag (personer, institutioner, konferenser, titlar ...)

  • Kerneis, MathieuSorbonne Université Paris 6, ACTION Study Group, Hôpital Pitié-Salpêtrière (AP-HP), Paris, France (författare)
  • Lattuca, BenoitDepartment of Cardiology, CHU Caremeau, Université de Montpellier, ACTION Study Group, Nimes, France (författare)
  • Yan, YanSorbonne Université Paris 6, ACTION Study Group, Hôpital Pitié-Salpêtrière (AP-HP), Paris, France (författare)
  • Cayla, GuillaumeDepartment of Cardiology, CHU Caremeau, Université de Montpellier, ACTION Study Group, Nimes, France (författare)
  • Silvain, JohanneSorbonne Université Paris 6, ACTION Study Group, Hôpital Pitié-Salpêtrière (AP-HP), Paris, France (författare)
  • Lapostolle, FrédéricSAMU 93 Hôpital Avicenne, Bobigny, France (författare)
  • Ecollan, PatrickService Médical d’Urgence, Brigade de Sapeurs-Pompiers de Paris, Paris, France (författare)
  • Diallo, AbdourahmaneACTION Study Group, Unité de Recherche Clinique, Hôpital Lariboisière, Paris, France (författare)
  • Vicaut, EricACTION Study Group, Unité de Recherche Clinique, Hôpital Lariboisière, Paris, France (författare)
  • Hamm, Christian WKerckhoff Klinik, Bad Nauheim, Universitätsklinikum Gießen, Giessen, Germany (författare)
  • Van 't Hof, Arnoud WDepartment of Cardiology, Isala Clinics, Zwolle, the Netherlands (författare)
  • Montalescot, GillesSorbonne Université Paris 6, ACTION Study Group, Hôpital Pitié-Salpêtrière (AP-HP), Paris, France (författare)
  • Janzon, Magnus,1961-Linköpings universitet,Avdelningen för kardiovaskulär medicin,Medicinska fakulteten,Region Östergötland, Kardiologiska kliniken US(Swepub:liu)magja75 (bidragsgivare)
  • Sorbonne Université Paris 6, ACTION Study Group, Hôpital Pitié-Salpêtrière (AP-HP), Paris, FranceDepartment of Cardiology, CHU Caremeau, Université de Montpellier, ACTION Study Group, Nimes, France (creator_code:org_t)

Sammanhörande titlar

  • Ingår i:EuroInterventionToulouse, France : Europa Digital & Publishing14:7, s. 789-7971774-024X1969-6213

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