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Impact of age on th...
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
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- Collet, Jean-Philippe (author)
- Sorbonne Université Paris 6, ACTION Study Group, Hôpital Pitié-Salpêtrière (AP-HP), Paris, France
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- Kerneis, Mathieu (author)
- Sorbonne Université Paris 6, ACTION Study Group, Hôpital Pitié-Salpêtrière (AP-HP), Paris, France
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- Lattuca, Benoit (author)
- Department of Cardiology, CHU Caremeau, Université de Montpellier, ACTION Study Group, Nimes, France
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- Yan, Yan (author)
- Sorbonne Université Paris 6, ACTION Study Group, Hôpital Pitié-Salpêtrière (AP-HP), Paris, France
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- Cayla, Guillaume (author)
- Department of Cardiology, CHU Caremeau, Université de Montpellier, ACTION Study Group, Nimes, France
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- Silvain, Johanne (author)
- Sorbonne Université Paris 6, ACTION Study Group, Hôpital Pitié-Salpêtrière (AP-HP), Paris, France
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- Lapostolle, Frédéric (author)
- SAMU 93 Hôpital Avicenne, Bobigny, France
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- Ecollan, Patrick (author)
- Service Médical d’Urgence, Brigade de Sapeurs-Pompiers de Paris, Paris, France
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- Diallo, Abdourahmane (author)
- ACTION Study Group, Unité de Recherche Clinique, Hôpital Lariboisière, Paris, France
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- Vicaut, Eric (author)
- ACTION Study Group, Unité de Recherche Clinique, Hôpital Lariboisière, Paris, France
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- Hamm, Christian W (author)
- Kerckhoff Klinik, Bad Nauheim, Universitätsklinikum Gießen, Giessen, Germany
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- Van 't Hof, Arnoud W (author)
- Department of Cardiology, Isala Clinics, Zwolle, the Netherlands
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- Montalescot, Gilles (author)
- Sorbonne Université Paris 6, ACTION Study Group, Hôpital Pitié-Salpêtrière (AP-HP), Paris, France
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- Janzon, Magnus, 1961- (contributor)
- Linköpings universitet,Avdelningen för kardiovaskulär medicin,Medicinska fakulteten,Region Östergötland, Kardiologiska kliniken US
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(creator_code:org_t)
- Toulouse, France : Europa Digital & Publishing, 2018
- 2018
- English.
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In: EuroIntervention. - Toulouse, France : Europa Digital & Publishing. - 1774-024X .- 1969-6213. ; 14:7, s. 789-797
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.4...
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Abstract
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- 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.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
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- art (subject category)
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- By the author/editor
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Collet, Jean-Phi ...
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Kerneis, Mathieu
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Lattuca, Benoit
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Yan, Yan
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Cayla, Guillaume
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Silvain, Johanne
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Lapostolle, Fréd ...
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Ecollan, Patrick
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Diallo, Abdourah ...
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Vicaut, Eric
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Hamm, Christian ...
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Van 't Hof, Arno ...
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Montalescot, Gil ...
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Janzon, Magnus, ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
- Articles in the publication
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EuroIntervention
- By the university
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Linköping University