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Sökning: onr:"swepub:oai:DiVA.org:liu-153879" > 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

Fabris, Enrico (författare)
Cardiology Department, Isala Heart Center, Zwolle, the Netherlands, , Cardiovascular Department, University of Trieste, Trieste, Italy
Van't Hof, Arnoud (författare)
Cardiology Department, Isala Heart Center, Zwolle, the Netherlands, Maastricht University Medical Center, Maastricht, the Netherlands, Zuyderland Hospital, Heerlen, the Netherlands
Hamm, Christian W (författare)
Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany
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Lapostolle, Frédéric (författare)
SAMU 93 Hôpital Avicenne, Bobigny, France
Lassen, Jens Flensted (författare)
Department of Cardiology B, Aarhus University Hospital, Aarhus, Denmark
Goodman, Shaun G (författare)
Canadian Heart Research Centre, Division of Cardiology, St. Michael's Hospital, University of Toronto, Toronto, Canada
Ten Berg, Jurriën M (författare)
Department of Cardiology, St. Antonius Hospital Nieuwegein, Nieuwegein, the Netherlands
Bolognese, Leonardo (författare)
Cardiovascular and Neurological Department, Azienda Ospedaliera Arezzo, Arezzo, Italy
Cequier, Angel (författare)
Heart Disease Institute, Hospital Universitario de Bellvitge, University of Barcelona, Spain
Chettibi, Mohamed (författare)
Centre Hospito-universitaire Frantz Fanon, Blida, Algeria
Hammett, Christopher J (författare)
Department of Cardiology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
Huber, Kurt (författare)
3rd Department of Medicine, Cardiology and Intensive Care Medicine, Wilhelminen hospital and Sigmund Freud University, Medical School, Vienna, Austria.
Janzon, Magnus (författare)
Linköpings universitet,Avdelningen för kardiovaskulär medicin,Medicinska fakulteten,Region Östergötland, Kardiologiska kliniken US
Merkely, Béla (författare)
Heart and Vascular Center, Semmelweis University, Budapest, Hungary
Storey, Robert F (författare)
Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
Zeymer, Uwe (författare)
Klinikum Ludwigshafen and Institut für Herzinfarktforschung, Ludwigshafen, Germany
Cantor, Warren J (författare)
Southlake Regional Health Centre, University of Toronto, Ontario, Canada
Kerneis, Mathieu (författare)
Sorbonne Université, ACTION Study Group, Hospital Pitie-Salpetriere (AP-HP), Paris, France
Diallo, Abdourahmane (författare)
Hospital Lariboisiere, ACTION Study Group, Paris, France
Vicaut, Eric (författare)
Hospital Lariboisiere, ACTION Study Group, Paris, France
Montalescot, Gilles (författare)
Sorbonne Université, ACTION Study Group, Hospital Pitie-Salpetriere (AP-HP), Paris, France
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 (creator_code:org_t)
2018-10-09
2019
Engelska.
Ingår i: Catheterization and cardiovascular interventions. - : John Wiley & Sons. - 1522-1946 .- 1522-726X. ; 93:7, s. E369-E377
Relaterad länk:
https://doi.org/10.1...
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https://urn.kb.se/re...
https://doi.org/10.1...
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  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
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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.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

Nyckelord

STEMI
antithrombotic drug
diabetes mellitus
ticagrelor

Publikations- och innehållstyp

ref (ämneskategori)
art (ämneskategori)

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