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Sökning: onr:"swepub:oai:DiVA.org:liu-127552" > Effect of Pre-Hospi...

Effect of Pre-Hospital Ticagrelor During the First 24 h After Primary Percutaneous Coronary Intervention in Patients With ST-Segment Elevation Myocardial Infarction The ATLANTIC-H-24 Analysis

Montalescot, Gilles (författare)
University of Paris 06, France
vant Hof, Arnoud W. (författare)
Isala Clin, Netherlands
Bolognese, Leonardo (författare)
Azienda Osped Arezzo, Italy
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Cantor, Warren J. (författare)
University of Toronto, Canada
Cequier, Angel (författare)
University of Barcelona, Spain
Chettibi, Mohamed (författare)
Centre Hospital University of Frantz Fanon, Algeria
Collet, Jean-Philippe (författare)
University of Paris 06, France
Goodman, Shaun G. (författare)
University of Toronto, Canada
Hammett, Christopher J. (författare)
Royal Brisbane and Womens Hospital, Australia
Huber, Kurt (författare)
Wilhelminenhosp, Austria
Janzon, Magnus (författare)
Linköpings universitet,Medicinska fakulteten,Avdelningen för kardiovaskulär medicin,Region Östergötland, Kardiologiska kliniken US
Lapostolle, Frederic (författare)
SAMU 93 Hop Avicenne, France
Flensted Lassen, Jens (författare)
Aarhus University Hospital, Denmark
Licour, Muriel (författare)
AstraZeneca, France
Merkely, Bela (författare)
Semmelweis University, Hungary
Salhi, Nejoua (författare)
AstraZeneca, England
Silvain, Johanne (författare)
University of Paris 06, France
Storey, Robert F. (författare)
University of Sheffield, England
ten Berg, Jurrien M. (författare)
St Antonius Hospital, Netherlands
Tsatsaris, Anne (författare)
AstraZeneca, France
Zeymer, Uwe (författare)
Klinikum Ludwigshafen, Germany; Institute Herzinfarktforsch Ludwigshafen, Germany
Vicaut, Eric (författare)
University of Paris 07, France
Hamm, Christian W. (författare)
Kerckhoff Heart Centre, Germany
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 (creator_code:org_t)
ELSEVIER SCIENCE INC, 2016
2016
Engelska.
Ingår i: JACC. - : ELSEVIER SCIENCE INC. - 1936-8798 .- 1876-7605. ; 9:7, s. 646-656
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
Stäng  
  • OBJECTIVES The aim of this landmark exploratory analysis, ATLANTIC-H-24, was to evaluate the effects of pre-hospital ticagrelor during the first 24 h after primary percutaneous coronary intervention (PCI) in the ATLANTIC (Administration of Ticagrelor in the cath Lab or in the Ambulance for New ST elevation myocardial infarction to open the Coronary artery) study. BACKGROUND The ATLANTIC trial in patients with ongoing ST-segment elevation myocardial infarction showed that pre-hospital ticagrelor was safe but did not improve pre-PCI coronary reperfusion compared with in-hospital ticagrelor. We hypothesized that the effect of pre-hospital ticagrelor may not have manifested until after PCI due to the rapid transfer time (31 min). METHODS The ATLANTIC-H-24 analysis included 1,629 patients who underwent PCI, evaluating platelet reactivity, Thrombolysis In Myocardial Infarction flow grade 3, >= 70% ST-segment elevation resolution, and clinical endpoints over the first 24 h. RESULTS Following PCI, largest between-group differences in platelet reactivity occurred at 1 to 6 h; coronary reperfusion rates numerically favored pre-hospital ticagrelor, and the degree of ST-segment elevation resolution was significantly greater in the pre-hospital group (median, 75.0% vs. 71.4%; p = 0.049). At 24 h, the composite ischemic endpoint was lower with pre-hospital ticagrelor (10.4% vs. 13.7%; p = 0.039), as were individual endpoints of definite stent thrombosis (p = 0.0078) and myocardial infarction (p = 0.031). All endpoints except death (1.1% vs. 0.2%; p = 0.048) favored pre-hospital ticagrelor, with no differences in bleeding events. CONCLUSIONS The effects of pre-hospital ticagrelor became apparent after PCI, with numerical differences in platelet reactivity and immediate post-PCI reperfusion, associated with reductions in ischemic endpoints, over the first 24 h, whereas there was a small excess of mortality. (Administration of Ticagrelor in the cath Lab or in the Ambulance for New ST elevation myocardial infarction to open the Coronary artery [ATLANTIC, NCT01347580]) (C) 2016 by the American College of Cardiology Foundation.

Ämnesord

MEDICAL AND HEALTH SCIENCES  -- Health Sciences (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskaper (hsv//swe)

Nyckelord

myocardial infarction; platelets; reperfusion; stents; thrombosis

Publikations- och innehållstyp

ref (ämneskategori)
art (ämneskategori)

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