Gustav Smith
Associate professor
No benefit of ticagrelor pretreatment compared with treatment during percutaneous coronary intervention in patients with ST-segment⇓elevation myocardial infarction undergoing primary percutaneous coronary intervention
Author
Summary, in English
Background—The effects of ticagrelor pretreatment in patients with ST-segment–elevation myocardial infarction undergoing primary percutaneous coronary intervention (PCI) is debated. This study investigated the effects of ticagrelor pretreatment on clinical outcomes in this patient group. Methods and Results—Patients with ST-segment–elevation myocardial infarction undergoing primary PCI were included from October 2010 to October 2014 in Sweden. Screening was done using the SWEDEHEART register (Swedish Web-System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies). A total of 7433 patients were included for analysis with 5438 patients receiving ticagrelor pretreatment and 1995 patients with ticagrelor given only in the catheterization laboratory. The primary end point of the study was 30-day event rates of a composite of all-cause mortality, myocardial infarction (MI), and stent thrombosis. Secondary end points were mortality, MI, or stent thrombosis alone and major in-hospital bleeding. Crude event rates showed no difference in 30-day composite end point (6.2% versus 6.5%; P=0.69), mortality (4.5% versus 4.7%; P=0.86), MI (1.6% versus 1.7%; P=0.72), or stent thrombosis (0.5% versus 0.4%; P=0.80) with ticagrelor pretreatment. Three different statistical models were used to correct for baseline differences. No difference in the composite end point, mortality, MI, or stent thrombosis was seen between the 2 groups after statistical adjustment. No increase in in-hospital major bleeding rate was observed with ticagrelor pretreatment. Conclusions—Ticagrelor pretreatment versus ticagrelor given in the catheterization laboratory in patients with ST-segment–elevation myocardial infarction undergoing primary PCI did not improve the composite end point of all-cause mortality or MI or stent thrombosis or its individual components at 30 days.
Department/s
- Molecular Cardiology
- EpiHealth: Epidemiology for Health
- Cardiovascular Epigenetics
- EXODIAB: Excellence of Diabetes Research in Sweden
- Cardiology
Publishing year
2018
Language
English
Publication/Series
Circulation. Cardiovascular Interventions
Volume
11
Issue
3
Links
Document type
Journal article
Publisher
American Heart Association
Topic
- Cardiac and Cardiovascular Systems
Keywords
- Myocardial infarction
- Percutaneous coronary intervention
- ST-elevation myocardial infarction
- Stents
- Thrombosis
Status
Published
Research group
- Molecular Cardiology
- Cardiovascular Epigenetics
ISBN/ISSN/Other
- ISSN: 1941-7640