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@article{1688915,
author = {Dusek, Jaroslav and Motovska, Zuzana and Hlinomaz, Ota and Miklík, Roman and Hromadka, Milan and Varvarovsky, Ivo and Jarkovský, Jiří and Tousek, Frantisek and Majtan, Bohumil and Simek, Stanislav and Branny, Marian and Mrozek, Jan and Widimsky, Petr},
article_location = {Clare},
article_number = {NOV 2020},
doi = {http://dx.doi.org/10.1016/j.ijcard.2020.06.067},
keywords = {Acute myocardial infarction; Primary percutaneous coronary intervention; Periprocedural myocardial infarction; Prognosis},
language = {eng},
issn = {0167-5273},
journal = {International Journal of Cardiology},
title = {The prognostic significance of periprocedural infarction in the era of potent antithrombotic therapy. The PRAGUE-18 substudy},
url = {https://www.sciencedirect.com/science/article/pii/S0167527320334458?via%3Dihub},
volume = {319},
year = {2020}
}
TY - JOUR
ID - 1688915
AU - Dusek, Jaroslav - Motovska, Zuzana - Hlinomaz, Ota - Miklík, Roman - Hromadka, Milan - Varvarovsky, Ivo - Jarkovský, Jiří - Tousek, Frantisek - Majtan, Bohumil - Simek, Stanislav - Branny, Marian - Mrozek, Jan - Widimsky, Petr
PY - 2020
TI - The prognostic significance of periprocedural infarction in the era of potent antithrombotic therapy. The PRAGUE-18 substudy
JF - International Journal of Cardiology
VL - 319
IS - NOV 2020
SP - 1-6
EP - 1-6
PB - Elsevier Ireland Ltd.
SN - 01675273
KW - Acute myocardial infarction
KW - Primary percutaneous coronary intervention
KW - Periprocedural myocardial infarction
KW - Prognosis
UR - https://www.sciencedirect.com/science/article/pii/S0167527320334458?via%3Dihub
L2 - https://www.sciencedirect.com/science/article/pii/S0167527320334458?via%3Dihub
N2 - Background: The prognostic significance of periprocedural myocardial infarction (MI) remains controversial. Methods and results: The study aims to investigate the incidence of periprocedural MI in the era of high sensitivity diagnostic markers and intense antithrombotics, and its impact on early outcomes of patients with acute MI treated with primary angioplasty (pPCI). Data from the PRAGUE-18 (prasugrel versus ticagrelor in pPCI) study were analyzed. The primary net-clinical endpoint (EP) included death, spontaneous MI, stroke, severe bleeding, and revascularization at day 7. The key secondary efficacy EP included cardiovascular death, spontaneous MI, and stroke within 30 days. The incidence of peri-pPCI MI was 2.3% (N = 28) in 1230 study patients. The net-clinical EP occurred in 10.7% of patients with, and in 3.6% of patients without, peri-pPCI MI (HR 2.92; 95% CI 0.91-9.38; P = 0.059). The key efficacy EP was 10.7% and 3.2%, respectively (HR 3.44; 95% CI 1.06-11.13; P = 0.028). Patients with periprocedural MI were at a higher risk of spontaneous MI (HR 6.19; 95% CI 1.41-27.24; P = 0.006) and stent thrombosis (HR 10.77; 95% CI 2.29-50.70; P = 0.003) within 30 days. Age, hyperlipidemia, multi-vessel disease, post-procedural TIMI <3, pPCI on circumflex coronary artery, and periprocedural GP IIb/IIIa inhibitor were independent predictors of peri-pPCI MI. Conclusions: In the era of intense antithrombotic therapy, the occurrence of peri-pPCI MI is despite highly sensitive diagnostic markers a rare complication, and is associated with an increased risk of early reinfarction and stent thrombosis. (C) 2020 Elsevier B.V. All rights reserved.
ER -
DUSEK, Jaroslav, Zuzana MOTOVSKA, Ota HLINOMAZ, Roman MIKLÍK, Milan HROMADKA, Ivo VARVAROVSKY, Jiří JARKOVSKÝ, Frantisek TOUSEK, Bohumil MAJTAN, Stanislav SIMEK, Marian BRANNY, Jan MROZEK and Petr WIDIMSKY. The prognostic significance of periprocedural infarction in the era of potent antithrombotic therapy. The PRAGUE-18 substudy. \textit{International Journal of Cardiology}. Clare: Elsevier Ireland Ltd., 2020, vol.~319, NOV 2020, p.~1-6. ISSN~0167-5273. Available from: https://dx.doi.org/10.1016/j.ijcard.2020.06.067.
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