2022
The relationship between symptom onset-to-needle time and ischemic outcomes in patients with acute myocardial infarction treated with primary PCI Observations from Prague-18 Study
HROMADKA, Milan; Zuzana MOTOVSKA; Ota HLINOMAZ; Petr KALA; Ivo VARVAROVSKY et al.Základní údaje
Originální název
The relationship between symptom onset-to-needle time and ischemic outcomes in patients with acute myocardial infarction treated with primary PCI Observations from Prague-18 Study
Autoři
HROMADKA, Milan; Zuzana MOTOVSKA; Ota HLINOMAZ; Petr KALA; Ivo VARVAROVSKY; Jaroslav DUSEK; Michal SVOBODA; Jiří JARKOVSKÝ ORCID; Frantisek TOUSEK; Pavel JANSKY; Stanislav SIMEK; Marian BRANNY; Jan MROZEK; Roman MIKLÍK; Richard ROKYTA a Petr WIDIMSKY
Vydání
JOURNAL OF CARDIOLOGY, NETHERLANDS, ELSEVIER, 2022, 0914-5087
Další údaje
Jazyk
angličtina
Typ výsledku
Článek v odborném periodiku
Obor
30201 Cardiac and Cardiovascular systems
Stát vydavatele
Nizozemské království
Utajení
není předmětem státního či obchodního tajemství
Odkazy
Impakt faktor
Impact factor: 2.500
Označené pro přenos do RIV
Ano
Kód RIV
RIV/00216224:14110/22:00128074
Organizační jednotka
Lékařská fakulta
UT WoS
EID Scopus
Klíčová slova anglicky
Acute myocardial infarction; Symptoms onset to needle time; Risk stratification; P2Y12 inhibitors; Ischemic endpoints
Příznaky
Mezinárodní význam, Recenzováno
Změněno: 24. 7. 2023 12:57, Mgr. Tereza Miškechová
Anotace
V originále
Objectives: Based on previous studies with clopidogrel, the time between acute myocardial infarction (AMI) symptoms onset and primary percutaneous coronary intervention (PCI) was proven as important prognostic factor. Our aim was to assess the relationship between symptoms onset to needle time (SNT) and procedural results and the occurrence of ischemic endpoints in primary angioplasty patients treated with potent P2Y12 inhibitors. Methods: A total of 1,131 out of 1,230 patients randomized to the Prague-18 study (prasugrel vs. ticagrelor in primary PCI) were divided into a high and a low-risk group. The effect of defined SNT on patients' ischemic endpoints and prognosis by their risk status at admission was tested. Results: The median SNT was 3.2 hours. Longer SNTs resulted in a more frequent incidence of TIMI flow <3 post PCI (p=0.015). There were significant differences in the occurrence of the combined ischemic endpoint among the compared SNT groups at 30 days (p=0.032), and 1 year (p=0.011), with the highest incidence in the <<= 1 h SNT group of patients. "Latecomers" (SNT>4 hs) in the high-risk group experienced more reinfarction within 1 year [OR (95% CI) 3.23 (1.09-9.62) p=0.035]; no difference was found in the low-risk group. Conclusions: In the era of intense antithrombotic medication, stratification of MI patients undergoing primary angioplasty, based on initial ischemic risk assessment affected prognosis more than symptom onset to needle time. Longer time delay was significantly related to increased incidence of ischemic events and all-cause mortality only in patients with high ischemic risk. (C) 2021 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.