J 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 (203 Česká republika), Zuzana MOTOVSKA (203 Česká republika, garant), Ota HLINOMAZ (203 Česká republika, domácí), Petr KALA (203 Česká republika, domácí), Ivo VARVAROVSKY (203 Česká republika), Jaroslav DUSEK (203 Česká republika), Michal SVOBODA (203 Česká republika, domácí), Jiří JARKOVSKÝ (203 Česká republika, domácí), Frantisek TOUSEK (203 Česká republika), Pavel JANSKY (203 Česká republika), Stanislav SIMEK (203 Česká republika), Marian BRANNY (203 Česká republika), Jan MROZEK (203 Česká republika), Roman MIKLÍK (203 Česká republika, domácí), Richard ROKYTA (203 Česká republika) a Petr WIDIMSKY (203 Česká republika)

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

Kód RIV

RIV/00216224:14110/22:00128074

Organizační jednotka

Lékařská fakulta

UT WoS

000821518300009

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.