Infarct size following loading with Ticagrelor/Prasugrel versus Clopidogrel in ST-segment elevation myocardial infarction

Muhammad Sabbah, Lars Nepper-Christensen, Lars Køber, Dan Eik Høfsten, Kiril Aleksov Ahtarovski, Christoffer Göransson, Kasper Kyhl, Adam Ali Ghotbi, Mikkel Malby Schoos, Golnaz Sadjadieh, Henning Kelbæk, Jacob Lønborg, Thomas Engstrøm

Publikation: Bidrag til tidsskriftArtikelForskningpeer review

Abstrakt

BACKGROUND: Treatment with newer direct-acting anti-platelet drugs (Ticagrelor and Prasugrel) prior to primary percutaneous coronary intervention (PCI) is associated with improved outcome in patients with ST-segment elevation myocardial infarction (STEMI) when compared with Clopidogrel. We compared infarct size following treatment with Ticagrelor/Prasugrel versus Clopidogrel in the DANish trial in Acute Myocardial Infarction (DANAMI-3) population of STEMI patients treated with primary PCI.

METHODS AND RESULTS: Patients were loaded with Clopidogrel, Ticagrelor or Prasugrel in the ambulance before primary PCI. Infarct size and myocardial salvage index were calculated using cardiac magnetic resonance (CMR) during index admission and at three-month follow-up. Six-hundred-and-ninety-three patients were included in this analysis. Clopidogrel was given to 351 patients and Ticagrelor/Prasugrel to 342 patients. The groups were generally comparable in terms of baseline and procedural characteristics. Median infarct size at three-month follow-up was 12.9% vs 10.0%, in patients treated with Clopidogrel and Ticagrelor/ Prasugrel respectively (p < 0.001), and myocardial salvage index was 66% vs 71% (p < 0.001). Results remained significant in a multiple regression model (p < 0.001).

CONCLUSIONS: Pre-hospital loading with Ticagrelor or Prasugrel compared to Clopidogrel, was associated with smaller infarct size and larger myocardial salvage index at three-month follow-up in patients with STEMI treated with primary PCI.

OriginalsprogEngelsk
Sider (fra-til)7-12
Antal sider6
TidsskriftInternational Journal of Cardiology
Vol/bind314
Tidlig onlinedato7 maj 2020
DOI
StatusUdgivet - 1 sep. 2020

Bibliografisk note

Copyright © 2020. Published by Elsevier B.V.

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