• Je něco špatně v tomto záznamu ?

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

M. Hromadka, Z. Motovska, O. Hlinomaz, P. Kala, I. Varvarovsky, J. Dusek, M. Svoboda, J. Jarkovsky, F. Tousek, P. Jansky, S. Simek, M. Branny, J. Mrozek, R. Miklik, R. Rokyta, P. Widimsky

. 2022 ; 79 (5) : 626-633. [pub] 20211216

Jazyk angličtina Země Nizozemsko

Typ dokumentu časopisecké články, randomizované kontrolované studie, práce podpořená grantem

Perzistentní odkaz   https://www.medvik.cz/link/bmc22018588

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.

Citace poskytuje Crossref.org

000      
00000naa a2200000 a 4500
001      
bmc22018588
003      
CZ-PrNML
005      
20220804134859.0
007      
ta
008      
220720s2022 ne f 000 0|eng||
009      
AR
024    7_
$a 10.1016/j.jjcc.2021.11.015 $2 doi
035    __
$a (PubMed)34924237
040    __
$a ABA008 $b cze $d ABA008 $e AACR2
041    0_
$a eng
044    __
$a ne
100    1_
$a Hromadka, Milan $u Department of Cardiology, University Hospital and Faculty of Medicine in Pilsen, Charles University, Czech Republic
245    14
$a 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 / $c M. Hromadka, Z. Motovska, O. Hlinomaz, P. Kala, I. Varvarovsky, J. Dusek, M. Svoboda, J. Jarkovsky, F. Tousek, P. Jansky, S. Simek, M. Branny, J. Mrozek, R. Miklik, R. Rokyta, P. Widimsky
520    9_
$a 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.
650    _2
$a klopidogrel $7 D000077144
650    _2
$a lidé $7 D006801
650    12
$a infarkt myokardu $7 D009203
650    12
$a koronární angioplastika $x škodlivé účinky $7 D062645
650    _2
$a inhibitory agregace trombocytů $x terapeutické užití $7 D010975
650    _2
$a prasugrel hydrochlorid $7 D000068799
650    _2
$a výsledek terapie $7 D016896
655    _2
$a časopisecké články $7 D016428
655    _2
$a randomizované kontrolované studie $7 D016449
655    _2
$a práce podpořená grantem $7 D013485
700    1_
$a Motovska, Zuzana $u Cardiocenter, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic. Electronic address: zuzana.motovska@lf3.cuni.cz
700    1_
$a Hlinomaz, Ota $u First Department of Internal Medicine - Cardioangiology, International Clinical Research Center, Faculty of Medicine, Masaryk University and St. Anne's University Hospital, Brno, Czech Republic
700    1_
$a Kala, Petr $u Department of Internal Medicine and Cardiology, Faculty of Medicine of Masaryk University and University Hospital Brno, Brno, Czech Republic
700    1_
$a Varvarovsky, Ivo $u Cardiology Centre AGEL, Pardubice, Czech Republic
700    1_
$a Dusek, Jaroslav $u First Department of Internal Medicine, University Hospital Hradec Kralove, Charles University in Prague, Faculty of Medicine in Hradec Kralove, Czech Republic
700    1_
$a Svoboda, Michal $u Institute of Biostatistics and Analyses at the Faculty of Medicine and the Faculty of Science of Masaryk University, Brno, Czech Republic
700    1_
$a Jarkovsky, Jiri $u Institute of Biostatistics and Analyses at the Faculty of Medicine and the Faculty of Science of Masaryk University, Brno, Czech Republic
700    1_
$a Tousek, Frantisek $u Cardiocenter - Department of Cardiology, Regional Hospital, Ceske Budejovice, Czech Republic
700    1_
$a Jansky, Pavel $u Department of Anesthesiology and Resuscitation, University Hospital Kralovske Vinohrady, Prague, Czech Republic
700    1_
$a Simek, Stanislav $u Second Department of Medicine-Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic
700    1_
$a Branny, Marian $u AGEL Research and Training Institute, Trinec Branch, Cardiovascular Center, Podlesi Hospital, Trinec, Czech Republic
700    1_
$a Mrozek, Jan $u Cardiovascular Department, University Hospital Ostrava, Ostrava, Czech Republic
700    1_
$a Miklik, Roman $u Department of Internal Medicine and Cardiology, Faculty of Medicine of Masaryk University and University Hospital Brno, Brno, Czech Republic
700    1_
$a Rokyta, Richard $u Department of Cardiology, University Hospital and Faculty of Medicine in Pilsen, Charles University, Czech Republic
700    1_
$a Widimsky, Petr $u Cardiocenter, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic
773    0_
$w MED00166926 $t Journal of cardiology $x 1876-4738 $g Roč. 79, č. 5 (2022), s. 626-633
856    41
$u https://pubmed.ncbi.nlm.nih.gov/34924237 $y Pubmed
910    __
$a ABA008 $b sig $c sign $y p $z 0
990    __
$a 20220720 $b ABA008
991    __
$a 20220804134852 $b ABA008
999    __
$a ok $b bmc $g 1822268 $s 1169831
BAS    __
$a 3
BAS    __
$a PreBMC
BMC    __
$a 2022 $b 79 $c 5 $d 626-633 $e 20211216 $i 1876-4738 $m Journal of cardiology $n J Cardiol $x MED00166926
LZP    __
$a Pubmed-20220720

Najít záznam

Citační ukazatele

Možnosti archivace