Impact of preprocedural coronary flow grade on duration of dual antiplatelet therapy in acute myocardial infarction
Abstract We investigated the impact of pre-percutaneous coronary intervention (pre-PCI) thrombolysis in myocardial infarction (TIMI) flow grade (pre-TIMI) on 3-month (3-mo) and 12-mo of dual antiplatelet therapy (DAPT) in patients with acute myocardial infarction (AMI). This was a post hoc analysis...
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doaj-b1da4088b6e445f192ff4097a5cac23c2021-06-06T11:38:28ZengNature Publishing GroupScientific Reports2045-23222021-06-0111111410.1038/s41598-021-91130-5Impact of preprocedural coronary flow grade on duration of dual antiplatelet therapy in acute myocardial infarctionYong Hoon Kim0Ae-Young Her1Byeong-Keuk Kim2Sung-Jin Hong3Chul-Min Ahn4Jung-Sun Kim5Young-Guk Ko6Donghoon Choi7Myeong-Ki Hong8Yangsoo Jang9Division of Cardiology, Department of Internal Medicine, Kangwon National University School of MedicineDivision of Cardiology, Department of Internal Medicine, Kangwon National University School of MedicineDivision of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of MedicineDivision of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of MedicineDivision of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of MedicineDivision of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of MedicineDivision of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of MedicineDivision of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of MedicineDivision of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of MedicineDivision of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of MedicineAbstract We investigated the impact of pre-percutaneous coronary intervention (pre-PCI) thrombolysis in myocardial infarction (TIMI) flow grade (pre-TIMI) on 3-month (3-mo) and 12-mo of dual antiplatelet therapy (DAPT) in patients with acute myocardial infarction (AMI). This was a post hoc analysis of the TICO trial. A total of 2083 patients with AMI (pre-TIMI 0/1: n = 1143; pre-TIMI 2/3: n = 940) were evaluated. The primary outcome was the occurrence of net adverse clinical events (NACE), defined as a composite of TIMI major bleeding and major adverse cardiac and cerebrovascular events (MACCE) within 12-mo following PCI. The secondary outcomes were the occurrence of the individual components of TIMI bleedings and MACCE. In the pre-TIMI 0/1 group, the primary and second outcomes were not significantly different between the 3-mo and 12-mo DAPT groups. However, in the pre-TIMI 2/3 group, the occurrences of TIMI minor (adjusted hazard ratio [aHR]: 0.294; p = 0.016) and major or minor bleeding (aHR: 0.483; p = 0.014) on intention-to-treat analysis were significantly higher in the 12-mo than in the 3-mo DAPT group. The occurrence of MACCE was similar between the two groups. A higher bleeding tendency in 12-mo DAPT compared with 3-mo DAPT was more obvious in the pre-TIMI 2/3 group than in the pre-TIMI 0/1 group. Clinical Trial Registration: URL: http://www.clinicaltrials.gov . Unique identifier: NCT02494895.https://doi.org/10.1038/s41598-021-91130-5 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Yong Hoon Kim Ae-Young Her Byeong-Keuk Kim Sung-Jin Hong Chul-Min Ahn Jung-Sun Kim Young-Guk Ko Donghoon Choi Myeong-Ki Hong Yangsoo Jang |
spellingShingle |
Yong Hoon Kim Ae-Young Her Byeong-Keuk Kim Sung-Jin Hong Chul-Min Ahn Jung-Sun Kim Young-Guk Ko Donghoon Choi Myeong-Ki Hong Yangsoo Jang Impact of preprocedural coronary flow grade on duration of dual antiplatelet therapy in acute myocardial infarction Scientific Reports |
author_facet |
Yong Hoon Kim Ae-Young Her Byeong-Keuk Kim Sung-Jin Hong Chul-Min Ahn Jung-Sun Kim Young-Guk Ko Donghoon Choi Myeong-Ki Hong Yangsoo Jang |
author_sort |
Yong Hoon Kim |
title |
Impact of preprocedural coronary flow grade on duration of dual antiplatelet therapy in acute myocardial infarction |
title_short |
Impact of preprocedural coronary flow grade on duration of dual antiplatelet therapy in acute myocardial infarction |
title_full |
Impact of preprocedural coronary flow grade on duration of dual antiplatelet therapy in acute myocardial infarction |
title_fullStr |
Impact of preprocedural coronary flow grade on duration of dual antiplatelet therapy in acute myocardial infarction |
title_full_unstemmed |
Impact of preprocedural coronary flow grade on duration of dual antiplatelet therapy in acute myocardial infarction |
title_sort |
impact of preprocedural coronary flow grade on duration of dual antiplatelet therapy in acute myocardial infarction |
publisher |
Nature Publishing Group |
series |
Scientific Reports |
issn |
2045-2322 |
publishDate |
2021-06-01 |
description |
Abstract We investigated the impact of pre-percutaneous coronary intervention (pre-PCI) thrombolysis in myocardial infarction (TIMI) flow grade (pre-TIMI) on 3-month (3-mo) and 12-mo of dual antiplatelet therapy (DAPT) in patients with acute myocardial infarction (AMI). This was a post hoc analysis of the TICO trial. A total of 2083 patients with AMI (pre-TIMI 0/1: n = 1143; pre-TIMI 2/3: n = 940) were evaluated. The primary outcome was the occurrence of net adverse clinical events (NACE), defined as a composite of TIMI major bleeding and major adverse cardiac and cerebrovascular events (MACCE) within 12-mo following PCI. The secondary outcomes were the occurrence of the individual components of TIMI bleedings and MACCE. In the pre-TIMI 0/1 group, the primary and second outcomes were not significantly different between the 3-mo and 12-mo DAPT groups. However, in the pre-TIMI 2/3 group, the occurrences of TIMI minor (adjusted hazard ratio [aHR]: 0.294; p = 0.016) and major or minor bleeding (aHR: 0.483; p = 0.014) on intention-to-treat analysis were significantly higher in the 12-mo than in the 3-mo DAPT group. The occurrence of MACCE was similar between the two groups. A higher bleeding tendency in 12-mo DAPT compared with 3-mo DAPT was more obvious in the pre-TIMI 2/3 group than in the pre-TIMI 0/1 group. Clinical Trial Registration: URL: http://www.clinicaltrials.gov . Unique identifier: NCT02494895. |
url |
https://doi.org/10.1038/s41598-021-91130-5 |
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