Safety of the primary percutaneous coronary intervention strategy combining pre-hospital prasugrel, enoxaparin and in-hospital bivalirudin in acute ST-segment elevation myocardial infarction

BMC Cardiovascular Disorders

Research Article

Ilkka Tierala¹  Tuomo Nieminen¹  Mika Laine¹  Juho Viikilä² 

[1] Department of Cardiology, Helsinki University Central Hospital, Helsinki, Finland;Department of Cardiology, Päijät-Häme Central Hospital, Keskussairaalankatu 7, 15850, Lahti, Finland;

关键词: Clopidogrel;    Stent Thrombosis;    Prasugrel;    Ticagrelor;    Primary Percutaneous Coronary Intervention;   

DOI  :  10.1186/s12872-016-0333-0

 received in 2016-01-31, accepted in 2016-07-21,  发布年份 2016

来源: Springer

【 摘 要 】

BackroundThe optimal antithrombotic treatment during a primary percutaneous coronary intervention (pPCI) is not known. This single center registry study aims to assess the safety of a novel antithrombotic regimen combining enoxaparine and prasugrel at presentation, followed by bivalirudin at the catheterisation laboratory.MethodsAll consecutive patients who underwent a pPCI were collected prospectively. The primary endpoint was major bleeding within 30 days. The secondary endpoints were a composite of major adverse cardiovascular events (MACE) consisting of cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, a new target vessel revascularisation and all-cause mortality at 30 days.ResultsNinety-nine out of the total of 390 patients were treated according to the new regimen (protocol-treated group). The rest received other antithrombotic treatment (non-protocol-treated group). The protocol-treated group had a lower risk than the non-protocol-treated group according to the GRACE ischaemic (112 vs. 124, p = 0.002) and CRUSADE bleeding scores (21 vs. 28, p < 0.0001). The incidences of bleeding were similar: severe GUSTO or TIMI bleeding occurred in 0 % of the protocol-treated group and in 1.0 and 0.3 %, respectively, of the other group (p = 0.311 for GUSTO and p = 0.559 for TIMI). The incidence of MACE in the groups was 6.1 and 10.7 %, respectively (p = 0.178). The respective incidences of all-cause mortality were 5.1 and 9.6 % (p = 0.158).ConclusionsAdministration of the novel antithrombotic regimen seems to be safe.

【 授权许可】

CC BY   
© The Author(s). 2016