| Autor: |
Wennan, Liu, Ziping, Li, Tianqi, Yang, Geru, A, Haonan, Sun, Hangkuan, Liu, Xiwen, Song, Zhengyang, Jin, Linjie, Li, Yongle, Li, Yongchen, Hao, Jing, Liu, Dong, Zhao, Xin, Zhou, Qing, Yang, Zuyi, Yuan |
| Rok vydání: |
2022 |
| Zdroj: |
Cardiovascular drugs and therapy. |
| ISSN: |
1573-7241 |
| Popis: |
Thrombus aspiration in ST-elevation myocardial infarction (STEMI) with high thrombus burden did not improve clinical outcomes. The clinical efficacy of the bailout use of platelet glycoprotein IIb/IIIa inhibitors (GPIs) in this clinical scenario remains unknown.We assessed associations between GPI use and in-hospital major bleeds, ischemic events, and mortality among STEMI patients treated with percutaneous coronary intervention (PCI) and thrombus aspiration in a nationwide acute coronary syndrome registry (the Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome project).A total of 5896 STEMI patients who received thrombus aspiration were identified, among which 56.3% received GPI therapy. In a 1-to-1 propensity-score-matched cohort, compared with STEMI patients not treated with GPI, GPI use was associated with a 69% increase in major in-hospital bleeds, with an odds ratio (OR) of 1.69, a 95% confidence interval (CI) of 1.08 to 2.65, and a nonsignificant reduction in ischemic events (OR: 0.61, 95% CI: 0.36 to 1.06), as well as a neutral effect on mortality (OR: 0.93, 95% CI: 0.55 to 1.58). However, among patients aged 60 years, GPI use was associated with a reduction in ischemic events (OR: 0.27, 95% CI: 0.08 to 0.98), and no significant increase in major bleeds was observed.In a nationwide registry, routine use of GPI following thrombus aspiration was not associated with reduced in-hospital ischemic events and mortality but at the cost of increased major bleeding. However, for patients aged 60 years, there may be a potential net benefit. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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