Impact of preprocedural coronary flow grade on duration of dual antiplatelet therapy in acute myocardial infarction

• Published in: Scientific reports Vol. 11; no. 1; p. 11735
• Main Authors: Kim, Yong Hoon, Her, Ae-Young, Kim, Byeong-Keuk, Hong, Sung-Jin, Ahn, Chul-Min, Kim, Jung-Sun, Ko, Young-Guk, Choi, Donghoon, Hong, Myeong-Ki, Jang, Yangsoo
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 03-06-2021; Nature Publishing Group; Nature Portfolio
• Subjects: 692/308; 692/4019; Antiplatelet therapy; Bleeding; Heart attacks; Humanities and Social Sciences; multidisciplinary; Myocardial infarction; NCT; NCT02494895; Science; Science (multidisciplinary); Thrombolysis
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-021-91130-5

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.