Journal Article

Prehospital Ticagrelor in ST-Segment Elevation Myocardial Infarction

Licour, Muriel, Goodman, Shaun G, van 't Hof, Arnoud W, Bolognese, Leonardo, Cantor, Warren J, Zeymer, Uwe, Swahn, Eva, Janzon, Magnus, Montalescot, Gilles, Stibbe, Olivier, Storey, Robert F, Merkely, Béla, Hammett, Christopher J, Chettibi, Mohamed, Willems, Frank F, Huber, Kurt, Ecollan, Patrick, Vicaut, Eric, Cequier, Ángel, Baradat, Caroline, Lapostolle, Frédéric, Tsatsaris, Anne, Hamm, Christian W, Heutz, Wim M.J.M, Collet, Jean-Philippe, Lassen, Jens Flensted, Silvain, Johanne

2014

Overview

This study compared administration of the antiplatelet agent ticagrelor in the ambulance with administration in the cath lab in patients with ST-segment elevation MI. Prehospital administration did not improve coronary reperfusion before PCI but did reduce the risk of stent thrombosis. Effective antiplatelet therapy combining the inhibition of both thromboxane A 2 –dependent platelet aggregation and P2Y 12 receptors is necessary in patients undergoing percutaneous coronary intervention (PCI), particularly those with ST-segment elevation myocardial infarction (STEMI). Studies in this patient population have shown that the more intense P2Y 12 -receptor inhibition achieved with the use of prasugrel, ticagrelor, or cangrelor, as compared with clopidogrel, is associated with better clinical outcomes and a lower risk of stent thrombosis. 1 – 5 The benefit was obtained with in-hospital administration of these drugs, and it is not known whether earlier administration would be as safe and . . .

• Publisher: Massachusetts Medical Society
• Subject: Acute coronary syndromes / Adenosine - administration & dosage / Adenosine - adverse effects / Adenosine - analogs & derivatives / Aged / Angiography / Anticoagulants - adverse effects / Anticoagulants - therapeutic use / Biological and medical sciences / Bleeding / Blood platelets / Cardiology. Vascular system / Catheterization / Clinical outcomes / Clinical trials / Coronary Angiography / Coronary heart disease / Coronary vessels / Double-Blind Method / Drug therapy / Drug Therapy, Combination / Electrocardiography - drug effects / Emergency Medical Services / Female / General aspects / Heart / Heart attacks / Hemorrhage - chemically induced / Humans / Implants / Intubation / Male / Medical sciences / Middle Aged / Myocardial infarction / Myocardial Infarction - diagnosis / Myocardial Infarction - drug therapy / Myocardial Infarction - mortality / Myocardial Reperfusion / Myocarditis. Cardiomyopathies / Patients / Purinergic P2Y Receptor Antagonists - administration & dosage / Purinergic P2Y Receptor Antagonists - adverse effects / Reperfusion / Thrombolysis / Thrombosis / Ticlopidine - administration & dosage / Ticlopidine - adverse effects / Ticlopidine - analogs & derivatives / Time-to-Treatment