Prehospital ticagrelor in ST-segment elevation myocardial infarction

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

Prehospital ticagrelor in ST-segment elevation myocardial infarction

Background:The direct-acting platelet P2Y receptor antagonist ticagrelor can reduce the incidence of major adverse cardiovascular events when administered at hospital admission to patients with ST-segment elevation myocardial infarction (STEMI). Whether prehospital administration of ticagrelor can i...

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Detalhes bibliográficos
Autores:	Montalescot, Gilles, Van't Hof, Arnoud W., Lapostolle, Frédéric, Silvain, Johanne, Lassen, Jens Flensted, Bolognese, Leonardo, Cantor, Warren J., Cequier Fillat, Àngel R., Chettibi, Mohamed, Goodman, Shaun G., Hammett, Christopher J., Huber, Kurt, Janzon, Magnus, Merkely, Béla, Storey, Robert F., Zeymer, Uwe, Stibbe, Olivier, Ecollan, Patrick, Heutz, Wim M.J.M., Swahn, Eva, Collet, Jean-Philippe, Willems, Frank F., Baradat, Caroline, Licour, Muriel, Tsatsaris, Anne, Vicaut, Eric, Hamm, C. W. (Christian W.)
Formato:	artículo
Estado:	Versión publicada
Fecha de publicación:	2014
País:	España
Recursos:	Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:	Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:	oai:recercat.cat:2445/65746
Acesso em linha:	https://hdl.handle.net/2445/65746
Access Level:	acceso abierto
Palavra-chave:	Infart de miocardi Malalties coronàries Anticoagulants (Medicina) Adenosina Myocardial infarction Coronary diseases Anticoagulants (Medicine) Adenosine

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spelling	Prehospital ticagrelor in ST-segment elevation myocardial infarctionMontalescot, GillesVan't Hof, Arnoud W.Lapostolle, FrédéricSilvain, JohanneLassen, Jens FlenstedBolognese, LeonardoCantor, Warren J.Cequier Fillat, Àngel R.Chettibi, MohamedGoodman, Shaun G.Hammett, Christopher J.Huber, KurtJanzon, MagnusMerkely, BélaStorey, Robert F.Zeymer, UweStibbe, OlivierEcollan, PatrickHeutz, Wim M.J.M.Swahn, EvaCollet, Jean-PhilippeWillems, Frank F.Baradat, CarolineLicour, MurielTsatsaris, AnneVicaut, EricHamm, C. W. (Christian W.)Infart de miocardiMalalties coronàriesAnticoagulants (Medicina)AdenosinaMyocardial infarctionCoronary diseasesAnticoagulants (Medicine)AdenosineBackground:The direct-acting platelet P2Y receptor antagonist ticagrelor can reduce the incidence of major adverse cardiovascular events when administered at hospital admission to patients with ST-segment elevation myocardial infarction (STEMI). Whether prehospital administration of ticagrelor can improve coronary reperfusion and the clinical outcome is unknown. Methods: We conducted an international, multicenter, randomized, double-blind study involving 1862 patients with ongoing STEMI of less than 6 hours' duration, comparing prehospital (in the ambulance) versus in-hospital (in the catheterization laboratory) treatment with ticagrelor. The coprimary end points were the proportion of patients who did not have a 70% or greater resolution of ST-segment elevation before percutaneous coronary intervention (PCI) and the proportion of patients who did not have Thrombolysis in Myocardial Infarction flow grade 3 in the infarct-related artery at initial angiography. Secondary end points included the rates of major adverse cardiovascular events and definite stent thrombosis at 30 days. Results: The median time from randomization to angiography was 48 minutes, and the median time difference between the two treatment strategies was 31 minutes. The two coprimary end points did not differ significantly between the prehospital and in-hospital groups. The absence of ST-segment elevation resolution of 70% or greater after PCI (a secondary end point) was reported for 42.5% and 47.5% of the patients, respectively. The rates of major adverse cardiovascular events did not differ significantly between the two study groups. The rates of definite stent thrombosis were lower in the prehospital group than in the in-hospital group (0% vs. 0.8% in the first 24 hours; 0.2% vs. 1.2% at 30 days). Rates of major bleeding events were low and virtually identical in the two groups, regardless of the bleeding definition usedMassachusetts Medical Society2015201520142015info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion12 p.application/pdfapplication/pdfhttps://hdl.handle.net/2445/65746Articles publicats en revistes (Ciències Clíniques)reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésReproducció del document publicat a: http://dx.doi.org/10.1056/NEJMoa1407024New England Journal of Medicine, 2014, vol. 371, num. 11, p. 1016-1027http://dx.doi.org/10.1056/NEJMoa1407024(c) Massachusetts Medical Society, 2014info:eu-repo/semantics/openAccessoai:recercat.cat:2445/657462026-05-29T05:05:01Z
dc.title.none.fl_str_mv	Prehospital ticagrelor in ST-segment elevation myocardial infarction
title	Prehospital ticagrelor in ST-segment elevation myocardial infarction
spellingShingle	Prehospital ticagrelor in ST-segment elevation myocardial infarction Montalescot, Gilles Infart de miocardi Malalties coronàries Anticoagulants (Medicina) Adenosina Myocardial infarction Coronary diseases Anticoagulants (Medicine) Adenosine
title_short	Prehospital ticagrelor in ST-segment elevation myocardial infarction
title_full	Prehospital ticagrelor in ST-segment elevation myocardial infarction
title_fullStr	Prehospital ticagrelor in ST-segment elevation myocardial infarction
title_full_unstemmed	Prehospital ticagrelor in ST-segment elevation myocardial infarction
title_sort	Prehospital ticagrelor in ST-segment elevation myocardial infarction
dc.creator.none.fl_str_mv	Montalescot, Gilles Van't Hof, Arnoud W. Lapostolle, Frédéric Silvain, Johanne Lassen, Jens Flensted Bolognese, Leonardo Cantor, Warren J. Cequier Fillat, Àngel R. Chettibi, Mohamed Goodman, Shaun G. Hammett, Christopher J. Huber, Kurt Janzon, Magnus Merkely, Béla Storey, Robert F. Zeymer, Uwe Stibbe, Olivier Ecollan, Patrick Heutz, Wim M.J.M. Swahn, Eva Collet, Jean-Philippe Willems, Frank F. Baradat, Caroline Licour, Muriel Tsatsaris, Anne Vicaut, Eric Hamm, C. W. (Christian W.)
author	Montalescot, Gilles
author_facet	Montalescot, Gilles Van't Hof, Arnoud W. Lapostolle, Frédéric Silvain, Johanne Lassen, Jens Flensted Bolognese, Leonardo Cantor, Warren J. Cequier Fillat, Àngel R. Chettibi, Mohamed Goodman, Shaun G. Hammett, Christopher J. Huber, Kurt Janzon, Magnus Merkely, Béla Storey, Robert F. Zeymer, Uwe Stibbe, Olivier Ecollan, Patrick Heutz, Wim M.J.M. Swahn, Eva Collet, Jean-Philippe Willems, Frank F. Baradat, Caroline Licour, Muriel Tsatsaris, Anne Vicaut, Eric Hamm, C. W. (Christian W.)
author_role	author
author2	Van't Hof, Arnoud W. Lapostolle, Frédéric Silvain, Johanne Lassen, Jens Flensted Bolognese, Leonardo Cantor, Warren J. Cequier Fillat, Àngel R. Chettibi, Mohamed Goodman, Shaun G. Hammett, Christopher J. Huber, Kurt Janzon, Magnus Merkely, Béla Storey, Robert F. Zeymer, Uwe Stibbe, Olivier Ecollan, Patrick Heutz, Wim M.J.M. Swahn, Eva Collet, Jean-Philippe Willems, Frank F. Baradat, Caroline Licour, Muriel Tsatsaris, Anne Vicaut, Eric Hamm, C. W. (Christian W.)
author2_role	author author author author author author author author author author author author author author author author author author author author author author author author author author
dc.subject.none.fl_str_mv	Infart de miocardi Malalties coronàries Anticoagulants (Medicina) Adenosina Myocardial infarction Coronary diseases Anticoagulants (Medicine) Adenosine
topic	Infart de miocardi Malalties coronàries Anticoagulants (Medicina) Adenosina Myocardial infarction Coronary diseases Anticoagulants (Medicine) Adenosine
description	Background:The direct-acting platelet P2Y receptor antagonist ticagrelor can reduce the incidence of major adverse cardiovascular events when administered at hospital admission to patients with ST-segment elevation myocardial infarction (STEMI). Whether prehospital administration of ticagrelor can improve coronary reperfusion and the clinical outcome is unknown. Methods: We conducted an international, multicenter, randomized, double-blind study involving 1862 patients with ongoing STEMI of less than 6 hours' duration, comparing prehospital (in the ambulance) versus in-hospital (in the catheterization laboratory) treatment with ticagrelor. The coprimary end points were the proportion of patients who did not have a 70% or greater resolution of ST-segment elevation before percutaneous coronary intervention (PCI) and the proportion of patients who did not have Thrombolysis in Myocardial Infarction flow grade 3 in the infarct-related artery at initial angiography. Secondary end points included the rates of major adverse cardiovascular events and definite stent thrombosis at 30 days. Results: The median time from randomization to angiography was 48 minutes, and the median time difference between the two treatment strategies was 31 minutes. The two coprimary end points did not differ significantly between the prehospital and in-hospital groups. The absence of ST-segment elevation resolution of 70% or greater after PCI (a secondary end point) was reported for 42.5% and 47.5% of the patients, respectively. The rates of major adverse cardiovascular events did not differ significantly between the two study groups. The rates of definite stent thrombosis were lower in the prehospital group than in the in-hospital group (0% vs. 0.8% in the first 24 hours; 0.2% vs. 1.2% at 30 days). Rates of major bleeding events were low and virtually identical in the two groups, regardless of the bleeding definition used
publishDate	2014
dc.date.none.fl_str_mv	2014 2015 2015 2015
dc.type.none.fl_str_mv	info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion
format	article
status_str	publishedVersion
dc.identifier.none.fl_str_mv	https://hdl.handle.net/2445/65746
url	https://hdl.handle.net/2445/65746
dc.language.none.fl_str_mv	Inglés
language_invalid_str_mv	Inglés
dc.relation.none.fl_str_mv	Reproducció del document publicat a: http://dx.doi.org/10.1056/NEJMoa1407024 New England Journal of Medicine, 2014, vol. 371, num. 11, p. 1016-1027 http://dx.doi.org/10.1056/NEJMoa1407024
dc.rights.none.fl_str_mv	(c) Massachusetts Medical Society, 2014 info:eu-repo/semantics/openAccess
rights_invalid_str_mv	(c) Massachusetts Medical Society, 2014
eu_rights_str_mv	openAccess
dc.format.none.fl_str_mv	12 p. application/pdf application/pdf
dc.publisher.none.fl_str_mv	Massachusetts Medical Society
publisher.none.fl_str_mv	Massachusetts Medical Society
dc.source.none.fl_str_mv	Articles publicats en revistes (Ciències Clíniques) reponame:Recercat. Dipósit de la Recerca de Catalunya instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str	Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str	Recercat. Dipósit de la Recerca de Catalunya
collection	Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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Prehospital ticagrelor in ST-segment elevation myocardial infarction

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