Comparison of Outcomes in Patients Presenting to the Emergency Department with Myocardial Infarction: Initial Administration of Oral Antithrombotic (P2Y12 Antagonist) Loading Therapy in the Emergency Setting

Abstract

Objective: We investigated the effect of the initial P2Y12 loading therapy in emergency department to clinical and angiographic results in patients admitted to the emergency department with myocardial infarction. Material and Methods: The initial P2Y12 loading therapy in emergency department with clinical and angiographic results in the patients admitted to the emergency department with myocardial infarction and had undergone to coronary angiography in year 2015 were investigated retrospectively. The age, gender, co-morbid diseases, the loading P2Y12 therapy in emergency department, the TIMI flow rate and myocardial Blush grade before and after the angiography was recorded. The effect of the initial P2Y12 loading therapy in emergency department to clinical and angiographic results in patients admitted to the emergency department with myocardial infarction were investigated. Results: The mean age of the males was 54.4±12.2 years and females was 65.2±13.9 years. The mean age of the females are greater than males significantly. Stent thrombosis is detected in 5.7% of the patients. The stent thrombosis was more frequently seen in patents with previous coronary artery disease. In-hospital mortality was 3.7%; the mortality rate after angioplasty was 1.98%. There was not any loading therapy in 65.3% of the patients; clopidogrel was loaded in 25%, ticagrelor was 2.2% and prasugrel was 7.4%. The TIMI score and blush grade was similar before angioplasty in all groups; also the TIMI score and blush grade was similar after angioplasty. Discussion: In conclusion, the results the loading therapy with clopidogrel, ticagrelor and prasugrel in emergency department were similar. Both of the three agents effectivity are similar.

Keywords

• P2Y12
• Myocardial İnfarction
• Coronary Angiography
• TIMI Flow Rate
• Myocardial Blush Grade

Supporting Institution

No financial support was received for this study

Ethical Statement

This retrospective study was designed to analyze data from patients presenting to the emergency department (ED) with acute myocardial infarction (STEMI/NSTEMI) who underwent emergency coronary angiography at Bağcılar Training and Research Hospital, following approval by the Institutional Ethics Committee.

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