Impact of P2Y12 Inhibitors on Thrombus Burden in Patients with ST-Segment Elevation Myocardial Infarction

Year 2024, , 268 - 275, 30.09.2024

Emre Eynel , Bülent Vatan , Direnç Yılmaz

https://doi.org/10.31832/smj.1467390

Abstract

Introduction and Aim: In this study, we aimed to investigate the effects of P2Y12 inhibitors administered at the time of admission to the emergency department in patients presenting with ST-segment elevation myocardial infarction (STEMI) and undergoing primary percutaneous coronary intervention on the thrombus score in the culprit lesion.
Materials and Methods: This retrospective study planned to compare the pre-procedural thrombus scores of 225 patients who presented with STEMI underwent primary percutaneous coronary intervention, and received different P2Y12 inhibitors within 2 hours after the onset of chest pain.
Results: A total of 225 patients were included in our study. Among them, 72 patients received clopidogrel, 85 received ticagrelor, and 68 received prasugrel as the P2Y12 inhibitor. The pre-procedural Grade 5 thrombus was significantly lower in the ticagrelor group compared to the other groups (Clopidogrel 77.78%, Ticagrelor 61.18%, Prasugrel 77.94%; p=0.017).
Conclusions: In our study, ticagrelor among the pre-procedurally loaded P2Y12 inhibitors was found to be superior in terms of early thrombus intensity, and these results are thought to be associated with the early onset antiplatelet effect of ticagrelor.

Keywords

ST segment elevation myocardial infarction, Clopidogrel, Prasugrel, Ticagrelor, Thrombus score

Primer perkütan koroner girişim uygulanan ST segment yükselmeli miyokardiyal enfarktüs (STEMI) hastalarında P2Y12 inhibitörlerinin trombüs yüküne etkisi

Abstract

GİRİŞ VE AMAÇ: Bu çalışmada, ST segment yükselmesi miyokardiyal enfarktüsü (STEMI) tanısıyla acil servise başvuran ve primer perkütan koroner girişim (PCI) uygulanan hastalarda, hastaneye kabul edildiklerinde verilen P2Y12 inhibitörlerinin, culprit lezyondaki trombus skoru üzerindeki etkilerini araştırmayı amaçladık.
MATERYAL VE METOT: Bu retrospektif çalışmada, STEMI tanısı alan ve primer PCI uygulanan ve göğüs ağrısının başlangıcından sonraki 2 saat içinde başvuran 225 hastada farklı P2Y12 inhibitörlerinin, pre-prosedür trombus yüküne etkilerinin karşılaştırması planlandı.
BULGULAR: Çalışmamıza toplam 225 hasta dahil edildi. Bu hastalardan 72'sine klopidogrel, 85'ine tikagrelor ve 68'ine prasugrel verilmişti. Girişim öncesi Grade 5 trombus skoru, tikagrelor grubunda diğer gruplara göre belirgin olarak daha düşüktü (Klopidogrel %77.78, Tikagrelor %61.18, Prasugrel %77.94; p=0.017).
SONUÇLAR: Çalışmamızda, girişim öncesi yüklenen P2Y12 inhibitörleri arasında, tikagrelorun trombus yükü açısından üstün olduğu belirlendi. Bu sonuçların, tikagrelorun erken başlangıçlı antiplatelet etkisi ile ilişkili olduğu düşünülmektedir.

Keywords

st segment yükselmeli miyokardiyal enfarktüs, tikagrelor, prasugrel, klopidogrel, trombüs skoru

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