Coronary disease & ACSCohort study
Pretreatment With P2Y12 Inhibitors in ST-Segment Elevation Myocardial Infarction
- Prospective registry cohort study
- single-centre registry (Bern-PCI)
Pretreatment given in 708 (63.4%) of Cohort 1; withheld in 798 (94.2%) of Cohort 2
Authors' conclusion
In this cohort study of patients with STEMI undergoing primary percutaneous coronary intervention, P2Y12 inhibitor pretreatment was not associated with improved MACCEs.
Study context
- Population
- STEMI patients undergoing PCI, Bern-PCI registry, 2016–2020
- Participants
- 1,116 vs 847
- Exposure
- Immediate vs delayed P2Y12 inhibitor pretreatment
- Cohort 1n = 1,116
- Cohort 2n = 847reference
- Outcome
- MACCE:
- All-cause death
- Recurrent MI
- Stroke
- Definite stent thrombosis
- Follow-up
- 30 days
Main finding
As reported in the abstract
Adjusted hazard ratio
0.91
95% CI 0.65–1.28
P = 0.59
By group
Cohort 1 vs Cohort 2
adjusted HR 0.91 (95% CI 0.65–1.28); P = 0.59
Observational data: associations, not effects.
Further findings
| Outcome | Values | adjusted HR (95% CI) | P value | |
|---|---|---|---|---|
| MACCE, pretreatment received vs not received (sensitivity analysis) | Pretreatment 7.1% · No pretreatment 8.4% | 1.17 (0.78–1.74) | P = 0.45 | |
| 0.512Adjusted hazard ratio (log scale) |
| Outcome | Values | median difference (minutes) | P value |
|---|---|---|---|
| Median difference in P2Y12 loading-to-angiography time — Cohort 1 vs Cohort 2 | 52 | ||
| Median difference in P2Y12 loading-to-angiography time — Pretreatment vs No pretreatment | 100 |
Original publication
Pretreatment With P2Y12 Inhibitors in ST-Segment Elevation Myocardial Infarction. JACC Cardiovasc Interv. Published 8 January 2024. doi:10.1016/j.jcin.2023.10.064
Summarised from the published abstract; every number is checked against it