What type of study is this?

This is a Cohort Study study (also classified as: Human Clinical Trial, Pre-Registered Trial).

December 2, 2025European Heart Journal Open1 citationsOpen Access

Acute Pharmacologic Management of Myocardial Infarction in Patients Undergoing PCI: Insights from the Italian nationwide EYESHOT-2 Prospective Registry

Key Points

In-hospital outcomes confirmed lower mortality rates in myocardial infarction patients undergoing PCI, indicating effective management strategies.
Antithrombotic therapy was utilized variably, with significant implications for acute coronary syndromes management across Italy's cardiac care units.
Data were analyzed from the EYESHOT-2 registry, a prospective study assessing PCI treatments and outcomes among 2,806 hospitalized patients.
Ongoing discrepancies highlight the importance of aligning clinical practices with evidence-based antithrombotic therapy guidelines.

Abstract

Abstract Aims International guidelines recommend specific antithrombotic strategies for acute myocardial infarction (AMI) patients undergoing percutaneous coronary intervention (PCI). However, real-world practice often diverges. This study aimed to assess antithrombotic therapy use in AMI patients admitted to cardiac care units (CCUs) across Italy. Methods and Results The EmploYEd Antithrombotic Therapies in Patients with Acute Coronary Syndromes Hospitalized in Italian Cardiac Care Units (EYESHOT-2) registry (NCT06316128) is an Italian nationwide, prospective study evaluating AMI management, focusing primarily on PCI-treated patients. Between February 1 and 29, 2024, 2,806 patients were enrolled across 183 Italian CCUs. PCI was performed in 83.5% of cases, while 16.5% received conservative treatment. Patients not undergoing PCI were older, more often female, had more comorbidities, and were more frequently diagnosed with NSTEMI. Pre-treatment with dual antiplatelet therapy (DAPT) before angiography was administered in 58.4% of PCI-treated patients. In the cath-lab, most received oral P2Y12 inhibitors post-procedure. In-hospital outcomes favoured PCI, with lower rates of mortality, re-infarction, and major bleeding. Independent predictors of in-hospital bleeding among PCI patients included older age (OR 1.05, 95% CI 1.03–1.07, p0.0001), prior bleeding (OR 2.38, 95% CI 1.02–5.59, p=0.046), recent surgery (OR 3.47, 95% CI 1.28–9.42, p=0.01), Killip class III/IV (OR 1.75, 95% CI 1.00–3.05, p=0.049), and femoral access (OR 2.85, 95% CI 1.80–4.49, p0.0001), while, among patients treated conservatively, included history of anaemia (OR 4.83, 95% CI 2.24-10.41, p0.0001) and peripheral vascular disease (OR 2.75, 95% 1.24-6.12, p=0.01). Conclusion This nationwide registry highlights improvements in AMI care in Italy but reveals persistent discrepancies between guideline-recommended and actual practice, underscoring the need for broader adoption of evidence-based strategies. Clinical Trial Registration URL: http://www.clinicaltrials.gov. NCT06316128.

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