Prior antiplatelet exposure in acute myocardial infarction was not independently associated with 3-year major adverse cardiac and cerebrovascular events (adjusted HR 0.967, 95% CI 0.850-1.100).
Does prior antiplatelet exposure affect 3-year major adverse cardiac and cerebrovascular events in Korean patients with acute myocardial infarction?
Prior antiplatelet exposure in AMI patients is a marker for a higher-risk clinical phenotype but does not independently worsen 3-year MACCE outcomes after adjusting for baseline differences.
Absolute Event Rate: 0% vs 0%
Background The impact of prior antiplatelet exposure on outcomes of acute myocardial infarction remains unclear, particularly in East Asian populations with distinct antithrombotic response profiles. Methods This retrospective cohort study analyzed 29 281 patients with acute myocardial infarction from 2 nationwide Korean registries. After excluding patients with atrial fibrillation, prior coronary artery disease, heart failure, cerebrovascular accident, or thrombolysis and those discharged on oral anticoagulants, 21 304 patients were categorized into previous‐user and nonuser groups. Propensity score matching was performed to adjust for baseline differences. The primary outcome was 3‐year major adverse cardiac and cerebrovascular events. Results Previous users were older and had more comorbidities and angiographic complexity. Unadjusted analysis showed higher major adverse cardiac and cerebrovascular event rates in previous users, but the difference attenuated after propensity score matching in both the overall matched (adjusted hazard ratio HR, 0.967 95% CI, 0.850–1.100) and selected population (adjusted HR, 1.036 95% CI, 0.847–1.267). All‐cause death remained slightly elevated in the overall matched cohort (HR, 1.204 95% CI, 1.004–1.443) but not in the selected population. In‐hospital outcomes and platelet reactivity findings supported the high‐risk profile of prior users. Conclusions Prior antiplatelet exposure was associated with a higher‐risk clinical phenotype among patients with acute myocardial infarction, but this relationship was not independent after adjustment for baseline differences. These findings should be interpreted as hypothesis generating and underscore the importance of individualized antithrombotic strategies tailored to risk profiles, particularly in East Asian populations.
Oh et al. (Fri,) reported a other. Prior antiplatelet exposure in acute myocardial infarction was not independently associated with 3-year major adverse cardiac and cerebrovascular events (adjusted HR 0.967, 95% CI 0.850-1.100).