Key result
Ticagrelor and prasugrel linked to ~31% lower in-hospital MACCE during PCI for stent thrombosis.
Why the study?
Data on outcomes of PCI following stent thrombosis are limited, and differences exist based on timing.
Does the timing of stent thrombosis and use of specific inhibitors affect in-hospital MACCE and mortality in patients undergoing PCI?
Cohort
Yes
Does the timing of stent thrombosis and use of specific inhibitors affect in-hospital MACCE and mortality in patients undergoing PCI?
Effect estimate: OR 0.69 (95% CI 0.49-0.95)
In patients undergoing PCI for stent thrombosis, the use of ticagrelor or prasugrel is associated with improved in-hospital outcomes.
May support potent P2Y12 inhibitor use in stent thrombosis PCI; leaves open need for randomized confirmation.
BACKGROUND: There are limited data on the outcomes of percutaneous coronary intervention (PCI) following stent thrombosis (ST) and differences exist based on timing. AIMS: Our aim was to study the rates of PCI procedures for an ST indication among all patients admitted for PCI at a national level and to compare their characteristics and procedural outcomes based on ST timing. METHODS: All PCI procedures in England and Wales (2014-2020) were retrospectively analysed and stratified by the presence of ST into four groups: non-ST, early ST (0-30 days), late ST (>30-360 days), very late ST (>360 days). Multivariable logistic regression models were performed to assess the odds ratios (OR) of in-hospital MACCE (major adverse cardiovascular and cerebrovascular events, a composite of mortality, acute stroke and reinfarction) and mortality. RESULTS: inhibitors (ticagrelor: OR 0.69, 95% CI: 0.49-0.95; prasugrel: OR 0.54, 95% CI: 0.30-0.96). CONCLUSIONS: inhibitors could further improve outcomes in this high-risk procedural group.
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Mohamed et al. (2022) conducted a cohort in Stent thrombosis. Ticagrelor or prasugrel was evaluated on In-hospital MACCE (mortality, acute stroke, and reinfarction) and mortality (OR 0.69, 95% CI 0.49-0.95). Ticagrelor (OR 0.69; 95% CI 0.49-0.95) and prasugrel (OR 0.54; 95% CI 0.30-0.96) were associated with reduced odds of in-hospital MACCE or mortality in patients undergoing PCI for stent thrombosis.
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