Key result
P2Y12 inhibitor pre-treatment in AMI-CS shows no MACE benefit and is linked to increased major bleeding.
Why the study?
Data were lacking regarding the effectiveness and safety of pre-treatment with P2Y12 inhibitors in patients with acute myocardial infarction complicated by cardiogenic shock.
Does pre-treatment with an oral loading dose of a P2Y12 inhibitor reduce MACE in patients with acute myocardial infarction complicated with cardiogenic shock?
Cohort (n=421)
Does pre-treatment with an oral loading dose of a P2Y12 inhibitor reduce MACE in patients with acute myocardial infarction complicated with cardiogenic shock?
Hazard Ratio: 1.11 (95% CI 0.82–1.5)
Absolute Event Rate: 42.1% vs 38.8%
Pre-treatment with oral P2Y12 inhibitors in AMI patients with cardiogenic shock is associated with increased major bleeding without cardiovascular benefit.
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Associated with higher major bleeding without MACE benefit in AMI-CS; hypothesis-generating and should not change practice.
Elhadad et al. (2025) conducted a cohort in Acute myocardial infarction complicated with cardiogenic shock (AMI-CS) (n=421). Pre-treatment with P2Y12 inhibitors vs. No pre-treatment was evaluated on Major adverse cardiovascular events (MACE) at 30 days (wHR 1.11, 95% CI 0.82-1.50). Pre-treatment with a P2Y12 inhibitor oral load in AMI-CS patients showed no benefit on 30-day MACE (wHR 1.11; 95% CI 0.82-1.50) but was associated with an increased risk of major bleeding.
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