Key result
Anticoagulant therapy significantly reduced the incidence of stroke (1.33% vs 7.33%, p<0.05) compared to standard care in patients with anterior acute myocardial infarction and severe left ventricular dysfunction post-PCI.
Why the study?
Severe LVD after AMI increases risks of stroke, thromboembolism, and recurrent AMI, making appropriate anticoagulation strategies and risk stratification crucial to mitigate adverse events.
Does post-PCI anticoagulant therapy reduce 30-day major adverse cardiovascular events in patients with anterior acute myocardial infarction and severe left ventricular dysfunction?
RCT (n=300)
Randomized
No
Does post-PCI anticoagulant therapy reduce 30-day major adverse cardiovascular events in patients with anterior acute myocardial infarction and severe left ventricular dysfunction?
In patients with anterior AMI and severe LVD undergoing PCI, the addition of anticoagulant therapy significantly reduced the 30-day incidence of stroke compared to standard care.
Answers are grounded in this paper and cite their sources.
Supports post-PCI anticoagulation in anterior AMI with severe LVD to reduce stroke; provides RCT data extending antithrombotic strategies in this subgroup.
Background: Acute myocardial infarction (AMI) can result in severe left ventricular dysfunction (LVD) and cardiac failure, increasing risk of complications like stroke, thrombo-embolism, and recurrent AMI. Appropriate anticoagulation strategies are crucial for mitigating adverse events. The risk stratification of these patients involves evaluating their propensity for thrombotic and hemorrhagic events. Objectives: The study determined risk stratification and anticoagulation strategies for AMI patients with severe LVD post-PCI. Methods: At a tertiary hospital in Peshawar Pakistan, an investigation was conducted on 300 patients who presented with anterior AMI and 40% LVEF upon admission. Group A received anticoagulant therapy as part of their post-PCI management, whereas Group B received standard post-PCI management without anticoagulant therapy. Various risk scores, including CHA2DS2-VASc and HAS-BLED score, and major adverse cardiovascular events, were used in assessing patient's risk of thrombosis events of bleeding through risk stratification. Results: Mean age of patients was 63.47+8.19 years, mean BMI was 28.76+3.0 and 193/300 (64.33%) were females. Hypertension, hyperlipidemia and diabetes were the prevailing comorbidities (p<0.05) among the subjects. CHA2DS2-VASc scores classified patients into low-risk group (29.33%), medium risk (59.66%) and high-risk cohort (11%).
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Ullah et al. (2023) conducted an RCT in Acute myocardial infarction with severe left ventricular dysfunction (n=300). Anticoagulant therapy vs. Standard post-PCI management without anticoagulant therapy was evaluated on Stroke within 30 days post-PCI (p=<0.05). Anticoagulant therapy significantly reduced the incidence of stroke (1.33% vs 7.33%, p<0.05) compared to standard care in patients with anterior acute myocardial infarction and severe left ventricular dysfunction post-PCI.
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