1. Clinical impact and predictors of complete ST segment resolution after primary percutaneous coronary intervention: A subanalysis of the ATLANTIC Trial
- Author
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Warren J. Cantor, Shaun G. Goodman, Mathieu Kerneis, Frédéric Lapostolle, Jens Flensted Lassen, Gilles Montalescot, Enrico Fabris, Anne Tsatsaris, Robert F. Storey, Leonardo Bolognese, Jurriën M. ten Berg, Uwe Zeymer, Christopher J. Hammett, Béla Merkely, Kurt Huber, Christian W. Hamm, Mohamed Chettibi, Eric Vicaut, Angel Cequier, Abdourahmane Diallo, Magnus Janzon, Arnoud W J van 't Hof, Fabris, Enrico, van 't Hof, Arnoud, Hamm, Christian W, Lapostolle, Frédéric, Lassen, Jens F, Goodman, Shaun G, Ten Berg, Jurriën M, Bolognese, Leonardo, Cequier, Angel, Chettibi, Mohamed, Hammett, Christopher J, Huber, Kurt, Janzon, Magnu, Merkely, Béla, Storey, Robert F, Zeymer, Uwe, Cantor, Warren J, Tsatsaris, Anne, Kerneis, Mathieu, Diallo, Abdourahmane, Vicaut, Eric, Montalescot, Gilles, Cardiologie, RS: CARIM - R2.01 - Clinical atrial fibrillation, MUMC+: MA Med Staf Spec Cardiologie (9), and RS: Carim - H01 Clinical atrial fibrillation
- Subjects
Male ,prehospital ticagrelor ,Ticagrelor ,REPERFUSION THERAPY ,st segment resolution ,medicine.medical_treatment ,PREHOSPITAL TICAGRELOR ,PRIMARY ANGIOPLASTY ,030204 cardiovascular system & hematology ,Coronary Angiography ,Critical Care and Intensive Care Medicine ,DOUBLE-BLIND ,Electrocardiography ,0302 clinical medicine ,TO-BALLOON TIME ,ST segment ,030212 general & internal medicine ,vasodilation ,Coronary Vessel ,Aspirin ,medicine.diagnostic_test ,General Medicine ,Middle Aged ,Coronary Vessels ,reperfusion ,ST-elevation myocardial infarction ,Treatment Outcome ,medicine.anatomical_structure ,Combination ,DELAY ,Cardiology ,Platelet aggregation inhibitor ,Drug Therapy, Combination ,Female ,Cardiology and Cardiovascular Medicine ,ST segment resolution ,Human ,medicine.drug ,medicine.medical_specialty ,st-elevation myocardial infarction ,delay ,ticagrelor ,Aged ,Coronary Circulation ,Double-Blind Method ,Humans ,Percutaneous Coronary Intervention ,Platelet Aggregation Inhibitors ,ST Elevation Myocardial Infarction ,Time-to-Treatment ,03 medical and health sciences ,Coronary circulation ,Reperfusion therapy ,Drug Therapy ,Internal medicine ,medicine ,business.industry ,MORTALITY ,Platelet Aggregation Inhibitor ,ELEVATION MYOCARDIAL-INFARCTION ,Percutaneous coronary intervention ,DIABETES-MELLITUS ,business ,VASODILATION - Abstract
Background: In the ATLANTIC (Administration of Ticagrelor in the catheterization laboratory or in the Ambulance for New ST elevation myocardial Infarction to open the Coronary artery) trial the early use of aspirin, anticoagulation, and ticagrelor coupled with very short medical contact-to-balloon times represent good indicators of optimal treatment of ST-elevation myocardial infarction and an ideal setting to explore which factors may influence coronary reperfusion beyond a well-established pre-hospital system. Methods: This study sought to evaluate predictors of complete ST-segment resolution after percutaneous coronary intervention in ST-elevation myocardial infarction patients enrolled in the ATLANTIC trial. ST-segment analysis was performed on electrocardiograms recorded at the time of inclusion (pre-hospital electrocardiogram), and one hour after percutaneous coronary intervention (post-percutaneous coronary intervention electrocardiogram) by an independent core laboratory. Complete ST-segment resolution was defined as ≥70% ST-segment resolution. Results: Complete ST-segment resolution occurred post-percutaneous coronary intervention in 54.9% ( n=800/1456) of patients and predicted lower 30-day composite major adverse cardiovascular and cerebrovascular events (odds ratio 0.35, 95% confidence interval 0.19–0.65; pConclusions: This study confirmed that post-percutaneous coronary intervention complete ST-segment resolution is a valid surrogate marker for cardiovascular clinical outcomes. In the current era of ST-elevation myocardial infarction reperfusion, patients’ delay and diabetes mellitus are independent predictors of poor reperfusion and need specific attention in the future.
- Published
- 2017