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Post a Comment Ticagrelor hemorrhagic safety in patients with acute coronary syndrome with ST-segment elevation received thrombolytic therapy in daily clinical practice: 30-day observation results
- Authors: Bocharov A.V.1, Sidorov D.V.1
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Affiliations:
- Kostroma Regional Clinical Hospital Named After Korolev E.I.
- Issue: Vol 11, No 1 (2020)
- Pages: 67-72
- Section: Original Study Articles
- URL: https://journals.rcsi.science/clinpractice/article/view/19125
- DOI: https://doi.org/10.17816/clinpract19125
- ID: 19125
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Abstract
Background. Effective antithrombotic therapy is a necessary condition for maintaining the patency of the infarct-dependent coronary artery during a primary percutaneous coronary intervention.
Aim. To compare the safety of ticagrelor use in patients with STEMI after ineffective thrombolytic treatment (TLT) and successfully performed recanalization of infarct-dependent artery (IDA) by PCI, withticagrelor loading dose administered in the time window from TLT to PCI, in comparison with the TREAT study results on the risk of bleeding in the real clinical practice.
Methods. A comparative analysis of the results of a 30-day follow-up of 52 patients with acute coronary syndrome with ST-segment elevation who received a thrombolytic therapy with alteplasa and early ticagrelor administration with the ticagrelor group in the TREAT study on the parameters of hemorrhagic safety.
Results. Arterial hypertension, dyslipidemia, generalized atherosclerosis, chronic obstructive pulmonary disease and a history of myocardial infarction were significantly more common in the study group. The analysis of the results revealed no significant differences between the groups in the frequency and risk of hemorrhagic complications. Conclusion. There are no significant differences in the frequency of major bleeding according to the TIMI and BARC criteria between the groups, which indicates the safety of early (within 24 hours after thrombolysis) ticagrelor use in the pharmacoinvasive approach in the real clinical practice.
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##article.viewOnOriginalSite##About the authors
A. V. Bocharov
Kostroma Regional Clinical Hospital Named After Korolev E.I.
Author for correspondence.
Email: bocharovav@mail.ru
ORCID iD: 0000-0002-6027-2898
SPIN-code: 6073-1445
ResearcherId: C-6324-2019
MD, PhD, Head of the Department of Roentgenosurgical Methods of Diagnosis and Treatment
Russian Federation, KostromaD. V. Sidorov
Kostroma Regional Clinical Hospital Named After Korolev E.I.
Email: denis.sidorov1972@mail.ru
Cardiologist, Department of cardiology
Russian Federation, KostromaReferences
- Ibanez B, James S, Agewall S, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: the task force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J. 2018;39:119–117. doi: 10.1093/eurheartj/ehx393.
- Armstrong PW, Gershlick AH, Goldstein P, et al. Fibrinolysis or primary PCI in ST-segment elevation myocardial infarction. N Engl J Med. 2013;368:1379–1387.
- Mehran R, Rao SV, Bhatt DL, et al. Standardized bleeding definitions for cardiovascular clinical trials. A consensus report from the Bleeding Academic Research Consortium. Circulation.2011;123(23):2736–2747. doi: 10.1161/CIRCULATIONAHA.110.009449.
- Berwanger O, Nicolau JC, Carvalho AC, et al. Ticagrelor versus clopidogrel after fibrinolytic therapy in patients with ST-elevation myocardial infarction: rationale and design of the TicagRElor in pAtients with ST elevation myocardial infarction treated with Thrombolysis (TREAT) trial. Am Heart J. 2018;202:89–96. doi: 10.1001/ jamacardio.2018.0612.
- Hicks KA, Stockbridge NI, Targum SI, Temple R.J. Bleeding academic research consortium consensus report the Food and Drug Administration perspective. Circulation. 2011;123:2664–2665.
- Rao AK, Pratt C, Berk A, et al. Thrombolysis in myocardial infarction (TIMI) trial-phase I: hemorragic manifestations and changes in plasma fibrinogen system and fibrinolytic system in patients treated with recombinant tissue plasminogen activator and streptokinase. JACC. 1988;11(1):1–11 doi: 10.1016/0735-1097(88)90158-1.
- Chen ZM, Jiang LX, Chen YP, et al. Addition of clopidogrel to aspirin in 45,852 patients with acute myocardial infarction: randomised placebo-controlled trial. Lancet. 2005;366:1607–1621. doi: 10.1016/S0140-6736(05)67660-X.
- Sabatine MS, Cannon CP, Gibson CM. et al. Addition of clopidogrel to aspirin and fibrinolytic therapy for myocardial infarction with ST-segment elevation. N Engl J Med. 2005;352:1179–1189. doi: 10.1056/NEJMoa050522.
- Wallentin L, Becker RC, Budaj A, et al. Ticagrelor versus clopidogrel in patients with acute coronary syndromes. N Engl J Med. 2009;361:1045–1057. doi: 10.1056/NEJMoa0904327.
- Berwanger O, Lopes RD, Moia DF, et al. Ticagrelor versus clopidogrel in patients with STEMI treated with fibrinolysis. TREAT Trial. JACC. 2019;73(22):2819–2828. doi: 10.1016/j.jacc.2019.03.011.
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