Author + information
- Eduardo Flores,
- Gustavo Jiménez-Brítez,
- Rodolfo San Antonio,
- Marco Hernandez,
- Gala Caixal,
- John García,
- Victoria Martin-Yuste,
- Monica Masotti,
- Manel Sabaté and
- Xavier Freixa
Background: Mild therapeutic hypothermia (MTH) is associated with an increased risk of Stent Thrombosis (ST) in patients with an Out-of-Hospital Cardiac Arrest (OHCA) underwent percutaneous coronary intervention (PCI). There is not a recommendations about which antiplatelet regimen should be used in patients with Acute Coronary Syndrome (ACS) after OHCA.
Aims: To assess the incidence of probable and definite ST and bleeding events in patients with ACS under MTH after an OHCA, compared the use of ticagrelor with clopidogrel.
Methods and Results: From January 2010 to August 2016, 144 patients were treated with MTH after an OHCA. Among them, 114 had an ACS (79%) and 98 (67,3%) were treated with primary PCI with stent implantation. Of them 61 (62,2%) were treated with clopidogrel, and 32 (32,6%) with ticagrelor. During hospitalization, the incidence of probable or definite ST was significantly higher in patients receiving clopidogrel than ticagrelor (11,4% vs. 0%; p: 0.04), there was no significantly differences in any (28,6% vs. 25%; p: 0.645) or major bleedings (BARC 3 or 5) (11,4% vs. 12,5%; p: 0.685), between groups. Finally, in-hospital mortality did not differ between groups (26,2% vs. 25%; p: 0.862).
Conclusions: In this study, as compared to clopidogrel, ticagrelor was associated with a lower rate of ST, without differences in bleedings events in patients with ACS under MTH with stent implantation. According to these results, ticagrelor should be considered in this setting.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Novel Developments in Acute Coronary Syndromes
Abstract Category: 15. Interventional Cardiology: ACS/AMI/Hemodynamics and Pharmacology
Presentation Number: 1194-145
- 2017 American College of Cardiology Foundation