Author + information
- Prasanna Venkataramana,b,
- Nick Andrianopoulosa,b,
- Andrew Teha,b,
- Louise Robertsa,b,
- Stephen Duffya,b,
- Angela Brennana,b,
- Andrew Ajania,b,
- David Clarka,b,
- Martin Sebastiana,b,
- Christopher Reida,b and
- Melanie Freemana,b
Background: There is uncertainty as to the optimal timing to load patients with P2Y12 inhibitors in ACS, with conflicting advice between American and European guidelines. We evaluated the short-term outcomes and safety of pre-lab versus in-lab loading with the novel P2Y12 inhibitors in patients undergoing PCI for ACS.
Methods: We analysed data from 2,887 consecutive patients from a large multicentre Australian registry between 2011 and 2013 who received either prasugrel or ticagrelor. Patients who were intubated, received clopidogrel or thrombolysis were excluded. Clinical and procedural characteristics and in-hospital and 30-day outcomes were compared between the two groups.
Results: Those pre-loaded were more likely to have hypertension, smoking, family history of CAD and prior MI. 1.5% of pre-loaded patients subsequently required inpatient CABG. Those loaded in-lab were more likely to present with cardiogenic shock and STEMI, have single vessel disease and receive GPIIb/IIIa inhibitors. Short-term outcomes were comparable in both groups with no differences in death, peri-procedural AMI, MACE or unplanned revascularization.
Conclusions: In those ACS patients undergoing PCI and pre-loading with novel P2Y12 inhibitors there were increased rate of 30-day bleeding, with the potential to delay CABG. Pre load with P2Y2 inhibitors did not improve short-term ischaemic outcomes.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Coronary Angiography, Intra-Vascular Imaging, Revascularization and Outcomes
Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1166-339
- 2017 American College of Cardiology Foundation