Pepe Martino
University of Bari, Italy
Posters & Accepted Abstracts: J Clin Exp Cardiolog
Objectives & Background: The goal of STEMI treatment is early reperfusion. New oral P2Y12 inhibitors demonstrated to improve angiographic results of primary PCI (pPCI) and patients' clinical prognosis. Of note, oral P2Y12 inhibitors onset of action is significantly impaired in STEMI patients. Aim of our observational study was to establish if the benefit of P2Y12 inhibitors loading dose (LD) administration is time related. Methods: A total of 201 consecutive patients with STEMI addressed to pPCI were enrolled and divided into 3 groups depending on the time interval from "P2Y12 inhibitors LD administration to balloon": Group 2 included patients receiving P2Y12 inhibitors LD at least 60 minutes before pPCI; group 1 within the 60 minutes before pPCI; and group 0 at the moment of pPCI. Angiographic, clinical and biochemical parameters were evaluated. Two-skilled interventional cardiologists evaluated the TFG of the IRA at first angiogram prior to pPCI and post pPCI in a double blinded fashion. ST resolution was as well evaluated as an indicator of successful reperfusion. Results: Pre-pPCI TFG improved throughout the groups proportionally to the increasing "P2Y12 inhibitors LD administration to balloon" time; we found the following rates of prePCI TFG 0/1: 84% in group 0; 51.8% in group 1 and 33.3% in group 2 (p<0.001). Moreover, post pPCI TFG was accordingly significantly different in the three groups (p<0.001): 81.9% in group 0; 88% in group 1; and 96.7% in group 2. Conclusions: Our observational study demonstrates an angiographic time-related benefit of P2Y12 inhibitors administration: A longer time window between P2Y12 inhibitors administration and pPCI significantly improves coronary reperfusion in terms of both pre and post pPCI TIMI flow grade.
Email: drmartinopepe@libero.it
