Hemodynamics, fluids & transfusion
Potent P2Y12 inhibitors in patients with acute myocardial infarction and cardiogenic shock
Main finding · MACEResult — go to the resultAdjusted hazard ratio 0.76 95% CI 0.59–0.99Authors' conclusion
In patients with AMI complicated by cardiogenic shock, the use of potent P2Y12 inhibitors was associated with a lower risk of MACE compared with clopidogrel, without an increased risk of BARC type 2 or greater bleeding.
Study context
- Population
- Patients with acute myocardial infarction (AMI) and cardiogenic shock who underwent PCI of the culprit vesselof 28,949 registry patients
- Participants
- 1,482 patients
- Exposure
- Potent P2Y12 inhibitors vs clopidogrel
- Potent P2Y12 inhibitorsn = 537
- Clopidogreln = 945reference
- Outcome
- Major adverse cardiovascular event (MACE):
- Cardiac death
- MI
- Repeat revascularization
- Definite stent thrombosis
- Follow-up
- 2 years
Methodological detailsnationwide pooled registry (KAMIR-NIH and KAMIR-V)
- Nationwide pooled registry (KAMIR-NIH and KAMIR-V)
Main finding
MACE
Adjusted hazard ratio
0.76
95% CI 0.59–0.99
P = 0.046
By group
Potent P2Y12 inhibitors vs Clopidogrel
aHR 0.76 (95% CI 0.59–0.99); P = 0.046
As reported in the abstract
Observational data: associations, not effects.
Safety
| Outcome | Potent P2Y12 inhibitors | Clopidogrel | aHR (95% CI) | P value | |
|---|---|---|---|---|---|
| BARC type 2 or greater bleeding (major secondary outcome) · 2 years | 12.5% | 10.7% | 1.36 (0.98–1.88) | P = 0.064 | |
| 0.512Adjusted hazard ratio (log scale) |
Bleeding Academic Research Consortium (BARC) type 2 or greater bleeding, subgroups (age ≥ 75 years; Venoarterial extracorporeal membrane oxygenator (VA-ECMO) use)
- Significantly increased bleeding risk with potent P2Y12 inhibitors in patients aged ≥ 75 years
- interaction P = 0.021
- Significantly increased bleeding risk with potent P2Y12 inhibitors with VA-ECMO use
- interaction P = 0.015
Original publication
Potent P2Y12 inhibitors in patients with acute myocardial infarction and cardiogenic shock. Crit Care. Published 6 February 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →