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Pre-Percutaneous Coronary Intervention TIMI Flow Grade in STEMI Patients Treated with Pre-Hospital Ticagrelor Loading
S Suleiman1, J J Coughlan2, S Arockiam2
1Tallaght University Hospital1, Tallaght, Dublin 24, Ireland.
Irish Medical Journal
|May 9, 2022
Summary
Pre-hospital ticagrelor loading in STEMI patients showed over one-fifth achieving TIMI flow grade 3 before PCI. This outcome is comparable to previous studies using clopidogrel.
Area of Science:
- Cardiology
- Emergency Medicine
- Pharmacology
Background:
- ST-elevation myocardial infarction (STEMI) requires rapid reperfusion.
- Pre-hospital antiplatelet therapy aims to improve outcomes.
- Ticagrelor is a P2Y12 inhibitor used in STEMI management.
Purpose of the Study:
- To evaluate the proportion of STEMI patients achieving TIMI flow grade 3 pre-PCI with pre-hospital ticagrelor loading.
- To compare these results with historical data from the clopidogrel era.
Main Methods:
- Retrospective observational analysis of STEMI patients from 01/01/2016 to 31/12/2019.
- Inclusion criteria: STEMI patients receiving pre-hospital 180 mg ticagrelor loading.
- Assessment of pre-PCI TIMI flow grade (ppTFG) in the infarct-related artery via coronary angiography.
Main Results:
- 590 patients met inclusion criteria.
- 21.2% (125 patients) presented with ppTFG 3.
- 78.8% (465 patients) presented with ppTFG ≤ 2.
- In-hospital mortality was similar between groups (4% vs 5.6%, p=0.48).
Conclusions:
- Over one-fifth of STEMI patients pre-loaded with ticagrelor achieved ppTFG 3.
- This finding is comparable to historical data from the clopidogrel era.
- Pre-hospital ticagrelor demonstrates a similar rate of early coronary artery patency in STEMI patients.
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