Prior Antiplatelet Exposure and Clinical Outcomes Among Korean Patients With Acute Myocardial Infarction

Area of Science:

• Cardiology
• Pharmacology
• Public Health

Background:

• The influence of previous antiplatelet medication on acute myocardial infarction (AMI) outcomes is not fully understood, especially in East Asian populations.
• East Asian individuals may exhibit unique responses to antithrombotic therapies.

Purpose of the Study:

• To investigate the association between prior antiplatelet exposure and 3-year major adverse cardiac and cerebrovascular events (MACCE) in AMI patients.
• To assess the impact of prior antiplatelet use on clinical outcomes in a large East Asian cohort.

Main Methods:

• Retrospective analysis of 21,304 AMI patients from Korean nationwide registries.
• Exclusion of patients with specific comorbidities or treatments (e.g., atrial fibrillation, oral anticoagulants).
• Propensity score matching to control for baseline differences between previous antiplatelet users and nonusers.

Main Results:

• Previous antiplatelet users had higher comorbidity burden and angiographic complexity.
• Unadjusted analysis showed increased MACCE in previous users; however, this association attenuated after propensity score matching.
• All-cause mortality was slightly elevated in the overall matched cohort but not in a selected subgroup.

Conclusions:

• Prior antiplatelet exposure in AMI patients is linked to a higher-risk profile but not an independent predictor of adverse outcomes after adjustment.
• Findings suggest the need for personalized antithrombotic strategies based on individual risk profiles.
• Further research is warranted, particularly in East Asian populations, to refine treatment approaches.