Practical guidance for P2Y12 inhibitors in acute myocardial infarction undergoing percutaneous coronary intervention
Abstract Aims Potent P2Y12 inhibitors for dual antiplatelet therapy (DAPT) is crucial for managing acute myocardial infarction; however, the selection of drugs is based on limited clinical information such as age and body weight. The current study sought to develop and validate a new risk scoring sy...
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| Veröffentlicht in: | European heart journal. Cardiovascular pharmacotherapy 2021-03, Vol.7 (2), p.112-124 |
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| container_title | European heart journal. Cardiovascular pharmacotherapy |
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| creator | Lee, Seung Hun Kim, Hyun Kuk Jeong, Myung Ho Yasuda, Satoshi Honda, Satoshi Jeong, Young-Hoon Lee, Joo Myung Hahn, Joo-Yong Kang, Jeehoon Chae, Shung Chull Seong, In-Whan Park, Jong-Seon Chae, Jei Keon Hur, Seung-Ho Cha, Kwang Soo Kim, Hyo-Soo Seung, Ki-Bae Rha, Seung-Woon Hwang, Jin-Yong Choi, Dong-Ju Oh, Seok Kyu Kim, Sung Soo Park, Taek Kyu Yang, Jeong Hoon Song, Young Bin Choi, Seung-Hyuk Gwon, Hyeon-Cheol |
| description | Abstract
Aims
Potent P2Y12 inhibitors for dual antiplatelet therapy (DAPT) is crucial for managing acute myocardial infarction; however, the selection of drugs is based on limited clinical information such as age and body weight. The current study sought to develop and validate a new risk scoring system that can be used to guide the selection of potent P2Y12 inhibitors by balancing ischaemic benefit and bleeding risk.
Methods and results
Derivation cohort of 10 687 patients who participated in the Korea Acute Myocardial Infarction Registry-National Institutes of Health study was used to construct a new scoring system. We combined the ischaemic and bleeding models to establish a simple clinical prediction score. Among the low score group (n = 1764), the observed bleeding risk (8.7% vs. 4.4%, P |
| doi_str_mv | 10.1093/ehjcvp/pvaa005 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_2344266243</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A690097717</galeid><oup_id>10.1093/ehjcvp/pvaa005</oup_id><sourcerecordid>A690097717</sourcerecordid><originalsourceid>FETCH-LOGICAL-c490t-c736aee8c276a05646b58e08cc2c8d29d76071edb5f8bb260ac2a188d51a5e93</originalsourceid><addsrcrecordid>eNqFkcFLHDEUxoO0qFivHkugl_aw-pJMMpmjSFsLQj146SlkMm_WLDPJNJlZ8L83y64KRSg55BF-3-PL9xFyweCSQSOu8HHjttPVtLUWQB6RUw5SrpSu5IfXWdQn5DznDQAwpRXX4picCNbUNYA-JfN9sm72zg50vfjOBoe0j4ne8z-MUx8efevnmHIZqXXLjHR8is6mzheFD71NRR0DXUKHaR19WNMJUwFtwLhk6mKKwaanws6Ythh29CfysbdDxvPDfUYefnx_uLld3f3--evm-m7lqgbmlauFsoja8VpZkKpSrdQI2jnudMebrlZQM-xa2eu25Qqs45Zp3UlmJTbijHzdr51S_Ltgns3os8Nh2HszXFQVV4pXoqBf_kE3cUmhmDNcMsEL2jRv1NoOaMrv41zS2y0116oBKKGyulCX71DldDh6FwP2vry_J3Ap5pywN1PyYwnNMDC7os2-aHMougg-H9wu7YjdK_5SawG-7YG4TP9b9gxLl7SP</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2513223499</pqid></control><display><type>article</type><title>Practical guidance for P2Y12 inhibitors in acute myocardial infarction undergoing percutaneous coronary intervention</title><source>MEDLINE</source><source>Oxford University Press Journals All Titles (1996-Current)</source><source>Alma/SFX Local Collection</source><creator>Lee, Seung Hun ; Kim, Hyun Kuk ; Jeong, Myung Ho ; Yasuda, Satoshi ; Honda, Satoshi ; Jeong, Young-Hoon ; Lee, Joo Myung ; Hahn, Joo-Yong ; Kang, Jeehoon ; Chae, Shung Chull ; Seong, In-Whan ; Park, Jong-Seon ; Chae, Jei Keon ; Hur, Seung-Ho ; Cha, Kwang Soo ; Kim, Hyo-Soo ; Seung, Ki-Bae ; Rha, Seung-Woon ; Hwang, Jin-Yong ; Choi, Dong-Ju ; Oh, Seok Kyu ; Kim, Sung Soo ; Park, Taek Kyu ; Yang, Jeong Hoon ; Song, Young Bin ; Choi, Seung-Hyuk ; Gwon, Hyeon-Cheol</creator><creatorcontrib>Lee, Seung Hun ; Kim, Hyun Kuk ; Jeong, Myung Ho ; Yasuda, Satoshi ; Honda, Satoshi ; Jeong, Young-Hoon ; Lee, Joo Myung ; Hahn, Joo-Yong ; Kang, Jeehoon ; Chae, Shung Chull ; Seong, In-Whan ; Park, Jong-Seon ; Chae, Jei Keon ; Hur, Seung-Ho ; Cha, Kwang Soo ; Kim, Hyo-Soo ; Seung, Ki-Bae ; Rha, Seung-Woon ; Hwang, Jin-Yong ; Choi, Dong-Ju ; Oh, Seok Kyu ; Kim, Sung Soo ; Park, Taek Kyu ; Yang, Jeong Hoon ; Song, Young Bin ; Choi, Seung-Hyuk ; Gwon, Hyeon-Cheol ; KAMIR, JAMIR, and SMART-DATE Investigators ; KAMIR, JAMIR, and SMART-DATE Investigators</creatorcontrib><description>Abstract
Aims
Potent P2Y12 inhibitors for dual antiplatelet therapy (DAPT) is crucial for managing acute myocardial infarction; however, the selection of drugs is based on limited clinical information such as age and body weight. The current study sought to develop and validate a new risk scoring system that can be used to guide the selection of potent P2Y12 inhibitors by balancing ischaemic benefit and bleeding risk.
Methods and results
Derivation cohort of 10 687 patients who participated in the Korea Acute Myocardial Infarction Registry-National Institutes of Health study was used to construct a new scoring system. We combined the ischaemic and bleeding models to establish a simple clinical prediction score. Among the low score group (n = 1764), the observed bleeding risk (8.7% vs. 4.4%, P < 0.001) due to potent P2Y12 inhibitors exceeded ischaemic benefit (1.3% vs. 2.2%, P = 0.185) during 12 months. Conversely, the high score group (n = 1898) showed an overall benefit from taking potent P2Y12 inhibitors from the standpoint of observed ischaemic (17.1% vs. 8.6%, P < 0.001) and bleeding events (10.1% vs. 6.8%, P = 0.073). The performance of ischaemic [integrated area under the curve (iAUC) = 0.809] and bleeding model (iAUC = 0.655) was deemed to be acceptable.
Conclusion
The new scoring system is a useful clinical tool for guiding DAPT by balancing ischaemic benefit and bleeding risk, especially among Asian populations. Further validation studies with other cohorts will be required to verify that the new system meets the needs of real clinical practice.</description><identifier>ISSN: 2055-6837</identifier><identifier>EISSN: 2055-6845</identifier><identifier>DOI: 10.1093/ehjcvp/pvaa005</identifier><identifier>PMID: 31977008</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Aggregation ; Analysis ; Angioplasty ; Blood platelets ; Cardiology ; Clinical medicine ; Clinical trials ; Drug dosages ; Evidence-based medicine ; Heart attack ; Heart attacks ; Humans ; Inhibitor drugs ; Internal medicine ; Medical prognosis ; Myocardial Infarction - drug therapy ; Myocardial Infarction - surgery ; Percutaneous Coronary Intervention ; Practice Guidelines as Topic ; Purinergic P2Y Receptor Antagonists - therapeutic use ; Transluminal angioplasty ; United States</subject><ispartof>European heart journal. Cardiovascular pharmacotherapy, 2021-03, Vol.7 (2), p.112-124</ispartof><rights>Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissions@oup.com. 2020</rights><rights>Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissions@oup.com.</rights><rights>COPYRIGHT 2021 Oxford University Press</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c490t-c736aee8c276a05646b58e08cc2c8d29d76071edb5f8bb260ac2a188d51a5e93</citedby><cites>FETCH-LOGICAL-c490t-c736aee8c276a05646b58e08cc2c8d29d76071edb5f8bb260ac2a188d51a5e93</cites><orcidid>0000-0002-2337-7826 ; 0000-0002-6632-7239 ; 0000-0002-1393-4270 ; 0000-0003-0146-2189 ; 0000-0003-3986-9152 ; 0000-0001-5242-2756 ; 0000-0003-0847-5329 ; 0000-0002-5190-227X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,1584,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31977008$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lee, Seung Hun</creatorcontrib><creatorcontrib>Kim, Hyun Kuk</creatorcontrib><creatorcontrib>Jeong, Myung Ho</creatorcontrib><creatorcontrib>Yasuda, Satoshi</creatorcontrib><creatorcontrib>Honda, Satoshi</creatorcontrib><creatorcontrib>Jeong, Young-Hoon</creatorcontrib><creatorcontrib>Lee, Joo Myung</creatorcontrib><creatorcontrib>Hahn, Joo-Yong</creatorcontrib><creatorcontrib>Kang, Jeehoon</creatorcontrib><creatorcontrib>Chae, Shung Chull</creatorcontrib><creatorcontrib>Seong, In-Whan</creatorcontrib><creatorcontrib>Park, Jong-Seon</creatorcontrib><creatorcontrib>Chae, Jei Keon</creatorcontrib><creatorcontrib>Hur, Seung-Ho</creatorcontrib><creatorcontrib>Cha, Kwang Soo</creatorcontrib><creatorcontrib>Kim, Hyo-Soo</creatorcontrib><creatorcontrib>Seung, Ki-Bae</creatorcontrib><creatorcontrib>Rha, Seung-Woon</creatorcontrib><creatorcontrib>Hwang, Jin-Yong</creatorcontrib><creatorcontrib>Choi, Dong-Ju</creatorcontrib><creatorcontrib>Oh, Seok Kyu</creatorcontrib><creatorcontrib>Kim, Sung Soo</creatorcontrib><creatorcontrib>Park, Taek Kyu</creatorcontrib><creatorcontrib>Yang, Jeong Hoon</creatorcontrib><creatorcontrib>Song, Young Bin</creatorcontrib><creatorcontrib>Choi, Seung-Hyuk</creatorcontrib><creatorcontrib>Gwon, Hyeon-Cheol</creatorcontrib><creatorcontrib>KAMIR, JAMIR, and SMART-DATE Investigators</creatorcontrib><creatorcontrib>KAMIR, JAMIR, and SMART-DATE Investigators</creatorcontrib><title>Practical guidance for P2Y12 inhibitors in acute myocardial infarction undergoing percutaneous coronary intervention</title><title>European heart journal. Cardiovascular pharmacotherapy</title><addtitle>Eur Heart J Cardiovasc Pharmacother</addtitle><description>Abstract
Aims
Potent P2Y12 inhibitors for dual antiplatelet therapy (DAPT) is crucial for managing acute myocardial infarction; however, the selection of drugs is based on limited clinical information such as age and body weight. The current study sought to develop and validate a new risk scoring system that can be used to guide the selection of potent P2Y12 inhibitors by balancing ischaemic benefit and bleeding risk.
Methods and results
Derivation cohort of 10 687 patients who participated in the Korea Acute Myocardial Infarction Registry-National Institutes of Health study was used to construct a new scoring system. We combined the ischaemic and bleeding models to establish a simple clinical prediction score. Among the low score group (n = 1764), the observed bleeding risk (8.7% vs. 4.4%, P < 0.001) due to potent P2Y12 inhibitors exceeded ischaemic benefit (1.3% vs. 2.2%, P = 0.185) during 12 months. Conversely, the high score group (n = 1898) showed an overall benefit from taking potent P2Y12 inhibitors from the standpoint of observed ischaemic (17.1% vs. 8.6%, P < 0.001) and bleeding events (10.1% vs. 6.8%, P = 0.073). The performance of ischaemic [integrated area under the curve (iAUC) = 0.809] and bleeding model (iAUC = 0.655) was deemed to be acceptable.
Conclusion
The new scoring system is a useful clinical tool for guiding DAPT by balancing ischaemic benefit and bleeding risk, especially among Asian populations. Further validation studies with other cohorts will be required to verify that the new system meets the needs of real clinical practice.</description><subject>Aggregation</subject><subject>Analysis</subject><subject>Angioplasty</subject><subject>Blood platelets</subject><subject>Cardiology</subject><subject>Clinical medicine</subject><subject>Clinical trials</subject><subject>Drug dosages</subject><subject>Evidence-based medicine</subject><subject>Heart attack</subject><subject>Heart attacks</subject><subject>Humans</subject><subject>Inhibitor drugs</subject><subject>Internal medicine</subject><subject>Medical prognosis</subject><subject>Myocardial Infarction - drug therapy</subject><subject>Myocardial Infarction - surgery</subject><subject>Percutaneous Coronary Intervention</subject><subject>Practice Guidelines as Topic</subject><subject>Purinergic P2Y Receptor Antagonists - therapeutic use</subject><subject>Transluminal angioplasty</subject><subject>United States</subject><issn>2055-6837</issn><issn>2055-6845</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqFkcFLHDEUxoO0qFivHkugl_aw-pJMMpmjSFsLQj146SlkMm_WLDPJNJlZ8L83y64KRSg55BF-3-PL9xFyweCSQSOu8HHjttPVtLUWQB6RUw5SrpSu5IfXWdQn5DznDQAwpRXX4picCNbUNYA-JfN9sm72zg50vfjOBoe0j4ne8z-MUx8efevnmHIZqXXLjHR8is6mzheFD71NRR0DXUKHaR19WNMJUwFtwLhk6mKKwaanws6Ythh29CfysbdDxvPDfUYefnx_uLld3f3--evm-m7lqgbmlauFsoja8VpZkKpSrdQI2jnudMebrlZQM-xa2eu25Qqs45Zp3UlmJTbijHzdr51S_Ltgns3os8Nh2HszXFQVV4pXoqBf_kE3cUmhmDNcMsEL2jRv1NoOaMrv41zS2y0116oBKKGyulCX71DldDh6FwP2vry_J3Ap5pywN1PyYwnNMDC7os2-aHMougg-H9wu7YjdK_5SawG-7YG4TP9b9gxLl7SP</recordid><startdate>20210301</startdate><enddate>20210301</enddate><creator>Lee, Seung Hun</creator><creator>Kim, Hyun Kuk</creator><creator>Jeong, Myung Ho</creator><creator>Yasuda, Satoshi</creator><creator>Honda, Satoshi</creator><creator>Jeong, Young-Hoon</creator><creator>Lee, Joo Myung</creator><creator>Hahn, Joo-Yong</creator><creator>Kang, Jeehoon</creator><creator>Chae, Shung Chull</creator><creator>Seong, In-Whan</creator><creator>Park, Jong-Seon</creator><creator>Chae, Jei Keon</creator><creator>Hur, Seung-Ho</creator><creator>Cha, Kwang Soo</creator><creator>Kim, Hyo-Soo</creator><creator>Seung, Ki-Bae</creator><creator>Rha, Seung-Woon</creator><creator>Hwang, Jin-Yong</creator><creator>Choi, Dong-Ju</creator><creator>Oh, Seok Kyu</creator><creator>Kim, Sung Soo</creator><creator>Park, Taek Kyu</creator><creator>Yang, Jeong Hoon</creator><creator>Song, Young Bin</creator><creator>Choi, Seung-Hyuk</creator><creator>Gwon, Hyeon-Cheol</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2337-7826</orcidid><orcidid>https://orcid.org/0000-0002-6632-7239</orcidid><orcidid>https://orcid.org/0000-0002-1393-4270</orcidid><orcidid>https://orcid.org/0000-0003-0146-2189</orcidid><orcidid>https://orcid.org/0000-0003-3986-9152</orcidid><orcidid>https://orcid.org/0000-0001-5242-2756</orcidid><orcidid>https://orcid.org/0000-0003-0847-5329</orcidid><orcidid>https://orcid.org/0000-0002-5190-227X</orcidid></search><sort><creationdate>20210301</creationdate><title>Practical guidance for P2Y12 inhibitors in acute myocardial infarction undergoing percutaneous coronary intervention</title><author>Lee, Seung Hun ; Kim, Hyun Kuk ; Jeong, Myung Ho ; Yasuda, Satoshi ; Honda, Satoshi ; Jeong, Young-Hoon ; Lee, Joo Myung ; Hahn, Joo-Yong ; Kang, Jeehoon ; Chae, Shung Chull ; Seong, In-Whan ; Park, Jong-Seon ; Chae, Jei Keon ; Hur, Seung-Ho ; Cha, Kwang Soo ; Kim, Hyo-Soo ; Seung, Ki-Bae ; Rha, Seung-Woon ; Hwang, Jin-Yong ; Choi, Dong-Ju ; Oh, Seok Kyu ; Kim, Sung Soo ; Park, Taek Kyu ; Yang, Jeong Hoon ; Song, Young Bin ; Choi, Seung-Hyuk ; Gwon, Hyeon-Cheol</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c490t-c736aee8c276a05646b58e08cc2c8d29d76071edb5f8bb260ac2a188d51a5e93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Aggregation</topic><topic>Analysis</topic><topic>Angioplasty</topic><topic>Blood platelets</topic><topic>Cardiology</topic><topic>Clinical medicine</topic><topic>Clinical trials</topic><topic>Drug dosages</topic><topic>Evidence-based medicine</topic><topic>Heart attack</topic><topic>Heart attacks</topic><topic>Humans</topic><topic>Inhibitor drugs</topic><topic>Internal medicine</topic><topic>Medical prognosis</topic><topic>Myocardial Infarction - drug therapy</topic><topic>Myocardial Infarction - surgery</topic><topic>Percutaneous Coronary Intervention</topic><topic>Practice Guidelines as Topic</topic><topic>Purinergic P2Y Receptor Antagonists - therapeutic use</topic><topic>Transluminal angioplasty</topic><topic>United States</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lee, Seung Hun</creatorcontrib><creatorcontrib>Kim, Hyun Kuk</creatorcontrib><creatorcontrib>Jeong, Myung Ho</creatorcontrib><creatorcontrib>Yasuda, Satoshi</creatorcontrib><creatorcontrib>Honda, Satoshi</creatorcontrib><creatorcontrib>Jeong, Young-Hoon</creatorcontrib><creatorcontrib>Lee, Joo Myung</creatorcontrib><creatorcontrib>Hahn, Joo-Yong</creatorcontrib><creatorcontrib>Kang, Jeehoon</creatorcontrib><creatorcontrib>Chae, Shung Chull</creatorcontrib><creatorcontrib>Seong, In-Whan</creatorcontrib><creatorcontrib>Park, Jong-Seon</creatorcontrib><creatorcontrib>Chae, Jei Keon</creatorcontrib><creatorcontrib>Hur, Seung-Ho</creatorcontrib><creatorcontrib>Cha, Kwang Soo</creatorcontrib><creatorcontrib>Kim, Hyo-Soo</creatorcontrib><creatorcontrib>Seung, Ki-Bae</creatorcontrib><creatorcontrib>Rha, Seung-Woon</creatorcontrib><creatorcontrib>Hwang, Jin-Yong</creatorcontrib><creatorcontrib>Choi, Dong-Ju</creatorcontrib><creatorcontrib>Oh, Seok Kyu</creatorcontrib><creatorcontrib>Kim, Sung Soo</creatorcontrib><creatorcontrib>Park, Taek Kyu</creatorcontrib><creatorcontrib>Yang, Jeong Hoon</creatorcontrib><creatorcontrib>Song, Young Bin</creatorcontrib><creatorcontrib>Choi, Seung-Hyuk</creatorcontrib><creatorcontrib>Gwon, Hyeon-Cheol</creatorcontrib><creatorcontrib>KAMIR, JAMIR, and SMART-DATE Investigators</creatorcontrib><creatorcontrib>KAMIR, JAMIR, and SMART-DATE Investigators</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>European heart journal. Cardiovascular pharmacotherapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lee, Seung Hun</au><au>Kim, Hyun Kuk</au><au>Jeong, Myung Ho</au><au>Yasuda, Satoshi</au><au>Honda, Satoshi</au><au>Jeong, Young-Hoon</au><au>Lee, Joo Myung</au><au>Hahn, Joo-Yong</au><au>Kang, Jeehoon</au><au>Chae, Shung Chull</au><au>Seong, In-Whan</au><au>Park, Jong-Seon</au><au>Chae, Jei Keon</au><au>Hur, Seung-Ho</au><au>Cha, Kwang Soo</au><au>Kim, Hyo-Soo</au><au>Seung, Ki-Bae</au><au>Rha, Seung-Woon</au><au>Hwang, Jin-Yong</au><au>Choi, Dong-Ju</au><au>Oh, Seok Kyu</au><au>Kim, Sung Soo</au><au>Park, Taek Kyu</au><au>Yang, Jeong Hoon</au><au>Song, Young Bin</au><au>Choi, Seung-Hyuk</au><au>Gwon, Hyeon-Cheol</au><aucorp>KAMIR, JAMIR, and SMART-DATE Investigators</aucorp><aucorp>KAMIR, JAMIR, and SMART-DATE Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Practical guidance for P2Y12 inhibitors in acute myocardial infarction undergoing percutaneous coronary intervention</atitle><jtitle>European heart journal. Cardiovascular pharmacotherapy</jtitle><addtitle>Eur Heart J Cardiovasc Pharmacother</addtitle><date>2021-03-01</date><risdate>2021</risdate><volume>7</volume><issue>2</issue><spage>112</spage><epage>124</epage><pages>112-124</pages><issn>2055-6837</issn><eissn>2055-6845</eissn><abstract>Abstract
Aims
Potent P2Y12 inhibitors for dual antiplatelet therapy (DAPT) is crucial for managing acute myocardial infarction; however, the selection of drugs is based on limited clinical information such as age and body weight. The current study sought to develop and validate a new risk scoring system that can be used to guide the selection of potent P2Y12 inhibitors by balancing ischaemic benefit and bleeding risk.
Methods and results
Derivation cohort of 10 687 patients who participated in the Korea Acute Myocardial Infarction Registry-National Institutes of Health study was used to construct a new scoring system. We combined the ischaemic and bleeding models to establish a simple clinical prediction score. Among the low score group (n = 1764), the observed bleeding risk (8.7% vs. 4.4%, P < 0.001) due to potent P2Y12 inhibitors exceeded ischaemic benefit (1.3% vs. 2.2%, P = 0.185) during 12 months. Conversely, the high score group (n = 1898) showed an overall benefit from taking potent P2Y12 inhibitors from the standpoint of observed ischaemic (17.1% vs. 8.6%, P < 0.001) and bleeding events (10.1% vs. 6.8%, P = 0.073). The performance of ischaemic [integrated area under the curve (iAUC) = 0.809] and bleeding model (iAUC = 0.655) was deemed to be acceptable.
Conclusion
The new scoring system is a useful clinical tool for guiding DAPT by balancing ischaemic benefit and bleeding risk, especially among Asian populations. Further validation studies with other cohorts will be required to verify that the new system meets the needs of real clinical practice.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>31977008</pmid><doi>10.1093/ehjcvp/pvaa005</doi><tpages>13</tpages><orcidid>https://orcid.org/0000-0002-2337-7826</orcidid><orcidid>https://orcid.org/0000-0002-6632-7239</orcidid><orcidid>https://orcid.org/0000-0002-1393-4270</orcidid><orcidid>https://orcid.org/0000-0003-0146-2189</orcidid><orcidid>https://orcid.org/0000-0003-3986-9152</orcidid><orcidid>https://orcid.org/0000-0001-5242-2756</orcidid><orcidid>https://orcid.org/0000-0003-0847-5329</orcidid><orcidid>https://orcid.org/0000-0002-5190-227X</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 2055-6837 |
| ispartof | European heart journal. Cardiovascular pharmacotherapy, 2021-03, Vol.7 (2), p.112-124 |
| issn | 2055-6837 2055-6845 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2344266243 |
| source | MEDLINE; Oxford University Press Journals All Titles (1996-Current); Alma/SFX Local Collection |
| subjects | Aggregation Analysis Angioplasty Blood platelets Cardiology Clinical medicine Clinical trials Drug dosages Evidence-based medicine Heart attack Heart attacks Humans Inhibitor drugs Internal medicine Medical prognosis Myocardial Infarction - drug therapy Myocardial Infarction - surgery Percutaneous Coronary Intervention Practice Guidelines as Topic Purinergic P2Y Receptor Antagonists - therapeutic use Transluminal angioplasty United States |
| title | Practical guidance for P2Y12 inhibitors in acute myocardial infarction undergoing percutaneous coronary intervention |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-04T23%3A44%3A00IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_proqu&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Practical%20guidance%20for%20P2Y12%20inhibitors%20in%20acute%20myocardial%20infarction%20undergoing%20percutaneous%20coronary%20intervention&rft.jtitle=European%20heart%20journal.%20Cardiovascular%20pharmacotherapy&rft.au=Lee,%20Seung%20Hun&rft.aucorp=KAMIR,%20JAMIR,%20and%20SMART-DATE%20Investigators&rft.date=2021-03-01&rft.volume=7&rft.issue=2&rft.spage=112&rft.epage=124&rft.pages=112-124&rft.issn=2055-6837&rft.eissn=2055-6845&rft_id=info:doi/10.1093/ehjcvp/pvaa005&rft_dat=%3Cgale_proqu%3EA690097717%3C/gale_proqu%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2513223499&rft_id=info:pmid/31977008&rft_galeid=A690097717&rft_oup_id=10.1093/ehjcvp/pvaa005&rfr_iscdi=true |