Residual platelet reactivity, thrombus burden and myocardial reperfusion in patients treated by PCI after successful pre-hospital fibrinolysis compared to primary PCI

We compared residual platelet reactivity and post PCI atherothrombotic burden using OFDI in patients successfully treated by primary PCI versus pharmacoinvasive approach (PI) defined as PCI after successful pre-hospital fibrinolysis. Despite pre-hospital P2Y12-inhibitor loading dose, high rates of h...

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Published inJournal of thrombosis and thrombolysis Vol. 50; no. 4; pp. 858 - 866
Main Authors Roule, Vincent, Schwob, Lin, Briet, Clément, Lemaitre, Adrien, Bignon, Mathieu, Ardouin, Pierre, Sabatier, Rémi, Blanchart, Katrien, Beygui, Farzin
Format Journal Article
LanguageEnglish
Published New York Springer US 01.11.2020
Springer Nature B.V
Subjects
Blood clots
Cardiology
Drug therapy
Fibrinolysis
Hematology
Medicine
Medicine & Public Health
Patients
Platelets
Reperfusion
Thrombosis
Primary PCI
Platelet reactivity
Fibrinolysis
Rhrombus
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Summary:We compared residual platelet reactivity and post PCI atherothrombotic burden using OFDI in patients successfully treated by primary PCI versus pharmacoinvasive approach (PI) defined as PCI after successful pre-hospital fibrinolysis. Despite pre-hospital P2Y12-inhibitor loading dose, high rates of high on-treatment platelet reactivity were found at the time of PCI in both groups. Primary PCI patients had higher post stenting thrombus burden and lower rates of final normal myocardial blush grade compared to PI. These findings support the use of a pharmacoinvasive reperfusion strategy especially when primary PCI cannot be timely performed.
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ISSN:0929-5305
1573-742X
DOI:10.1007/s11239-020-02113-8