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Introduction: We aimed to compare the outcomes of acute coronary syndrome (ACS) patients undergoing in-hospital percutaneous coronary intervention treated with prasugrel versus ticagrelor.
Methods: Among 7,233 patients enrolled to the Acute Coronary Syndrome Israeli Survey (ACSIS) between 2010 and 2018, we identified 1,126 eligible patients treated with prasugrel and 817 with ticagrelor. Comparison between the groups was performed separately in ST-elevation myocardial infarction (STEMI) patients, propensity score matched (PSM) STEMI patients, and non-ST-elevation ACS (NSTE-ACS) patients.
Results: In-hospital complication rates, including rates of stent thrombosis, were not significantly different between groups. In PSM STEMI patients, 30-day re-hospitalization rate (p < 0.05), 30-day MACE (the composite of death, MI, stroke, and urgent revascularization, p = 0.006), and 1-year mortality rates (p = 0.08) were higher in the ticagrelor group compared to the prasugrel group; in NSTE-ACS patients, outcomes were not associated with drug choice. In Cox regression analysis applied on the entire cohort, prasugrel was associated with lower 1-year mortality in STEMI patients but not in NSTE-ACS patients (p for interaction 0.03).
Conclusions: Compared to ticagrelor, prasugrel was associated with superior clinical outcomes in STEMI patients, but not in NSTE-ACS patients.
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http://dx.doi.org/10.1159/000521042 | DOI Listing |
Atherosclerosis
September 2025
Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China; Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin, China; State Key Laboratory of Frigid Zone Cardiovascular Diseases, Harbin Medical University, Harbin, China. Electronic address
Background And Aims: Cold weather is associated with an increased risk of cardiovascular events, but its impact on culprit plaque characteristics in ST-segment elevation myocardial infarction (STEMI) remains unclear.
Methods: This study included 647 STEMI patients who underwent optical coherence tomography (OCT) to assess untreated culprit lesions. Participants were grouped based on ambient temperature on the day of admission or mean ambient temperatures over the preceding 7-, 14-, 21-, and 28-day periods.
Heart
September 2025
Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China.
Background: Early reperfusion therapy is critical in patients with ST-segment elevation myocardial infarction (STEMI). However, limitations in resources and patient-level and system-level barriers delay the administration of reperfusion therapy. This study evaluated the impact of an integrated care strategy for STEMI management in China.
View Article and Find Full Text PDFHeart
September 2025
Kingston University, London, UK.
Importance/background: The 12-lead ECG is recommended in clinical guidelines for prehospital assessment of patients with suspected acute coronary syndrome (ACS) presenting to Emergency Medical Services (EMS).
Objectives: To determine prehospital ECG (PHECG) utilisation since UK national rollout of primary percutaneous coronary intervention, and whether this is associated with clinical outcomes in patients with ACS.
Design: Population-based, linked cohort study using Myocardial Ischaemia National Audit Project data from 1 January 2010 to 31 December 2017, related to patients with ACS conveyed by the EMS to hospital in England and Wales.
Clin Res Cardiol
September 2025
Department of Cardiology, University Heart Center, University Hospital Zurich, Center for Translational and Experimental Cardiology (CTEC), University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.
Background: Diabetic patients with ST-segment elevation myocardial infarction (STEMI) are at an increased risk of cardiovascular events as compared to non-diabetic patients. This analysis investigated outcomes of diabetic patients presenting with multivessel disease (MVD) and STEMI in a contemporary trial and the relevance of an immediate versus staged multivessel PCI strategy in this high-risk population.
Methods: Patients enrolled in the MULTISTARS AMI trial were stratified according to the presence/absence of diabetes.
JACC Case Rep
July 2025
Department of Emergency Medicine, McGovern Medical School at the University of Texas Health Science Center at Houston (UTHealth Houston), Houston, Texas, USA; Texas Emergency Medicine Research Center, Houston, Texas, USA.
Background: The timely transfer of patients with ST-segment elevation myocardial infarction (STEMI) to percutaneous coronary intervention-capable centers is critical for improving outcomes. Although the American Heart Association recommends a door-in-door-out (DIDO) time of ≤30 minutes, national compliance remains low.
Project Rationale: At Harris Health, no patients with STEMI met this benchmark before 2022.