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001-es BibID:	BIBFORM079024
035-os BibID:	(WoS)000433402600002 (Scopus)85046123774
Első szerző:	Komócsi András
Cím:	Comparison of Platelet Function Guided Versus Unguided Treatment With P2Y12 Inhibitors in Patients With Acute Myocardial Infarction (from the Hungarian Myocardial Infarction Registry) / Komócsi András, Aradi Dániel, Szűk Tibor, Nagy Gergely György, Ebrahim Noori, Ruzsa Zoltán, Kiss Róbert G., Andrássy Péter, Nagy Lajos, Nagy Ferenc Tamás, Lupkovics Géza, Kőszegi Zsolt, Dézsi Csaba András, Papp Előd, Molnár Zsolt, Kupó Péter, Ofner Péter, Merkely Béla, Jánosi András
Dátum:	2018
ISSN:	0002-9149
Megjegyzések:	Evidence is conflicting regarding the clinical benefits of selecting P2Y12 inhibitors based on platelet function testing (PFT). Between March 1, 2013 and March 1, 2014, we collected clinical characteristics and platelet function data in a nationwide acute myocardial infarction (AMI) registry from 15 interventional cardiology centers in Hungary. The risk of allcause mortality at 1 year were compared after propensity score (PS) matching between patients receiving PFT-guided and unguided P2Y12-inhibitor therapies. High platelet reactivity on clopidogrel (HPRoC) was uniformly defined with the Multiplate assay. A total of 5,583 patients with AMI and coronary intervention were registered. After exclusion of cases with contraindication to prasugrel, propensity matching resulted in a sample of 2,104 patients with well-adjusted characteristics. Clopidogrel was the dominant P2Y12 inhibitor in both groups (unguided: 96% vs PFT guided: 85%, p <0.001). In the PFT-guided group, 19% of patients had HPRoC and 77% of them were switched to prasugrel. According to the adjusted analysis, all-cause mortality at 1 year was significantly lowerin the PFT-guided compared with the unguided group (hazard ratio 0.57 [95% confidence interval 0.43 to 0.77], p <0.001). Although prasugrel treatment was not associated with lower all-cause mortality in the overall cohort, patients with HPRoC who switched to prasugrel had significantly lower mortality when compared with those continuing clopidogrel (hazard ratio 0.33 [95% confidence interval 0.12 to 0.92], p <0.05). In conclusion, in patients with AMI, PFT-guided treatment with a high rate of switchover to prasugrel was associated with a lower risk of mortality. Prasugrel was a predictor of lower mortality in patients with HPRoC but not in the overall cohort of AMI.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:	American Journal Of Cardiology. - 121 : 10 (2018), p. 1129-1137. -
További szerzők:	Aradi Dániel Szűk Tibor (1967-) (kardiológus) Nagy Gergely György (1976-) (orvos) Ebrahim, Noori Ruzsa Zoltán Kiss Róbert Gábor Andrássy Péter Nagy Lajos Nagy Ferenc (orvos Szeged) Lupkovics Géza Kőszegi Zsolt (1962-) (kardiológus, belgyógyász) Dézsi Csaba András Papp Előd Molnár Zsolt Kupó Péter Ofner Péter Merkely Béla (1965-) (orvos) Jánosi András
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