Abstract
Abstract 12219: Pre-Treatment With P2Y12 Inhibitor in Patients With Non-ST Elevation Acute Coronary Syndrome; a Meta-Analysis
Circulation (New York, N.Y.), Vol.144(Suppl_1), pp.A12219-A12219
11/16/2021
DOI: 10.1161/circ.144.suppl_1.12219
Abstract
IntroductionThe guidelines for the management of acute coronary syndrome in patients presenting without persistent ST-segment elevation (NSTE-ACS) recommend against the routine use of pre-treatment with P2Y12 inhibitors when early invasive management is planned. Recently, multiple randomized clinical trials (RCTs) were published to compare the efficacy and safety of pre-treatment with P2Y12 inhibitors HypothesisPre-treatment with P2Y12 inhibitors improves clinical outcomes in NSTE-ACS. MethodsWe conducted a meta-analysis of all studies that evaluated clinical outcomes of pre-treatment with P2Y12 inhibitors versus no-pretreatment in the treatment of NSTE-ACS. The primary outcome was 30-days major adverse cardiovascular events (MACE). Secondary outcomes included risk of major bleeding, all-cause mortality, myocardial infarction (MI), and target vessel revascularization (TVR). ResultsA total of 7 studies, and 103,678 patients were included. In regards to the primary outcome, the rate of MACE was similar between the two groups (OR 0.89; 95% CI 0.67-1.19; p=0.44). On the other hand, the rate of major bleeding was significantly higher in the pre-treatment group when compared to no- pre-treatment (Pre-treatment 2.6% vs control 1.7%, p=0.008). All-cause mortality, risk of MI, and risk of TVR were similar between the two treatment groups (Figure 1). ConclusionsOur findings correlate with the ESC guidelines, and we recommend against the routine use of pre-treatment with P2Y12 inhibitors in patients with NSTE-ACS.
Details
- Title: Subtitle
- Abstract 12219: Pre-Treatment With P2Y12 Inhibitor in Patients With Non-ST Elevation Acute Coronary Syndrome; a Meta-Analysis
- Creators
- Abdullah Al-abcha - Michigan State UniversityYehia Saleh - Houston MethodistLayan El-khatib - Ford Motor CompanyAhmed Elshafie - Michigan State UniversityHarith Ghnaima - University of BaghdadSandeep Banga - Michigan State Universitygeorge Abela - Michigan State University
- Resource Type
- Abstract
- Publication Details
- Circulation (New York, N.Y.), Vol.144(Suppl_1), pp.A12219-A12219
- Publisher
- Lippincott Williams & Wilkins
- DOI
- 10.1161/circ.144.suppl_1.12219
- ISSN
- 0009-7322
- eISSN
- 1524-4539
- Language
- English
- Date published
- 11/16/2021
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984757271302771
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