Most Read Articles
Jairia Dela Cruz, 2 days ago
In patients with heart failure with reduced ejection fraction (HFrEF) receiving angiotensin-converting-enzyme (ACE) inhibitors, high dosing confers benefits for the risk of death or hospitalization that are similar to that obtained with lower dosing, according to a systematic review and meta-analysis.
11 Sep 2020
Men who use calcium channel blockers (CCBs) are at risk of developing prostate cancer, and the risk increases with the duration of CCB exposure, according to the results of a systematic review and meta-analysis.
06 Sep 2020
Type 2 diabetes mellitus patients taking proton pump inhibitors (PPIs) are at a higher risk of sustaining hip fractures, a recent study has found.
4 days ago
Osteoarthritis (OA) is the most common condition affecting the joints. Dr Lee Eu Jin, an Orthopaedic Surgeon from Liberty Orthopaedic Clinic at Mount Elizabeth Medical Centre, Singapore, shares his insights with Pearl Toh on how to manage OA in the primary care setting.


Pre-hospital loading with ticagrelor/prasugrel trumps clopidogrel in STEMI patients

28 Jun 2020

Pre-hospital loading with ticagrelor or prasugrel reduces infarct size and greater myocardial salvage index in patients with ST-elevation myocardial infarction (STEMI) relative to clopidogrel, a recent study has found.

The study included STEMI patients who were loaded with either clopidogrel (n=351; mean age, 58.8±10.6 years) or ticagrelor/prasugrel (n=342; mean age, 57.8±10.4 years) in the ambulance before receiving primary percutaneous coronary injury. Cardiac magnetic resonance (CMR) was used in the calculation of infarct size and the myocardial salvage index. Outcomes were measured at baseline and after 3 months.

At baseline, all CMR findings were comparable between the clopidogrel and ticagrelor/prasugrel groups, except for left ventricular mass index, which was significantly higher in the latter group (p=0.002).

By the 3-month follow-up, infarct size was significantly lower in the ticagrelor/prasugrel group (10.0 vs 12.9 percent of left ventricular mass; p<0.001), while the myocardial salvage index was significantly higher (71 percent vs 66 percent; p<0.001). Left ventricular mass index remained significantly elevated in the ticagrelor/prasugrel group (p=0.003).

These differences were reported despite no significant gaps in the time to CMR between the clopidogrel and ticagrelor/prasugrel groups (p=0.18). Agent choice had no significant effect on left ventricular ejection fraction, and left ventricular end-diastolic and end-systolic volume indices.

“This is a retrospective study with non-prespecified sub-analysis. Antiplatelet treatment was not randomized. No specific data were available on the timing of loading in relation to symptom onset and time of wiring/PCI,” the researchers said, referring to the study’s limitations.

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Doctor - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Jairia Dela Cruz, 2 days ago
In patients with heart failure with reduced ejection fraction (HFrEF) receiving angiotensin-converting-enzyme (ACE) inhibitors, high dosing confers benefits for the risk of death or hospitalization that are similar to that obtained with lower dosing, according to a systematic review and meta-analysis.
11 Sep 2020
Men who use calcium channel blockers (CCBs) are at risk of developing prostate cancer, and the risk increases with the duration of CCB exposure, according to the results of a systematic review and meta-analysis.
06 Sep 2020
Type 2 diabetes mellitus patients taking proton pump inhibitors (PPIs) are at a higher risk of sustaining hip fractures, a recent study has found.
4 days ago
Osteoarthritis (OA) is the most common condition affecting the joints. Dr Lee Eu Jin, an Orthopaedic Surgeon from Liberty Orthopaedic Clinic at Mount Elizabeth Medical Centre, Singapore, shares his insights with Pearl Toh on how to manage OA in the primary care setting.