How do cardiologists select patients for dual antiplatelet therapy continuation beyond 1 year after a myocardial infarction? Insights from the EYESHOT Post‐MI Study

Luca, Leonardo De; Colivicchi, Furio; Meessen, Jennifer; Uguccioni, Massimo; Piscione, Federico; Bernabò, Paola; Lardieri, Gerardina; Granatelli, Antonino; Gabrielli, Domenico; Gulizia, Michele Massimo; Investigators, Eyeshot Post-MI

doi:10.1002/clc.23262

Cited by 4 publications

(2 citation statements)

References 26 publications

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“…Each site started patient enrolment after local IRB approval. Therefore, data were collected in different periods of consecutive 3 months in each site between March 1 st , 2017, and December 16 th , 2017 [ 10 , 13 ]. Over these periods, 1633 consecutive patients were enrolled in 165 cardiology centers.…”

Section: Methodsmentioning

confidence: 99%

Incidence, Characteristics, and Management of Patients with Recurrent Myocardial Infarctions: Insights from the EYESHOT POST-MI

Luca

Colivicchi

Gabrielli

et al. 2022

Journal of Interventional Cardiology

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Background. It is unknown whether patients who survived two or multiple episodes of myocardial infarction (MI) present different clinical characteristics and management than patients at their first MI. Methods. The EYESHOT post-MI was a prospective, observational, nationwide study aimed to evaluate the management of patients presenting to cardiologists 1 to 3 years from the last MI event. In 3 months of enrolment, 165 Italian cardiology centers included 1633 consecutive post-MI patients. In the present analysis, we stratified the study cohort according to the number of prior MI episodes (i.e., 1, 2 or ≥3). Results. Among the 1618 patients enrolled with complete data on MI history, 1335 (82.5%) were at their first MI episode, 209 (12.9%) had a history of 2 MIs, and the remaining 74 (4.6%) had ≥ 3 prior MIs. Patients with a history of multiple MIs were increasingly older and presented a significantly higher rate of risk factors compared to those at their first MI. During the year prior to enrolment, patients with 2 or ≥3 MI episodes more frequently underwent coronary angiography compared to the other group ( p < 0.0001 ). In addition, several lifesaving and antianginal drugs were more frequently prescribed in patients presenting with a history of multiple MIs compared to those at their first MI. Conclusions. Our data suggest that patients with multiple MIs managed by cardiologists in routine clinical practice present an incremental clinical risk, more frequently undergo coronary angiography, and are more intensively managed with pharmacological therapies compared to patients at their first MI episode.

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Section: Methodsmentioning

confidence: 99%

Incidence, Characteristics, and Management of Patients with Recurrent Myocardial Infarctions: Insights from the EYESHOT POST-MI

Luca

Colivicchi

Gabrielli

et al. 2022

Journal of Interventional Cardiology

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“…To do so, it is necessary to identify the subjects most at risk and to evaluate all relevant therapeutic optimizations, including the duration of dual antiplatelet therapy (DAPT) with aspirin and a P2Y 12 inhibitor in subsets of patients at high ischemic risk in the absence of a concomitant high hemorrhagic risk [6][7][8]. Both the American College of Cardiology/American Heart Association (ACC/AHA) and the ESC GLs recommend treatment with DAPT based on acetylsalicylic acid (ASA, aspirin) and an oral platelet adenosine diphosphate receptor (P2Y 12 ) inhibitor) for 12 months after the acute event, unless a high 2 of 16 hemorrhagic risk is present or unless there is a need for surgery that cannot be deferred within this time [9,10].…”

Section: Introductionmentioning

confidence: 99%

A Therapeutic Pathway in Patients with Chronic Coronary Syndromes: Proposal for Optimization

Caterina

Calabrò

Campo

et al. 2022

JCM

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There is uncertainty in cardiologists’ attitudes for prolonging dual antiplatelet therapy (DAPT) with ticagrelor 60 mg beyond 12 months in post-myocardial infarction (MI) patients. We aimed at characterizing the Italian cardiologists’ perceptions and needs in the management of such patients. Two consecutive questionnaires were proposed between June and November 2021, and compiled by 122 and 87 Cardiologists, respectively. Agreement among cardiologists was defined as either a >70% frequency of concordant responses relative to total respondents or following the Delphi method as developed by the RAND Corporation. An agreement was reached on the indication of ticagrelor as the first choice P2Y12 inhibitor in MI patients, irrespective of the presentation [ST elevation MI (STEMI), 72%, vs. non-ST elevation MI (NSTEMI), 71%] or the management [invasive vs. conservative (75%)]. A consensus was also achieved on the possibility to consider a patient suitable for long-term DAPT with ticagrelor 60 mg even in case of another P2Y12 inhibitor used in the first year after the acute event (74, 85%). To define ischemic and bleeding risks, a consensus was reached on the utilization of one or more scores (87, 71%).

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Low-Dose Ticagrelor in Patients With High Ischemic Risk and Previous Myocardial Infarction: A Multicenter Prospective Real-World Observational Study

Cesaro

Taglialatela

Gragnano

et al. 2020

Journal of Cardiovascular Pharmacology

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Prolonged dual antiplatelet therapy after 12 months in patients with previous myocardial infarction (MI) is attractive to reduce long-term ischemic complications. In the PEGASUS-TIMI 54, the use of low-dose ticagrelor (60 mg b.i.d.) plus aspirin after 12 months from MI reduced the risk of ischemic events, at the price of limited increase on bleeding complications. However, data on the use of low-dose ticagrelor in real-world practice lack. We aim at providing data on prescription/eligibility criteria and outcomes in patients receiving low-dose ticagrelor in the real-world setting. We enrolled consecutive patients eligible for ticagrelor 60 mg according to Italian national regulation in 3 high-volume centers and collected 1-year outcomes. The primary objective of the study is to generate real-world data about clinical characteristics, eligibility criteria, major adverse cardiovascular events, bleeding, and adverse event in patients receiving low-dose ticagrelor from our cohort. One hundred eighty-one patients were consecutively enrolled with a median follow-up of 18 months. The most used and the least used prescription criteria were multivessel coronary disease (72.4%) and chronic kidney disease (15.5%), respectively. At 1-year follow-up, the rate of major adverse cardiovascular events was 4.97%; of these, 3.86% of patients had a MI, and 1.1% had a stroke/transient ischemic attack, whereas no major bleeding occurred. In conclusion, in a real-world study, including patients with previous MI, low-dose ticagrelor for prolonged dual antiplatelet therapy showed to be effective and safe, with no major bleeding occurring at follow-up.

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How do cardiologists select patients for dual antiplatelet therapy continuation beyond 1 year after a myocardial infarction? Insights from the EYESHOT Post‐MI Study

Cited by 4 publications

References 26 publications

Incidence, Characteristics, and Management of Patients with Recurrent Myocardial Infarctions: Insights from the EYESHOT POST-MI

Incidence, Characteristics, and Management of Patients with Recurrent Myocardial Infarctions: Insights from the EYESHOT POST-MI

A Therapeutic Pathway in Patients with Chronic Coronary Syndromes: Proposal for Optimization

Low-Dose Ticagrelor in Patients With High Ischemic Risk and Previous Myocardial Infarction: A Multicenter Prospective Real-World Observational Study

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