The current status and outcomes of in-hospital P2Y12 receptor inhibitor switching in Korean patients with acute myocardial infarction

Abstract

Background/Aims: While switching strategies of P2Y12 receptor inhibitors (RIs) have sometimes been used in acute myocardial infarction (AMI) patients, the current status of in-hospital P2Y12RI switching remains unknown. Methods: Overall, 8,476 AMI patients who underwent successful revascularization from Korea Acute Myocardial Infarction Registry-National Institute of Health (KAMIR-NIH) were divided according to in-hospital P2Y12RI strategies, and net adverse cardiovascular events (NACEs), defined as a composite of cardiac death, non-fatal myocardial infarction (MI), stroke, or thrombolysis in myocardial infarction (TIMI) major bleeding during hospitalization were compared. Results: Patients with in-hospital P2Y12RI switching accounted for 16.5%, of which 867 patients were switched from clopidogrel to potent P2Y12RI (C-P) and 532 patients from potent P2Y12RI to clopidogrel (P-C). There were no differences in NACEs among the unchanged clopidogrel, the unchanged potent P2Y12RIs, and the P2Y12RI switching groups. However, compared to the unchanged clopidogrel group, the C-P group had a higher incidence of non-fatal MI, and the P-C group had a higher incidence of TIMI major bleeding. In clinical events of in-hospital P2Y12RI switching, 90.9% of non-fatal MI occurred during pre-switching clopidogrel administration, 60.7% of TIMI major bleeding

Meta-Analysis of the Effects of Recombinant Human Brain Natriuretic Peptides on Left Ventricular Remodeling in Patients with Acute Myocardial Infarction

“…When the two groups left the hospital, the difference in the left ventricular poststretch volume (LVEDV) had no obvious meaning ( P > 0.05), while the rhBNP group had EF values and Tei [ 17 ]. The index was significantly higher in the comparison group ( P < 0.05); 6 months after leaving the hospital, the rhBNP group had a Tei index, EF [ 17 ].…”

“…When the two groups left the hospital, the difference in the left ventricular poststretch volume (LVEDV) had no obvious meaning ( P > 0.05), while the rhBNP group had EF values and Tei [ 17 ]. The index was significantly higher in the comparison group ( P < 0.05); 6 months after leaving the hospital, the rhBNP group had a Tei index, EF [ 17 ]. The value comparison group still significantly increased ( P < 0.05), while the rhBNP group's LVEDV and △ LVEDV% were compared to the lower coefficient group, and the difference has a total academic significance ( P < 0.05).…”