Antithrombotic treatment during coronary angioplasty after failed thrombolysis: strategies and prognostic implications. Results of the RESPIRE registry

Sagredo, Mario Sádaba; Arrieta, Miren Telleria; Carlos, Federico Gimeno de; Lacuesta, Elena Sánchez; Ramírez, Juan A. Bullones; Rocamora, Javier Pineda; Yuste, Victoria Martín; Camarero, Tamara García; Larman, Mariano; Rumoroso, José Ramón

doi:10.1186/s12872-017-0636-9

Cited by 4 publications

(1 citation statement)

References 23 publications

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“…Согласно данным многоцентрового проспективного ис следования, основанного на испанском регистре RESPIRE, в которое в 2012-2013 гг. были включены 417 больных, подвергшихся «спасительному» ЧКВ (после неуспешной ТЛТ), 22,3 % не получали дополнительную терапию, 36,6 % получили НФГ, 15,5 % -абциксимаб, 10,5 % -абциксимаб с НФГ, 5,7 % -бивалирудин, 4,3 % эноксапарин [20].…”

Section: парентеральная антикоагулянтная терапия при тромболитической...unclassified

Features of Parenteral Anticoagulant Therapy in Patients With Myocardial Infarction According to the Russian Register of Acute Myocardial Infarction – REGION-IM

et al. 2022

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Aim To study specific features of the parenteral anticoagulant therapy for acute myocardial infarction (MI) in the Russian Federation and to evaluate the consistency of the prescribed parenteral anticoagulant therapy with the effective clinical guidelines.Material and methods REGION-MI, the Russian rEGIstry for acute myOcardial iNfarction, is a multicenter observational study. This registry includes all patients admitted to hospitals with a documented diagnosis of ST-elevation acute MI (STEMI) and non-ST-elevation acute MI (NSTEMI) based on the criteria of the Forth Universal Definition of MI of the European Society of Cardiology. Risk of bleeding was assessed with the Academic Research Consortium for High Bleeding Risk (ARC-HBR) scale, and risk of major bleeding in patients with NSTEMI was additionally assessed with the CRUSADE scale.Results From November 01, 2020 through April 03, 2022, 5025 patients were included into the REGION-MI registry. At primary vascular departments, 70.5% of patients were administered unfractionated heparin (NFH); at regional vascular centers, 37.1 % of patients were administered NFH, 29.6 % enoxaparin, 20,2% NFH in combination with enoxaparin, 6.8 % fondaparinux, 4.2 % NFH in combination with fondaparinux, and 1.9 % nadroparin. At the prehospital stage, NFH was used as an anticoagulant support for the thrombolytic therapy (TLT) in 84% of patients, and low-molecular heparins (LMH) were used in 16 %. At the hospital stage, UFH was administered to 64.4 % of patients, and enoxaparin was administered to 23.9 % of patients. Among the patients who had undergone primary percutaneous coronary intervention (PCI), 40 % received NFH, 25 % enoxaparin, 22 % NFH in combination with enoxaparin, 7 % fondaparinux, and 4 % NFH in combination with fondaparinux. In conservative and invasive tactics of therapy for NSTEMI, NFH was also administered more frequently (43 and 43 %, respectively), followed by (according to frequency of administration) enoxaparin (36 and 34 %, respectively), NFH in combination with enoxaparin (10 and 16 %, respectively), fondaparinux (7 and 6 %, respectively), and NFH in combination with fondaparinux (3 and 1 %, respectively).Conclusion According to the Russian registry of acute MI, REGION-MI, with all strategies for the treatment of MI, parenteral anticoagulants are not prescribed in full consistency with clinical guidelines. The most frequently used parenteral anticoagulant is NFH. Despite the high efficacy and safety of fondaparinux, the frequency of its administration remains unjustifiably low not only in the Russian Federation but also in other countries. The same can be said about the administration of enoxaparin to patients who had received TLT. Attention should be paid to physicians’ awareness of recent clinical guidelines, to minimize the prehospital treatment with parenteral anticoagulants, to limit this treatment to the TLT support, and to provide continuity between all stages of medical care.

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Section: парентеральная антикоагулянтная терапия при тромболитической...unclassified

Features of Parenteral Anticoagulant Therapy in Patients With Myocardial Infarction According to the Russian Register of Acute Myocardial Infarction – REGION-IM

et al. 2022

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Life after abciximab; what’s next for intracoronary thrombus?

McGhie¹,

Amos²,

Elder³

et al. 2019

J Thromb Thrombolysis

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Sex differences in distribution, management and outcomes of combined ischemic-bleeding risk following acute coronary syndrome

Mohamed

Rashid

Clarke

et al. 2021

International Journal of Cardiology

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Background: Risk factors of bleeding and recurrent ischemic events after acute coronary syndrome (ACS) often overlap. Whether the distribution and management of these complications vary by sex remains unknown.Methods: ACS hospitalizations in the United Kingdom between 2010 and 2017 were retrospectively analyzed, stratified by sex and bleeding-ischaemic risk combination (using CRUSADE and GRACE scores). Regression analyses were performed to examine the association between risk-groups and receipt of percutaneous coronary intervention (PCI) and dual antiplatelet therapy (DAPT) on discharge, as well as in-hospital clinical outcomes.Results: Out of 584,360 patients, a third of males (32.3%) and females (32.6%) were in the dual high bleeding-ischemic risk group. Dual high-risk patients of both sexes were less likely to receive PCI and DAPT, with a significant increase in odds of MACE, allcause and cardiac mortality, and bleeding (see figure), with the greatest difference between sexes observed in the dual-high risk group in which females were less likely to receive guideline-recommended therapy (PCI and DAPT) and more likely to experience adverse outcomes. Conclusion:ACS patients with dual high bleeding-ischemic risk are less likely to receive guideline-recommended therapy and experience significantly worse outcomes, especially in females. Novel strategies are needed to effectively manage this highly prevalent and complex patient group and address the under-treatment of females.

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Antithrombotic treatment during coronary angioplasty after failed thrombolysis: strategies and prognostic implications. Results of the RESPIRE registry

Cited by 4 publications

References 23 publications

Features of Parenteral Anticoagulant Therapy in Patients With Myocardial Infarction According to the Russian Register of Acute Myocardial Infarction – REGION-IM

Features of Parenteral Anticoagulant Therapy in Patients With Myocardial Infarction According to the Russian Register of Acute Myocardial Infarction – REGION-IM

Life after abciximab; what’s next for intracoronary thrombus?

Sex differences in distribution, management and outcomes of combined ischemic-bleeding risk following acute coronary syndrome

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