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Exploring The Risks And Benefits of Upstream Loading of P2Y12 inhibitors In Acute Coronary Syndrome Patients
Exploring The Risks And Benefits of
Upstream Loading of P2Y12 inhibitors In Acute Coronary Syndrome Patients
https://doi.org/10.1161/circ.150.suppl_1.4139561
Abstract
Background: Acute coronary syndrome (ACS) is the
leading cause of heart disease, resulting in over 300,000 deaths annually. The 2014 ACC/AHA guideline recommends a loading dose of a P2Y12 receptor inhibitor
prior to PCI with stenting (Class IA).
Objective: This study aims to evaluate the
risks and benefits of upstream loading of P2Y12 inhibitors in Acute coronary syndrome patients.
Methodology: We retrospectively analyzed the
charts of all Acute coronary syndrome patients over 18 years old admitted to our community hospital in Michigan from August 2022 to July 2023. Exclusion criteria included patients with type II NSTEMI, hypersensitivity to P2Y12 inhibitors, active bleeding, hemoglobin levels less than 7 g/dl, those already on P2Y12 inhibitors, and pregnant patients.
Results: Out of 518 patients reviewed, 399 were included in the study. Among 285 NSTEMI patients, 89.5% were not loaded with P2Y12 inhibitors in the ED, while 10.5% were. In the loaded group, 3% underwent CABG, 90% required PCI, and 6% received medical treatment. In the non-loaded
group, 12.5% underwent CABG, one patient had an aortic dissection, and 53.8% and 33.7% required PCI and medical treatment, respectively. Among 114 STEMI patients, 74.5% were not loaded with P2Y12 inhibitors in the ED, while 25.5% were. In the loaded group, 100% required PCI. In the non-loaded group, 8.2% underwent CABG, and 92% required
PCI.
Conclusion: Our real-world data from a community
hospital indicate that most Acute coronary syndrome patients benefit from P2Y12 loading, with only a minority experiencing adverse effects. To address this, we
plan to collaborate with our information technology department to implement reminders for ED physicians to consult with cardiologists about P2Y12 inhibitor
loading in Acute coronary syndrome patients.
Disclaimer:
Lupin makes no representation or warranty of any kind, expressed or implied, regarding the accuracy, adequacy, validity, reliability, availability, or completeness of any
scientific information shared by the HCP on the STAR UPDATE podcast. You should not allow the contents of this to substitute for your own medical judgment, which you should exercise in evaluating the information on this
website.
View all episodes
By ImagicaHealthExploring The Risks And Benefits of
Upstream Loading of P2Y12 inhibitors In Acute Coronary Syndrome Patients
https://doi.org/10.1161/circ.150.suppl_1.4139561
Abstract
Background: Acute coronary syndrome (ACS) is the
leading cause of heart disease, resulting in over 300,000 deaths annually. The 2014 ACC/AHA guideline recommends a loading dose of a P2Y12 receptor inhibitor
prior to PCI with stenting (Class IA).
Objective: This study aims to evaluate the
risks and benefits of upstream loading of P2Y12 inhibitors in Acute coronary syndrome patients.
Methodology: We retrospectively analyzed the
charts of all Acute coronary syndrome patients over 18 years old admitted to our community hospital in Michigan from August 2022 to July 2023. Exclusion criteria included patients with type II NSTEMI, hypersensitivity to P2Y12 inhibitors, active bleeding, hemoglobin levels less than 7 g/dl, those already on P2Y12 inhibitors, and pregnant patients.
Results: Out of 518 patients reviewed, 399 were included in the study. Among 285 NSTEMI patients, 89.5% were not loaded with P2Y12 inhibitors in the ED, while 10.5% were. In the loaded group, 3% underwent CABG, 90% required PCI, and 6% received medical treatment. In the non-loaded
group, 12.5% underwent CABG, one patient had an aortic dissection, and 53.8% and 33.7% required PCI and medical treatment, respectively. Among 114 STEMI patients, 74.5% were not loaded with P2Y12 inhibitors in the ED, while 25.5% were. In the loaded group, 100% required PCI. In the non-loaded group, 8.2% underwent CABG, and 92% required
PCI.
Conclusion: Our real-world data from a community
hospital indicate that most Acute coronary syndrome patients benefit from P2Y12 loading, with only a minority experiencing adverse effects. To address this, we
plan to collaborate with our information technology department to implement reminders for ED physicians to consult with cardiologists about P2Y12 inhibitor
loading in Acute coronary syndrome patients.
Disclaimer:
Lupin makes no representation or warranty of any kind, expressed or implied, regarding the accuracy, adequacy, validity, reliability, availability, or completeness of any
scientific information shared by the HCP on the STAR UPDATE podcast. You should not allow the contents of this to substitute for your own medical judgment, which you should exercise in evaluating the information on this
website.
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