The Impact of Preoperative P2Y12 Inhibitors on Short- and Long-Term Outcomes Following Percutaneous CoronaryIntervention

DOI: 10.1016/j.jscai.2025.103226 ExternalLink

 Background

The preoperative usage of P2Y12 inhibitors primarily aim to reduce thrombotic complications for percutaneous coronary intervention (PCI), however, there is limited data on how these medications impact rates of adverse outcomes post- percutaneous coronary intervention.

 Methods

We conducted a single-center observationalstudy to evaluate outcomes of percutaneous coronary intervention with or without preoperative P2Y12 inhibitor usage at our high-burden, urban percutaneouscoronary intervention center. Multivariable logistic regression analysis was employed to evaluate clinical outcomes between cohorts, adjusting for demographic and clinical covariates.

 Results

After adjustments, our study included 2,222 patients who underwent percutaneous coronary intervention. After 30 days, patients preoperatively administered P2Y12 inhibitors had significantly lower rates of reinterventions in any lesion (p=0.001). After 6 months and 1 year, patients administered P2Y12 inhibitors had significantly lower rates of all-causemortality (p=0.002 and p=0.017). There were no significant differences in outcomes post- percutaneous coronary intervention for mortality (all-cause or cardiovascular), recurrent acute coronary syndrome, congestive heart failure readmission, cardiac arrest, reintervention, or cerebrovascular accident among either group 1 year post- percutaneous coronary intervention (p>0.05).

 Conclusions

While P2Y12 inhibitors are indicated post- percutaneouscoronary intervention to prevent stent thrombosis, there is limited data on how preprocedural administration affects post- percutaneous coronary intervention outcomes.Our study underscores the importance of these medications in reducing rates of short-term lesion reintervention and long-term mortality.

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