12/17/2023 0 Comments Timi ii flowHowever, cardiomyocytes that are exposed to low residual oxygen levels may be able to maintain sufficient adenosine triphosphate to survive for an extended period, even if the amount of adenosine triphosphate is insufficient to allow their contraction 7. Hence, after a certain duration of complete ischemia, there is no treatment modality that can salvage ischemic myocardium 7. Under the circumstance where blood supply is completely absent, available oxygen in the ischemic zone of the myocardium disappears within seconds. Platelets play a key role in the development of acute coronary syndrome 5, and platelet activation and plugging are of significant importance in the development of impaired pre-PCI flow because platelet-mediated release of vasoactive mediators increases platelet-rich thrombi formation 5, 6. However, more recent reports 3, 4 have shown that 3-month (3-mo) duration of DAPT could reduce hemorrhagic risk without increasing the risk of ischemic events. Unique identifier: NCT02494895.Ĭurrent guidelines 1, 2 recommend 12-month (12-mo) dual antiplatelet therapy (DAPT) consisting of aspirin with a P2Y 12 inhibitor after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI). A higher bleeding tendency in 12-mo DAPT compared with 3-mo DAPT was more obvious in the pre-TIMI 2/3 group than in the pre-TIMI 0/1 group.Ĭlinical Trial Registration: URL. The occurrence of MACCE was similar between the two groups. However, in the pre-TIMI 2/3 group, the occurrences of TIMI minor (adjusted hazard ratio : 0.294 p = 0.016) and major or minor bleeding (aHR: 0.483 p = 0.014) on intention-to-treat analysis were significantly higher in the 12-mo than in the 3-mo DAPT group. In the pre-TIMI 0/1 group, the primary and second outcomes were not significantly different between the 3-mo and 12-mo DAPT groups. The secondary outcomes were the occurrence of the individual components of TIMI bleedings and MACCE. The primary outcome was the occurrence of net adverse clinical events (NACE), defined as a composite of TIMI major bleeding and major adverse cardiac and cerebrovascular events (MACCE) within 12-mo following PCI. This was a post hoc analysis of the TICO trial. We investigated the impact of pre-percutaneous coronary intervention (pre-PCI) thrombolysis in myocardial infarction (TIMI) flow grade (pre-TIMI) on 3-month (3-mo) and 12-mo of dual antiplatelet therapy (DAPT) in patients with acute myocardial infarction (AMI).
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