ArticleEuropean heart journal. Cardiovascular pharmacotherapy2021
Antithrombotic therapy in patients with acute coronary syndrome complicated by cardiogenic shock or out-of-hospital cardiac arrest: a joint position paper from the European Society of Cardiology (ESC) Working Group on Thrombosis, in association with the Acute Cardiovascular Care Association (ACCA) and European Association of Percutaneous Cardiovascular Interventions (EAPCI).
Article in European heart journal. Cardiovascular pharmacotherapy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
34 citing papers in PubMed, 2 syntheses or guidelines pooled it, 63 citations in OpenAlex.
- Anti-Platelet Therapy with Cangrelor in Cardiogenic Shock Patients: A Systematic Review and Single-Arm Meta-Analysis.Medicina (Kaunas, Lithuania) · 2024Pooled it
- Heart failure during the COVID-19 pandemic: clinical, diagnostic, management, and organizational dilemmas.ESC heart failure · 2022Pooled it
- Bleeding complications in patients with out-of-hospital cardiac arrest treated with cangrelor and oral P2Y12 inhibitors.European heart journal. Acute cardiovascular care · 2026Article
- The Impact of Cangrelor in the UK for the Treatment of STEMI Patients with Gastric Absorption Issues Undergoing Percutaneous Coronary Intervention.Journal of clinical medicine · 2025Article
- Antiplatelet therapy in acute myocardial infarction complicated by cardiogenic shock.Clinical research in cardiology : official journal of the German Cardiac Society · 2025Review
- Antiplatelet treatment in different clinical settings.European heart journal. Cardiovascular pharmacotherapy · 2025Article
- The role of cangrelor in acute and high-risk PCI settings.European heart journal. Cardiovascular pharmacotherapy · 2025Review
- Pre-treatment with P2Y12 inhibitors in acute myocardial infarction with cardiogenic shock.European heart journal. Cardiovascular pharmacotherapy · 2025Observational
- Clopidogrel vs. ticagrelor in ST-elevation myocardial infarction complicated by cardiogenic shock undergoing primary PCI : Findings from a National, multicenter registry.Thrombosis journal · 2025Article
- Safety and efficacy of post-procedure anticoagulation in ST-elevation myocardial infarction complicated by cardiogenic shock undergoing primary percutaneous coronary intervention.BMC cardiovascular disorders · 2025Observational
- Potent P2YCritical care (London, England) · 2025Article
- Bleeding outcomes in critically ill patients on heparin with discordant aPTT and anti-Xa activity.Journal of thrombosis and thrombolysis · 2025Article
- STEMI Antithrombotic Therapy: The Evolving Role of P2Y12 Inhibitor Pretreatment in Contemporary Practice.Reviews in cardiovascular medicine · 2024Review
- Cangrelor versus crushed ticagrelor in patients with acute myocardial infarction and cardiogenic shock: rationale and design of the randomised, double-blind DAPT-SHOCK-AMI trial.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2024Article
- Role of Mechanical Circulatory Support in Complex High-Risk and Indicated Percutaneous Coronary Intervention: Current Indications, Device Options, and Potential Complications.Journal of clinical medicine · 2024Review
- Optimal intravenous antiplatelet therapy in patients with ST-elevation myocardial infarction: is the picture becoming clearer?Journal of thrombosis and thrombolysis · 2024Article
- Immediate Platelet Inhibition Strategy for Comatose Out-of-Hospital Cardiac Arrest Survivors Undergoing Percutaneous Coronary Intervention and Mild Therapeutic Hypothermia.Journal of clinical medicine · 2024Article
- Optimal Antithrombotic Strategies in Cardiogenic Shock.Journal of clinical medicine · 2024Review
- Contemporary approach to cardiogenic shock care: a state-of-the-art review.Frontiers in cardiovascular medicine · 2024Review
- Percutaneous Coronary Intervention in Out-of-Hospital Cardiac Arrest Related to Acute Coronary Syndrome: A Literature Review.Journal of clinical medicine · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors at 16 institutions in 8 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Timely and effective antithrombotic therapy is critical to improving outcome, including survival, in patients with acute coronary syndrome (ACS). Achieving effective platelet inhibition and anticoagulation, with minimal risk, is particularly important in high-risk ACS patients, especially those with cardiogenic shock (CS) or those successfully resuscitated following out-of-hospital cardiac arrest (OHCA), who have a 30-50% risk of death or a recurrent ischaemic event over the subsequent 30 days. There are unique challenges to achieving effective and safe antithrombotic treatment in this cohort of patients that are not encountered in most other ACS patients. This position paper focuses on patients presenting with CS or immediately post-OHCA, of presumed ischaemic aetiology, and examines issues related to thrombosis and bleeding risk. Both the physical and pharmacological impacts of CS, namely impaired drug absorption, metabolism, altered distribution and/or excretion, associated multiorgan failure, co-morbidities and co-administered treatments such as opiates, targeted temperature management, renal replacement therapy and circulatory or left ventricular assist devices, can have major impact on the effectiveness and safety of antithrombotic drugs. Careful attention to the choice of antithrombotic agent(s), route of administration, drug-drug interactions, therapeutic drug monitoring and factors that affect drug efficacy and safety, may reduce the risk of sub- or supra-therapeutic dosing and associated adverse events. This paper provides expert opinion, based on best available evidence, and consensus statements on optimising antithrombotic therapy in these very high-risk patients, in whom minimising the risk of thrombosis and bleeding is critical to improving outcome.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.