Evidence map›Paper›PMID 34171919›Full record

Observational studyInteractive cardiovascular and thoracic surgery2021

Dual antiplatelet therapy is under-prescribed in patients with surgically treated acute myocardial infarction.

Marco Roberto, Dragana Radovanovic, Carmelo Buttà, Gregorio Tersalvi, Joël Krüll, Paul Erne, Hans Rickli, Giovanni Battista Pedrazzini, Marco Moccetti

Registry-linked trialOpen access · bronzeAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Interactive cardiovascular and thoracic surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01305785 (National Registry of Acute Myocardial Infarction in Switzerland), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact, top 86% of its field
1 · What the graph read from 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.

2 · The registry

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.

NCT01305785 unknown statusnot on this map

National Registry of Acute Myocardial Infarction in Switzerland

TypeobservationalSponsorLuzerner KantonsspitalRan1997Enrolled60,000ConditionsAcute Coronary Syndrome
3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 2 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 1 country.

Marco RobertoCardiology Department, Cardiocentro Ticino, Lugano, Switzerland.
Dragana RadovanovicAMIS Plus Data Centre, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.
Carmelo ButtàCardiology Department, Cardiocentro Ticino, Lugano, Switzerland.
Gregorio TersalviCardiology Department, Cardiocentro Ticino, Lugano, Switzerland.
Joël KrüllCardiology Department, Cardiocentro Ticino, Lugano, Switzerland.
Paul ErneAMIS Plus Data Centre, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.
Hans RickliCardiology Department, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
Giovanni Battista PedrazziniCardiology Department, Cardiocentro Ticino, Lugano, Switzerland.
Marco MoccettiCardiology Department, Cardiocentro Ticino, Lugano, Switzerland.ORCID 0000-0002-5871-0684
Epatocentro Ticino · CHUniversity of Zurich · CHUniversity of St.Gallen · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesDespite guideline recommendations, previous reports, coming mainly from outside Europe, showed low rates of prescriptions for dual antiplatelet therapy (DAPT) in patients with acute myocardial infarction (AMI) undergoing surgical revascularization. The present study assesses this issue in the era of potent P2Y12 inhibitors in Switzerland.

methodsAll patients with a diagnosis of AMI included in the Acute Myocardial Infarction in Switzerland Plus Registry from January 2014 to December 2019 were screened; 9050 patients undergoing either percutaneous (8727, 96.5%) or surgical (323, 3.5%) revascularization were included in the analysis.

resultsSurgically treated patients were significantly less likely to receive DAPT at discharge (56.3% vs 96.7%; P < 0.001). Even when discharged with a prescription for DAPT, those patients were significantly less likely to receive a regimen containing a new P2Y12 inhibitor (67/182 [36.8%] vs 6945/8440 [83.2%]; P < 0.001). At multivariate analysis, surgical revascularization was independently associated with a lower likelihood of receiving a prescription for DAPT at discharge (odds ratio 0.03, 95% confidence interval 0.02-0.06).

conclusionsDAPT prescriptions for patients with AMI undergoing surgical revascularization are not in line with current guideline recommendations. Efforts are necessary to clarify the role of DAPT for secondary prevention in these patients and increase the confidence of treating physicians in guideline recommendations. CLINICAL

trial registrationAcute Myocardial Infarction in Switzerland Plus Registry; registration number at ClinicalTrials.gov: NCT01305785.

Indexed as

Acute Coronary SyndromeDual Anti-Platelet TherapyMyocardial InfarctionAspirinDrug Therapy, CombinationHumansPlatelet Aggregation InhibitorsPrasugrel HydrochlorideProspective StudiesTreatment OutcomeAspirinPlatelet Aggregation InhibitorsPrasugrel HydrochlorideAcute myocardial infarctionClopidogrelCoronary artery bypass graftDual antiplatelet therapyPrasugrelTicagrelor

Identifiers

PMID34171919
PMCPMC8691680
OpenAlexW3176989080

What OpenQuestion holds

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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.