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Intensive antithrombotic therapy is necessary for long-term treatment in patients with symptomatic peripheral artery disease after acute myocardial infarction

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MATEJKA Jan MOTOVSKA Zuzana HLINOMAZ Ota KALA Petr HROMADKA Milan VARVAROVSKY Ivo DUSEK Jaroslav JARKOVSKÝ Jiří ROKYTA Richard MROZEK Jan CERVINKA Pavel SIMEK Stanislav OSTRANSKY Jiri

Rok publikování 2025
Druh Článek v odborném periodiku
Časopis / Zdroj Nature Scientific Reports
Fakulta / Pracoviště MU

Lékařská fakulta

Citace
www https://pubmed.ncbi.nlm.nih.gov/41203670/
Doi https://doi.org/10.1038/s41598-025-24372-2
Klíčová slova Acute myocardial infarction; Peripheral artery disease; Antiplatelet therapy; Ticagrelor; Prasugrel
Přiložené soubory
Popis Patients with acute myocardial infarction (AMI) who have concomitant peripheral artery disease (PAD) represent a subgroup at high risk of subsequent ischaemic events. This post hoc analysis of PRAGUE-18, a multicenter, randomised trial comparing prasugrel versus ticagrelor in primary PCI, analysed the effect of symptomatic PAD and intensity of antithrombotic therapy on the prognosis of AMI patients treated with primary percutaneous coronary intervention (PCI). During 12-month follow-up, de-escalation from intensive antiplatelet therapy to clopidogrel was allowed with the permission of the treating physician for economic reasons. Symptomatic PAD was present in 2.9% of the study population (n = 1230). The presence of PAD did not significantly affect short-term outcome. At one year, the risk of death was higher in patients with concomitant PAD, 49 (4.1%) vs. 6(16.7%), HR 4.211 (1.803-9.830); p = 0,001. All-cause mortality significantly increased only in subgroup of patients who de-escalated to clopidogrel [6.37 (2.16-18.84), p = 0.001] as opposed to those who did not [3.02 (0.72-12.61), p = 0.13]. These findings suggest that long-term intensive antithrombotic therapy may be particularly important for post-AMI patients with concomitant symptomatic PAD and warrant further investigation.
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