Safety and efficacy of post-procedure anticoagulation in ST-elevation myocardial infarction complicated by cardiogenic shock undergoing primary percutaneous coronary intervention
Abstract Introduction Cardiogenic shock (CS) is a lethal complication of ST-elevation myocardial infarction (STEMI). The impact of post-procedure anticoagulants (PPAC) in STEMI-CS patients undergoing primary percutaneous coronary intervention (PPCI) remains unknown. Method In the Improving Care for...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-03-01
|
| Series: | BMC Cardiovascular Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12872-025-04639-2 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850063829355986944 |
|---|---|
| author | Can Zhou Minghui Zhang Zixu Zhao Enze Li Yichen Zhao Hong Wang Wei Luo Keyang Zheng Yu Liu Chengqian Yin Xinyong Zhang Hai Gao Xiaotong Hou Dong Zhao Changsheng Ma |
| author_facet | Can Zhou Minghui Zhang Zixu Zhao Enze Li Yichen Zhao Hong Wang Wei Luo Keyang Zheng Yu Liu Chengqian Yin Xinyong Zhang Hai Gao Xiaotong Hou Dong Zhao Changsheng Ma |
| author_sort | Can Zhou |
| collection | DOAJ |
| description | Abstract Introduction Cardiogenic shock (CS) is a lethal complication of ST-elevation myocardial infarction (STEMI). The impact of post-procedure anticoagulants (PPAC) in STEMI-CS patients undergoing primary percutaneous coronary intervention (PPCI) remains unknown. Method In the Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome registry (2014–2019), STEMI patients with CS on admission undergoing PPCI were stratified into two groups based on the use of PPAC or not. The primary outcome was all-cause mortality during hospitalization. Other outcomes including major bleeding were also investigated. Results Of 36,873 patients with STEMI, 855 eligible patients with CS undergoing PPCI were included in our study, among which 614 patients were treated by PPAC and 241 were not. Adjusted by multi-variable Cox regression, PPAC was associated with a lower risk of in-hospital all-cause mortality (14.9% vs. 30.3%; adjusted HR: 0.60; 95% CI: 0.37 to 0.97; p = 0.037), while a non-significant difference in major bleeding (4.6% vs. 7.0%; adjusted HR: 1.05; 95% CI: 0.36 to 3.05; p = 0.925) was observed between PPAC and non-PPAC. Consistent results were observed in the sensitivity analyses adjusted by propensity score matching and inverse probability of treatment weighting. Conclusion Our study suggested the use of PPAC in STEMI-CS patients undergoing PPCI was associated with a lower risk of in-hospital all-cause mortality without increasing the risk of major bleeding. Trial registration ClinicalTrials.gov, NCT02306616. Registered 29 November 2014. |
| format | Article |
| id | doaj-art-e5ac15884e614e1da9bf4092f2c2f101 |
| institution | DOAJ |
| issn | 1471-2261 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj-art-e5ac15884e614e1da9bf4092f2c2f1012025-08-20T02:49:29ZengBMCBMC Cardiovascular Disorders1471-22612025-03-0125111010.1186/s12872-025-04639-2Safety and efficacy of post-procedure anticoagulation in ST-elevation myocardial infarction complicated by cardiogenic shock undergoing primary percutaneous coronary interventionCan Zhou0Minghui Zhang1Zixu Zhao2Enze Li3Yichen Zhao4Hong Wang5Wei Luo6Keyang Zheng7Yu Liu8Chengqian Yin9Xinyong Zhang10Hai Gao11Xiaotong Hou12Dong Zhao13Changsheng Ma14Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular DiseasesDepartment of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular DiseasesDepartment of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular DiseasesDepartment of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular DiseasesDepartment of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular DiseasesDepartment of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular DiseasesDepartment of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular DiseasesDepartment of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular DiseasesDepartment of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular DiseasesDepartment of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular DiseasesDepartment of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular DiseasesDepartment of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular DiseasesDepartment of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular DiseasesCenter for Clinical and Epidemiologic Research, Beijing Anzhen Hospital, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical UniversityDepartment of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular DiseasesAbstract Introduction Cardiogenic shock (CS) is a lethal complication of ST-elevation myocardial infarction (STEMI). The impact of post-procedure anticoagulants (PPAC) in STEMI-CS patients undergoing primary percutaneous coronary intervention (PPCI) remains unknown. Method In the Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome registry (2014–2019), STEMI patients with CS on admission undergoing PPCI were stratified into two groups based on the use of PPAC or not. The primary outcome was all-cause mortality during hospitalization. Other outcomes including major bleeding were also investigated. Results Of 36,873 patients with STEMI, 855 eligible patients with CS undergoing PPCI were included in our study, among which 614 patients were treated by PPAC and 241 were not. Adjusted by multi-variable Cox regression, PPAC was associated with a lower risk of in-hospital all-cause mortality (14.9% vs. 30.3%; adjusted HR: 0.60; 95% CI: 0.37 to 0.97; p = 0.037), while a non-significant difference in major bleeding (4.6% vs. 7.0%; adjusted HR: 1.05; 95% CI: 0.36 to 3.05; p = 0.925) was observed between PPAC and non-PPAC. Consistent results were observed in the sensitivity analyses adjusted by propensity score matching and inverse probability of treatment weighting. Conclusion Our study suggested the use of PPAC in STEMI-CS patients undergoing PPCI was associated with a lower risk of in-hospital all-cause mortality without increasing the risk of major bleeding. Trial registration ClinicalTrials.gov, NCT02306616. Registered 29 November 2014.https://doi.org/10.1186/s12872-025-04639-2Cardiogenic shockPrimary percutaneous coronary interventionAnticoagulationST-elevation myocardial infarction |
| spellingShingle | Can Zhou Minghui Zhang Zixu Zhao Enze Li Yichen Zhao Hong Wang Wei Luo Keyang Zheng Yu Liu Chengqian Yin Xinyong Zhang Hai Gao Xiaotong Hou Dong Zhao Changsheng Ma Safety and efficacy of post-procedure anticoagulation in ST-elevation myocardial infarction complicated by cardiogenic shock undergoing primary percutaneous coronary intervention BMC Cardiovascular Disorders Cardiogenic shock Primary percutaneous coronary intervention Anticoagulation ST-elevation myocardial infarction |
| title | Safety and efficacy of post-procedure anticoagulation in ST-elevation myocardial infarction complicated by cardiogenic shock undergoing primary percutaneous coronary intervention |
| title_full | Safety and efficacy of post-procedure anticoagulation in ST-elevation myocardial infarction complicated by cardiogenic shock undergoing primary percutaneous coronary intervention |
| title_fullStr | Safety and efficacy of post-procedure anticoagulation in ST-elevation myocardial infarction complicated by cardiogenic shock undergoing primary percutaneous coronary intervention |
| title_full_unstemmed | Safety and efficacy of post-procedure anticoagulation in ST-elevation myocardial infarction complicated by cardiogenic shock undergoing primary percutaneous coronary intervention |
| title_short | Safety and efficacy of post-procedure anticoagulation in ST-elevation myocardial infarction complicated by cardiogenic shock undergoing primary percutaneous coronary intervention |
| title_sort | safety and efficacy of post procedure anticoagulation in st elevation myocardial infarction complicated by cardiogenic shock undergoing primary percutaneous coronary intervention |
| topic | Cardiogenic shock Primary percutaneous coronary intervention Anticoagulation ST-elevation myocardial infarction |
| url | https://doi.org/10.1186/s12872-025-04639-2 |
| work_keys_str_mv | AT canzhou safetyandefficacyofpostprocedureanticoagulationinstelevationmyocardialinfarctioncomplicatedbycardiogenicshockundergoingprimarypercutaneouscoronaryintervention AT minghuizhang safetyandefficacyofpostprocedureanticoagulationinstelevationmyocardialinfarctioncomplicatedbycardiogenicshockundergoingprimarypercutaneouscoronaryintervention AT zixuzhao safetyandefficacyofpostprocedureanticoagulationinstelevationmyocardialinfarctioncomplicatedbycardiogenicshockundergoingprimarypercutaneouscoronaryintervention AT enzeli safetyandefficacyofpostprocedureanticoagulationinstelevationmyocardialinfarctioncomplicatedbycardiogenicshockundergoingprimarypercutaneouscoronaryintervention AT yichenzhao safetyandefficacyofpostprocedureanticoagulationinstelevationmyocardialinfarctioncomplicatedbycardiogenicshockundergoingprimarypercutaneouscoronaryintervention AT hongwang safetyandefficacyofpostprocedureanticoagulationinstelevationmyocardialinfarctioncomplicatedbycardiogenicshockundergoingprimarypercutaneouscoronaryintervention AT weiluo safetyandefficacyofpostprocedureanticoagulationinstelevationmyocardialinfarctioncomplicatedbycardiogenicshockundergoingprimarypercutaneouscoronaryintervention AT keyangzheng safetyandefficacyofpostprocedureanticoagulationinstelevationmyocardialinfarctioncomplicatedbycardiogenicshockundergoingprimarypercutaneouscoronaryintervention AT yuliu safetyandefficacyofpostprocedureanticoagulationinstelevationmyocardialinfarctioncomplicatedbycardiogenicshockundergoingprimarypercutaneouscoronaryintervention AT chengqianyin safetyandefficacyofpostprocedureanticoagulationinstelevationmyocardialinfarctioncomplicatedbycardiogenicshockundergoingprimarypercutaneouscoronaryintervention AT xinyongzhang safetyandefficacyofpostprocedureanticoagulationinstelevationmyocardialinfarctioncomplicatedbycardiogenicshockundergoingprimarypercutaneouscoronaryintervention AT haigao safetyandefficacyofpostprocedureanticoagulationinstelevationmyocardialinfarctioncomplicatedbycardiogenicshockundergoingprimarypercutaneouscoronaryintervention AT xiaotonghou safetyandefficacyofpostprocedureanticoagulationinstelevationmyocardialinfarctioncomplicatedbycardiogenicshockundergoingprimarypercutaneouscoronaryintervention AT dongzhao safetyandefficacyofpostprocedureanticoagulationinstelevationmyocardialinfarctioncomplicatedbycardiogenicshockundergoingprimarypercutaneouscoronaryintervention AT changshengma safetyandefficacyofpostprocedureanticoagulationinstelevationmyocardialinfarctioncomplicatedbycardiogenicshockundergoingprimarypercutaneouscoronaryintervention |