title: Pre-hospital ticagrelor in ST-segment elevation myocardial infarction: Ready for prime time?
abstract: In ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI) peri-procedural P2Y12 antagonism - although of great importance - is often suboptimal, even with the novel oral antiplatelet agents prasugrel and ticagrelor. The concept of pre-hospital ticagrelor loading, investigated in the recently published Administration of Ticagrelor in the Cath Lab or in the Ambulance for New ST Elevation Myocardial Infarction to Open the Coronary Artery (ATLANTIC) trial, appears quite a promising strategy to optimize peri-procedural platelet inhibition and potentially clinical outcome. Implementation of such an approach when treating low risk STEMI patients in 'real life' practice might prove even more beneficial than expected from the ATLANTIC results, given the reported delays from first medical contact to primary PCI performance.
authors.affiliation: Department of Cardiology, Patras University Hospital, Patras, Greece. Electronic address: dalex@med.upatras.gr.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Alexopoulos
authors.affiliation: Department of Cardiology, Patras University Hospital, Patras, Greece.
authors.forename: Athanasios
authors.initials: A
authors.lastname: Moulias
authors.affiliation: Department of Cardiology, Alexandra General Hospital, Athens, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Kanakakis
authors.affiliation: Department of Cardiology, Patras University Hospital, Patras, Greece.
authors.forename: Ioanna
authors.initials: I
authors.lastname: Xanthopoulou
mesh_terms: D000241:Adenosine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D004562:Electrocardiography / Q000379:methods; D006801:Humans; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000628:therapy; D015425:Myocardial Reperfusion / Q000379:methods; D062645:Percutaneous Coronary Intervention / Q000379:methods; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D000068799:Prasugrel Hydrochloride / Q000627:therapeutic use; D058921:Purinergic P2Y Receptor Antagonists / Q000627:therapeutic use*; D000077486:Ticagrelor; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors; D058921:Purinergic P2Y Receptor Antagonists; D000068799:Prasugrel Hydrochloride; D000077486:Ticagrelor; D000241:Adenosine
keywords: ATLANTIC; Angioplasty; P2Y(12) antagonists; Primary PCI; STEMI; Ticagrelor