Authors

• Zdravko Babić — University Hospital Center «Sestre milosrdnice», Zagreb, Croatia — ORCID: 0000-0002-7060-8375
• Joško Bulum — University Hospital Center Zagreb, Zagreb, Croatia — ORCID: 0000-0002-1482-6503
• Sandro Brusich — University Hospital Center Rijeka, Rijeka, Croatia — ORCID: 0000-0001-7394-6698
• Hrvoje Pintarić — University Hospital Center «Sestre milosrdnice», Zagreb, Croatia — ORCID: 0000-0002-9882-9145
• Robert Steiner — University Hospital Center Osijek, Osijek, Croatia
• Ivica Kristić — University Hospital Center Split, Split, Croatia
• Ilko Vuksanović — University Hospital Dubrava, Zagreb, Croatia — ORCID: 0000-0002-4462-8647
• Krešimir Štambuk — Clinic for Cardiovascular Diseases Magdalena, Krapinske Toplice, Croatia
• Jozica Šikić — University Hospital «Sveti Duh», Zagreb, Croatia — ORCID: 0000-0003-4488-0559
• Dražen Zekanović — Zadar General Hospital, Zadar, Croatia
• Đeiti Prvulović — General Hospital «Dr. Josip Benčević», Slavonski Brod, Croatia
• Damir Kozmar — Clinical Hospital «Merkur», Zagreb, Croatia
• Davor Miličić — University Hospital Center Zagreb, Zagreb, Croatia — ORCID: 0000-0001-9101-1570

Keywords

acute ST segment elevation myocardial infarction, ticagrelor, clopidogrel

DOI

Full Text

**Introduction:** PLATO (“Platelet Inhibition and Patient Outcomes”) study demonstrated advantage of ticagrelor in comparison with clopidogrel in acute coronary syndrome in prevention of the cardiovascular death, myocardial infarction and stroke. These results introduced ticagrelor in the European Society of Cardiology and other guidelines for management of acute coronary syndrome. (1-3) **Patients and Methods:** This prospective multicentric observational study compares results of clopidogrel and ticagrelor in the treatment of acute ST-elevation myocardial infarction (STEMI) on national level. Authors investigated acute STEMI patients treated with primary percutaneous coronary intervention (pPCI) in 11 Croatian pPCI centers between June 1st 2015 and May 31st 2016. Patients were divided in three groups: the ticagrelor group, converted group (treatment initiated with clopidogrel and replaced with ticagrelor), and clopidogrel group. **Results:** In 1947 investigated acute STEMI patients treated with pPCI investigators revealed statistically significant better results of treatment (postprocedural TIMI 3 flow, intrahospital mortality) with statistically significant less clinicaly significant bleeding in those treated with ticagrelor in comparision with those treated only with clopidogrel. **Conclusion**: These findings may be considered as real-life confirmation of similar results obtained in randomized studies.

Literature

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2. Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC), Steg PG, James SK, Atar D, Badano LP, Blömstrom-Lundqvist C, Borger MA, et al. ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J. 2012;33(20):2569-619. https://doi.org/10.1093/eurheartj/ehs215
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