Antiplatelets and hemorrhagic MI outcome in reperfused STEMI
Bibliographic record
Abstract
Abstract Background The intricate interplay between antiplatelet agents, including aspirin, P2y12 inhibitors, and glycoprotein IIb/IIIa (GPIIb/IIIa) inhibitors, and outcomes in ST-elevation myocardial infarction (STEMI) poses a complex challenge, particularly in the context of post-reperfusion hemorrhagic MI (hMI). This study thoroughly examines the association of these antiplatelet agents with the incidence of hMI in patients with STEMI, unraveling potential clinical implications. Methods From February 1, 2015, through July 31, 2023, we studied 6180 STEMI patients admitted to seven institutional hospitals. The patients were categorized in two groups, hemorrhagic MI (hMI; n=1323) and non-hemorrhagic MI (non-hMI; n=4857). Both groups were studied by clinical characteristics, procedural intricacies, and medication profiles. Logistic regression analyses, adjusted for confounding variables, were employed to interpret the independent link between aspirin, P2y12 inhibitors, GPIIb/IIIa inhibitor use, and hemorrhagic MI outcome. The primary outcome measure was occurrence of hMI following reperfusion. Results Out of 6180 patients, 21.41% patients were hemorrhagic STEMI. Within the hemorrhagic STEMI cohort, GPIIb/IIIa inhibitors were administered significantly more frequently than in the non-hemorrhagic STEMI group (49.13% vs. 42.54%, p < 0.0001). Logistic regression analyses revealed a robust association, with an adjusted odds ratio of 1.303 (95% CI 1.102-1.538, p = 0.002), signifying an independent and statistically significant connection between GPIIb/IIIa inhibitor use and heightened odds of hemorrhagic STEMI. P2y12 inhibitors showed reduced incidence of hMI compared to those without (odds ratio 0.721, 95% CI 0.562-0.924, p = 0.010). Furthermore, aspirin use was not associated with a significant difference in hemorrhagic STEMI incidence (odds ratio 1.023, 95% CI 0.897-1.167, p = 0.756). Conclusion This study reveals the intricate relationship between antiplatelet agents—specifically aspirin, P2Y12 inhibitors, and GPIIb/IIIa inhibitors—and ischemi-reperfusion injury outcomes in STEMI, hemorrhagic MI b. Strong associations, especially with GPIIb/IIIa inhibitors, highlight the need for an evaluated approach in STEMI management, balancing thrombotic prevention with the risk of hemorrhagic MI complications. Future research should refine strategies for optimal antiplatelet therapy, aligning with evolving post-reperfusion scenarios.MIRON PLATELET Odds Ratio Clinical Characteristics of Cohort
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".