1. ATLANTIC
Trial design: Participants with STEMI being transported for primary PCI were randomized in the ambulance to ticagrelor 180 mg (n = 909) vs. placebo (n = 953).
Results
(p = 0.63)
≥70% ST-segment resolution before PCI: 86.8% for ticagrelor vs. 87.6% for placebo (p = 0.63)
< TIMI 3 flow before PCI: 82.6% for ticagrelor vs. 83.1% for placebo (p = 0.82)
Definite stent thrombosis at 30 days: 0.2% vs. 1.2% (p = 0.02), respectively
Non-CABG major bleeding: 1.3% vs. 1.3% (p = 0.91), respectively
87.6 %
86.8
Conclusions
Among STEMI patients, ambulance administration of ticagrelor compared with placebo did not improve myocardial perfusion pre-PCI
However, early administration of ticagrelor reduced stent thrombosis without increasing major bleeding
Ambulance ticagrelor
Ambulance placebo
Montalescot G, et al. N Engl J Med 2014;