Antiplatelets and Intramyocardial Hemorrhage in STEMI: Incidence and Outcomes (MIRON-PLATELET)

Rohan Dharmakumar

Status: Completed

Conditions: Acute Myocardial Infarction; STEMI

Study type: Observational

Funder types: Other

Identifiers

NCT06851325

19978g

Details and patient eligibility

About

The MIRON-PLATELET study is a retrospective, observational multi-center analysis assessing the impact of different antiplatelet therapies on hemorrhagic myocardial infarction (HMI) incidence and outcomes in STEMI patients. Key endpoints include hemorrhagic transformation, MACE, bleeding complications, and 30-day mortality. Findings will offer insights into the safety and clinical implications of antiplatelet therapy in high-risk patients.

Enrollment: 6,180 patients

Sex: All

Ages: 18 to 79 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Age ≥18-79 years at the time of STEMI diagnosis
2. Diagnosed with ST-segment elevation myocardial infarction (STEMI) based on standard clinical criteria
3. Received antiplatelet therapy as part of STEMI management
4. Underwent primary percutaneous coronary intervention (PCI)
5. Evidence of hemorrhagic MI confirmed by Cardiac Magnetic Resonance Imaging OR Post-PCI biomarker diagnostics
6. Availability of comprehensive medical records documenting STEMI presentation, treatment details, and clinical outcomes
7. Minimum of 30-day follow-up data, with extended follow-up available for up to 10 years

Exclusion criteria

1. Diagnosis of non-STEMI (NSTEMI), unstable angina, or other non-ischemic cardiomyopathies
2. History of prior hemorrhagic stroke or active intracranial bleeding before the index STEMI event
3. Known bleeding disorders (e.g., hemophilia, thrombocytopenia <50,000/µL)
4. Use of chronic antiplatelet therapy (aspirin, clopidogrel, ticagrelor, prasugrel) before STEMI diagnosis
5. Use of long-term anticoagulation therapy (warfarin, DOACs such as apixaban, rivaroxaban, dabigatran) before STEMI diagnosis
6. Incomplete or missing medical records preventing outcome assessment
7. History of malignancy with life expectancy <1 year at the time of STEMI diagnosis
8. Patients lost to follow-up before 30 days post-STEMI