RT Journal Article SR Electronic T1 Early clinical outcomes as a function of use of newer oral P2Y12 inhibitors versus clopidogrel in the EUROMAX trial JF Open Heart JO Open Heart FD British Cardiovascular Society SP e000677 DO 10.1136/openhrt-2017-000677 VO 4 IS 2 A1 Kurt Huber A1 Gregory Ducrocq A1 Christian W Hamm A1 Arnoud van ’t Hof A1 Frédéric Lapostolle A1 Pierre Coste A1 Giovanni Gordini A1 Jacob Steinmetz A1 Freek W A Verheugt A1 Jennifer Adgey A1 Lutz Nibbe A1 Vojko Kaniĉ A1 Peter Clemmensen A1 Uwe Zeymer A1 Debra Bernstein A1 Jayne Prats A1 Efthymios N Deliargyris A1 Ph Gabriel Steg YR 2017 UL http://openheart.bmj.com/content/4/2/e000677.abstract AB Objective To ascertain whether different oral P2Y12 inhibitors might affect rates of acute stent thrombosis and 30-day outcomes after primary percutaneous coronary intervention (pPCI).Methods The European Ambulance Acute Coronary Syndrome Angiography (EUROMAX) randomised trial compared prehospital bivalirudin with heparin with optional glycoprotein IIb/IIIa inhibitor treatment in patients with ST-segment elevation myocardial infarction triaged to pPCI. Choice of P2Y12 inhibitor was at the investigator’s discretion. In a prespecified analysis, we compared event rates with clopidogrel and newer oral P2Y12 inhibitors (prasugrel, ticagrelor). Rates of the primary outcome (acute stent thrombosis) were examined as a function of the P2Y12 inhibitor used for loading and 30-day outcomes (including major adverse cardiac events) as a function of the P2Y12 inhibitor used for maintenance therapy. Logistic regression was used to adjust for differences in baseline characteristics.Results Prasugrel or ticagrelor was given as the loading P2Y12 inhibitor in 49% of 2198 patients and as a maintenance therapy in 59%. No differences were observed in rates of acute stent thrombosis for clopidogrel versus newer P2Y12 inhibitors (adjusted OR 0.50, 95% CI 0.13 to 1.85). After adjustment, no difference was observed in 30-day outcomes according to maintenance therapy except for protocol major (p=0.029) or minor (p=0.025) bleeding and Thrombolysis In Myocardial Infarction minor bleeding (p=0.002), which were less frequent in patients on clopidogrel. Consistent results were observed in the bivalirudin and heparin arms.Conclusions The choice of prasugrel or ticagrelor over clopidogrel was not associated with differences in acute stent thrombosis or 30-day ischaemic outcomes after pPCI.Trial registration number NCT01087723.