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Fig 1.

PINPOINT-PPCI study timeline.

LD–loading dose, PFA–platelet function assessment. Times displayed are medians and IQRs. *The median baseline PFA time was 2 minutes after procedure start (IQR -1 to 6). **The median residual PFA1 time was 0 minutes post procedure (IQR 0 to 2). Missing data were as follows: 1 patient was missing flow time; 5 patients were missing baseline PFA times; 4 patients were missing residual PFA1 times; 8 patients were missing residual PFA2 times; 8 patients were missing residual PFA3 times; 17 patients were missing residual PFA4 times.

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Table 1.

Baseline clinical and demographic characteristics.

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Table 2.

Angiographic and procedural characteristics.

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Table 2 Expand

Fig 2.

ADP platelet reactivity profile.

Panel A—Median ADP receptor platelet activity profile in first 24 hours post-presentation with STEMI and treatment with PPCI. Red markers identify platelet response for the four acute ST patients (dotted line indicates the high residual platelet reactivity threshold of 46.8 U for ADP-test). Panel B–The profile of high residual platelet activity, in the first 24 hours, following administration of a 60 mg Prasugrel loading dose at the time of PPCI.

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Fig 3.

Effect of door to end of procedure time and baseline ADP platelet activity on ADP platelet function in the first 24 hours post-presentation with STEMI and treatment with PPCI.

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Fig 4.

Influence of pre-procedural opiate and anti-emetic treatment on platelet function in the first 24 hours post-presentation with STEMI and treatment with PPCI.

ADP: morphine effects pre-PPCI p = 0.56, end of PPCI p<0.001, 1 hour post-PPCI p = 0.035, 2 hours post-PPCI p = 0.007, 24hours post-PPCI p = 0.16; morphine x time interaction p<0.001. ASPI: morphine effect p = 0.67; morphine x time interaction p = 0.36. TRAP: morphine effect p = 0.08; morphine x time interaction p = 0.30. U44619: morphine effect p = 0.43; morphine x time interaction p = 0.82.

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