Antiplatelet therapy for myocardial injury in ICU patients

This project was done during the SG Healthcare AI Datathon 2022(SHADE22).

Clinical question

Is antiplatelet therapy beneficial for patients who had myocardial injury during their stay in the ICU?

Background

• Management of patients with type 2 myocardial infarction (MI) or myocardial injury is a recognized gap in existing knowledge.
• JACC 2022 Expert Consensus guidelines recommend that where there is uncertainty regarding whether the diagnosis is a type 1 or type 2 MI (T2MI), clinicians should generally manage as presumed type 1 MI (T1MI)

Problem Statement

Determine if there is an association between initiation of antiplatelet medical medical therapy for patients in ICU with myocardial injury, and mortality

Method

From the MIMIC-IV database,

Cohort flow chart

Baseline Characteristics

Results

Conclusion

While there is a slight difference in mortality percentage, the minimal difference suggest that antiplatelet therapy does not yield much morality benefits for patients who had myocardial injury during their stay in the ICU. The side effects/complications of the antiplatelet therapy might even outweigh its benefits for the more vulnerable patients.

Contributors

PI: Dr Matthew Low Mentor: Dr Dominic Marshall Coordinator: Yeshe Kway (PhD student) Data Analysts: Dr Chong Sook Yee, Karen Cheung Kai Ning (NUS), Tristan Choo (NUS) Clinicians: Dr Matthew Low, Dr Cheryl Woo Ting Zhen, Kira Huiqi Ho (PT)