The analysis of Mariusz Tomaniak, MD, PhD, showed, among others, that in patients with myocardial infarction, shortening the currently recommended treatment with a combination of two antiplatelet drugs and continuing the therapy with a more potent platelet inhibitor (ticagrelor) instead of acetylsalicylic acid (aspirin) significantly reduces the risk of serious bleeding complications. At the same time, it does not increase the risk of in-stent thrombotic complications. These studies shed new light on the potential for optimizing therapy in a selected group of patients at increased risk for hemorrhagic and ischemic complications.
This is an important topic because despite significant progress in cardiology, every year tens of thousands of patients in Poland die from ischemic heart disease (IHD), including myocardial infarction. The mainstay of treatment for MI is stent implantation into the coronary artery (percutaneous coronary intervention, PCI) and antiplatelet therapy to prevent blood clotting in the stent and reinfarction. However, such treatment is also associated with an increased risk of bleeding, especially in elderly patients, patients with kidney disease, patients with chronic obstructive pulmonary disease. The benefits of the proposed new treatment regimen were also seen among patients undergoing the most complex interventions, e.g., stenoses located in branches of the coronary arteries, chronically obstructed arteries, left coronary artery trunk stenosis.
The observations also showed that among elderly patients (older than 75 years), the incidence of stent thrombosis was lower in the group using the new treatment strategy (single therapy with ticagrelor) compared to the reference group, with a borderline increased risk of bleeding. Moreover, the reduction in the relative risk of bleeding during such an antiplatelet treatment regimen was even greater among patients with abnormal renal function. These results allow modification of current antiplatelet therapy regimens after PCI, improving treatment safety and consequently reducing the number of patients who die from myocardial infarction or its complications.
The scientific achievement awarded by the Prime Minister includes a series of seven papers entitled "Novel strategies for antiplatelet pharmacotherapy following Percutaneous Coronary Interventions in a patient population at high risk for ischemic and hemorrhagic complications." Mariusz Tomaniak, MD, PhD, has taken up this issue in cooperation with foreign and domestic centers.
The papers authored by Mariusz Tomaniak, MD, PhD, have been published in leading international cardiology journals including Journal of the American Medical Association (JAMA) Cardiology, Clinical Research in Cardiology, EuroIntervention.
The Prime Minister’s awards are granted for outstanding doctoral dissertations, highly valued achievements being the basis for granting the PhD degree or the degree of Doctor of Arts, and for achievements in scientific activities. This year 43 people received such awards.