Antiplatelets and Intramyocardial Hemorrhage in STEMI: Incidence and Outcomes

Inclusion criteria

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

Exclusion criteria

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