[Influence of the double antiplatelet therapy on patency of the occluded artery after acute myocardial infarction with ST-segment elevation].

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  • Additional Information
    • Source:
      Publisher: Military Medical Academy, INI Country of Publication: Serbia NLM ID: 21530700R Publication Model: Print Cited Medium: Print ISSN: 0042-8450 (Print) Linking ISSN: 00428450 NLM ISO Abbreviation: Vojnosanit Pregl Subsets: MEDLINE
    • Publication Information:
      Publication: <2013>- : Belgrade, Serbia : Military Medical Academy, INI
      Original Publication: Beograd : Institut Vojnomedicinski Dokumentaciju
    • Subject Terms:
      Thrombolytic Therapy* ; Vascular Patency*; Aspirin/*administration & dosage ; Myocardial Infarction/*drug therapy ; Platelet Aggregation Inhibitors/*administration & dosage ; Ticlopidine/*analogs & derivatives; Adult ; Aged ; Clopidogrel ; Coronary Angiography ; Drug Therapy, Combination ; Electrocardiography ; Female ; Fibrinolytic Agents/administration & dosage ; Humans ; Male ; Middle Aged ; Myocardial Infarction/physiopathology ; Ticlopidine/administration & dosage
    • Abstract:
      Background/aim: Most patients with acute myocardial infarction with ST-segment elevation (STEMI) are still treated with pharmacological reperfusion, which is not always successful. That is the reason for searching possibilities for a better success of reperfusion with adding new antiplatelet drugs. The aim of this study was to investigate weather addition of clopidogrel as a second antiplatelet drug, improves the patency of the infarct-related artery after STEMI.
      Methods: We prospectively enrolled 65 patients, 29-72 years old, hospitalized due to the first STEMI within 6 hours after the on-set of a chest pain. They were treated with a fibrinolytic agent (streptokinase or tissue plasminogen activator--tPA), aspirin, and low molecular heparin (enoxaparin). A group of 50 patients, beside this therapy, received clopidogrel. Coronary angiography was performed between 5th and 10th day of hospitalization to assess for late patency of the infarct-related artery. Infarct-related artery was considered as patent if thrombolysis in myocardial infarction (TIMI) flow grade was 2 or 3, and as occluded if TIMI flow grade was 0 or 1.
      Results: In the group of patients who received double antiplatelet therapy (aspirin and clopidogrel), infarct-related artery was occluded in 3 cases (6%); in the group of patients without clopidogrel, infarct-related artery was occluded in 4 patients (26.7%),p < 0.05. There were less frequency of postinfarction angina (6% vs 13.3%), and rarer necessity for rescue percutaneous coronary intervention (4% vs. 13.3%) in the first group, but without statistical significance.
      Conclusion: Adding of clopidogrel to the standard reperfusion pharmacotherapy, as a second antiplatelet drug, increases the number of patients with patent infarct-related artery and the success of reperfusion.
    • Accession Number:
      0 (Fibrinolytic Agents)
      0 (Platelet Aggregation Inhibitors)
      A74586SNO7 (Clopidogrel)
      OM90ZUW7M1 (Ticlopidine)
      R16CO5Y76E (Aspirin)
    • Publication Date:
      Date Created: 20070314 Date Completed: 20070424 Latest Revision: 20190917
    • Publication Date:
      20221213
    • Accession Number:
      10.2298/vsp0702117d
    • Accession Number:
      17348463