Influence of the double antiplatelet therapy on patency of the infarct related artery after acute myocardial infarction with ST-segment elevation
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....
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| Format: | Article |
| Language: | English |
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Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade
2007-01-01
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| Series: | Vojnosanitetski Pregled |
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| Online Access: | http://www.doiserbia.nb.rs/img/doi/0042-8450/2007/0042-84500702117D.pdf |
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| author | Đorđević-Radojković Danijela Perišić Zoran Tomašević Miloje Pavlović Milan Apostolović Svetlana Janković Ružica Damjanović Miodrag Šalinger-Martinović Sonja Božinović Nenad Milenković Dušan |
| author_facet | Đorđević-Radojković Danijela Perišić Zoran Tomašević Miloje Pavlović Milan Apostolović Svetlana Janković Ružica Damjanović Miodrag Šalinger-Martinović Sonja Božinović Nenad Milenković Dušan |
| author_sort | Đorđević-Radojković Danijela |
| collection | DOAJ |
| description | 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 onset 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. |
| format | Article |
| id | doaj-art-ea8289a17ca84738bc68275076d97872 |
| institution | OA Journals |
| issn | 0042-8450 |
| language | English |
| publishDate | 2007-01-01 |
| publisher | Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade |
| record_format | Article |
| series | Vojnosanitetski Pregled |
| spelling | doaj-art-ea8289a17ca84738bc68275076d978722025-08-20T02:22:02ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski Pregled0042-84502007-01-0164211712110.2298/VSP0702117DInfluence of the double antiplatelet therapy on patency of the infarct related artery after acute myocardial infarction with ST-segment elevationĐorđević-Radojković DanijelaPerišić ZoranTomašević MilojePavlović MilanApostolović SvetlanaJanković RužicaDamjanović MiodragŠalinger-Martinović SonjaBožinović NenadMilenković DušanBackground/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 onset 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.http://www.doiserbia.nb.rs/img/doi/0042-8450/2007/0042-84500702117D.pdfmyocardial infarctionplatelet aggregation inhibitorsdrug therapycombinationheparinlow-molecularweightfibrinolytic agentsangioplastyballoon |
| spellingShingle | Đorđević-Radojković Danijela Perišić Zoran Tomašević Miloje Pavlović Milan Apostolović Svetlana Janković Ružica Damjanović Miodrag Šalinger-Martinović Sonja Božinović Nenad Milenković Dušan Influence of the double antiplatelet therapy on patency of the infarct related artery after acute myocardial infarction with ST-segment elevation Vojnosanitetski Pregled myocardial infarction platelet aggregation inhibitors drug therapy combination heparin low-molecularweight fibrinolytic agents angioplasty balloon |
| title | Influence of the double antiplatelet therapy on patency of the infarct related artery after acute myocardial infarction with ST-segment elevation |
| title_full | Influence of the double antiplatelet therapy on patency of the infarct related artery after acute myocardial infarction with ST-segment elevation |
| title_fullStr | Influence of the double antiplatelet therapy on patency of the infarct related artery after acute myocardial infarction with ST-segment elevation |
| title_full_unstemmed | Influence of the double antiplatelet therapy on patency of the infarct related artery after acute myocardial infarction with ST-segment elevation |
| title_short | Influence of the double antiplatelet therapy on patency of the infarct related artery after acute myocardial infarction with ST-segment elevation |
| title_sort | influence of the double antiplatelet therapy on patency of the infarct related artery after acute myocardial infarction with st segment elevation |
| topic | myocardial infarction platelet aggregation inhibitors drug therapy combination heparin low-molecularweight fibrinolytic agents angioplasty balloon |
| url | http://www.doiserbia.nb.rs/img/doi/0042-8450/2007/0042-84500702117D.pdf |
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