scholarly journals Aspirin in combination with clopidogrel in the treatment of acute myocardial infarction patients undergoing percutaneous coronary intervention

2019 ◽  
Vol 35 (2) ◽  
Author(s):  
Xiaoyan Zhang ◽  
Lizhen Qi ◽  
Yongxuan Liu
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Cardiac Function ◽  
Coronary Intervention ◽  
Control Group ◽  
Observation Group ◽  
Percutaneous Coronary ◽  
Significant Difference ◽  
Before And After

Objective: To investigate the clinical effect of aspirin combined with clopidogrel on acute myocardial infarction after percutaneous coronary intervention (PCI). Methods: One hundred thirty two patients with acute myocardial infarction who were admitted to the hospital between December 2016 and December 2017 were divided into a control group and an observation group according to random number table, 66 each group. Both groups were given emergency PCI and symptomatic treatment. The control group was given aspirin on the basis of conventional treatment before and after operation, while the observation group was given clopidogrel treatment on the basis of the treatment the same as the control group. The treatment lasted for 4 months. The clinical efficacy of the two groups was analyzed, and the cardiac function indicator, coagulation indicator and occurrence of adverse reactions were compared before and after treatment. Results: There was no thrombosis at the infarct site in coronary angiography after treatment in both groups. The efficacy in the observation group and control group were 89.4% and 81.8%, respectively; there was no significant difference between the two groups. The incidence of re-thrombosis in the two groups was 1.5% and 12.1% respectively, which was significantly lower in the observation group than in the control group (P<0.05). The cardiac function indicator of both groups improved after treatment, especially the observation group (P<0.05). There was no significant difference in prothrombin time (PT), activated partial thromboplastin time (APTT), prothrombin activity (PA) and platelet aggregation rate (PAR) in the two groups before treatment (P>0.05). There was also no significant difference in PT and PA before and after treatment (P>0.05). The APTT and PAR were significantly different after treatment (P<0.05), and the PAR of the observation group was significantly higher than that of the control group (P<0.05). The incidence of adverse reactions in the observation group was 7.58%, which was not significantly different with that of the control group (12.12%) (P<0.05). Conclusion: Aspirin combined with clopidogrel can effectively reduce the occurrence of re-thrombosis after PCI and improve the recovery of cardiac function after acute operation, moreover the safety is high. It has important clinical application values. How to cite this:Zhang X, Qi L, Liu Y. Aspirin in combination with clopidogrel in the treatment of acute myocardial infarction patients undergoing percutaneous coronary intervention. Pak J Med Sci. 2019;35(2):---------. doi: https://doi.org/10.12669/pjms.35.2.87 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals The effect of unguided de-escalation of P2Y12 receptor inhibitor therapy after acute myocardial infarction in patients undergoing percutaneous coronary intervention: a nationwide cohort study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J.S Yeh ◽  
C.Y Hsu ◽  
C.Y Huang ◽  
W.T Chen ◽  
Y.C Hsieh ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Bleeding Complications ◽  
Funding Source ◽  
P2y12 Inhibitor ◽  
Risk Of Death ◽  
Percutaneous Coronary ◽  
Significant Difference

Abstract Aims To examine the effect of de-escalation of P2Y12 inhibitor in dual antiplatelet therapy (DAPT) on major adverse cardiovascular events (MACE) and bleeding complications after acute myocardial infarction (AMI) in Taiwanese patients undergoing percutaneous coronary intervention (PCI). Methods and results We retrospectively evaluated patients who had received PCI during AMI hospitalisation and were initially on aspirin and ticagrelor and without adverse events at 3 months between 2013 and 2016. In total, 1,901 and 8,199 patients were identified as switched DAPT (switched to aspirin and clopidogrel) and unswitched DAPT (continued on aspirin and ticagrelor) cohorts, respectively. With a mean follow-up of 8 months, the incidence rates (per 100 person-year) of death, AMI readmission and MACE were 2.89, 3.68 and 4.91 in the switched cohort and 2.42, 3.28 and 4.72 in the unswitched cohort, respectively based on an inverse probability of treatment weighted method. (Table) After adjustment for patients' clinical variables, two groups were no significant difference in death (A), AMI admission (B) and MACE (C). Additionally, there was no difference in the risk of major (D) or non-major clinically relevant bleeding (E) (Figure 1). Conclusions Unguided de-escalation of P2Y12 inhibitor in DAPT was not associated with higher risk of death, MACE, AMI readmission in Taiwanese patients with AMI undergoing PCI. Figure 1 Funding Acknowledgement Type of funding source: Private hospital(s). Main funding source(s): Taipei Medical University

Can WeChat group-based intervention reduce reperfusion time in patients with ST-segment myocardial infarction? A controlled before and after study

2019 ◽  
Vol 26 (10) ◽  
pp. 627-637
Author(s):  
Hui Liu ◽  
Wei Wang ◽  
Haojia Chen ◽  
Zhi Li ◽  
Shushuang Feng ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
St Elevation Myocardial Infarction ◽  
Control Group ◽  
Catheterization Laboratory ◽  
Percutaneous Coronary ◽  
Before And After ◽  
St Elevation ◽  
Before And After Study

Background Pre-hospital identification of acute ST-elevation myocardial infarction and activation of the catheterization laboratory can reduce first medical contact to wire-crossing times. We conducted a study on providing 24-hour tele-electrocardiography services via the WeChat group application, aiming to reduce the time taken for diagnosis and treatment of ST-elevation myocardial infarction. Methods A controlled before and after study was conducted on 140 ST-elevation myocardial infarction patients who were initially seen in non-percutaneous coronary intervention-capable hospital and transferred for primary percutaneous coronary intervention at our percutaneous coronary intervention centre from 1 February to 31 October 2018. The WeChat group had 70 patients with pre-hospital electrocardiography transmission via WeChat and the control group had 70 patients who did not transfer pre-hospital electrocardiography. The reperfusion time of the two groups was compared to evaluate the effect of the WeChat group intervention. Results In the WeChat group versus the control group, the median symptom onset to first medical contact time was similar (129 vs 150 min, p > 0.05), but the median first medical contact to wire, door to wire and first medical contact to catheterization laboratory activity were significantly shorter (132 vs 171 minutes, p < 0.001; 60 vs 95 minutes, p < 0.001; 29 vs 74 minutes, p < 0.001, respectively). Conclusions Pre-hospital electrocardiography transfer via a WeChat group resulted in earlier reperfusion of ST-elevation myocardial infarction patients who were transferred from the non-percutaneous coronary intervention centre.

Markers of oxidative stress in acute myocardial infarction treated by percutaneous coronary intervention

Open Medicine ◽  
2009 ◽  
Vol 4 (1) ◽  
pp. 26-31 ◽  
Author(s):  
Eva Sedláková ◽  
Oliver Rácz ◽  
Eva Lovásová ◽  
Roman Beòaèka ◽  
Martin Kurpas ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Venous Blood ◽  
Plasma Lipid ◽  
Coronary Intervention ◽  
Control Group ◽  
Coronary Syndrome ◽  
Percutaneous Coronary

AbstractIn the current study, we evaluated the dynamics of oxidative stress markers in patients with acute myocardial infarction (AMI) treated by primary percutaneous coronary intervention (PCI). Thirty consecutive patients with AMI with ST elevation were included. Plasma lipid peroxidation end product malondialdehyde (MDA) and total antioxidant capacity (TAC) in blood plasma were evaluated. Peripheral venous blood samples were obtained prior to reperfusion and at five time points after reperfusion. The control group consisted of 20 ischemic patients without acute coronary syndrome. TAC in the AMI group at admission was lower than in control patients (1.26 + 0.32 vs. 1.52 + 0.24 mmol/l). Within 1 h after reperfusion, in most cases, values significantly declined (1 min, 1.10 + 0.33 mmol/l; 1 h, 1.06 + 0.21 mmol/l [p= 0.03]). After 3 h, values began to increase (1.14 + 0.29 mmol/l) and returned to basal values after 3 d (1.29 + 0.24 mmol/l). MDA levels in AMI patients at admission were higher than in control patients (1.66 + 0.55 vs. 1.44 + 0.55 mmol/l) but showed a sustained decrease over the 3 h after reperfusion of the occluded artery (1 min, 1.57 + 0.37 mmol/l; 1 h, 1.50 + 0.35 μmol/l; 3 h, 1.35 + 0.59 μmol/l [p = 0.03]). Reperfusion of the occluded coronary artery by PCI in AMI lead to an immediate decrease in TAC, suggesting formation of reactive oxygen species. However, the MDA level significantly decreased after reperfusion. This may suggests less reperfusion injury after PCI.

scholarly journals New Electrocardiographic Algorithm for the Diagnosis of Acute Myocardial Infarction in Patients With Left Bundle Branch Block

2020 ◽  
Vol 9 (14) ◽  
Author(s):  
Andrea Di Marco ◽  
Marcos Rodriguez ◽  
Juan Cinca ◽  
Antoni Bayes‐Genis ◽  
Jose T. Ortiz‐Perez ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Left Bundle Branch Block ◽  
Primary Percutaneous Coronary Intervention ◽  
Validation Cohort ◽  
Coronary Intervention ◽  
Control Group ◽  
Bundle Branch Block ◽  
Percutaneous Coronary

Background Current electrocardiographic algorithms lack sensitivity to diagnose acute myocardial infarction ( AMI ) in the presence of left bundle branch block. Methods and Results A multicenter retrospective cohort study including consecutive patients with suspected AMI and left bundle branch block, referred for primary percutaneous coronary intervention between 2009 and 2018. Pre‐2015 patients formed the derivation cohort (n=163, 61 with AMI ); patients between 2015 and 2018 formed the validation cohort (n=107, 40 with AMI ). A control group of patients without suspected AMI was also studied (n=214). Different electrocardiographic criteria were tested. A total of 484 patients were studied. A new electrocardiographic algorithm ( BARCELONA algorithm) was derived and validated. The algorithm is positive in the presence of ST deviation ≥1 mm (0.1 mV) concordant with QRS polarity, in any lead, or ST deviation ≥1 mm (0.1 mV) discordant with the QRS , in leads with max (R|S) voltage (the voltage of the largest deflection of the QRS , ie, R or S wave) ≤6 mm (0.6 mV). In both the derivation and the validation cohort, the BARCELONA algorithm achieved the highest sensitivity (93%–95%), negative predictive value (96%–97%), efficiency (91%–94%) and area under the receiver operating characteristic curve (0.92–0.93), significantly higher than previous electrocardiographic rules ( P <0.01); the specificity was good in both groups (89%–94%) as well as the control group (90%). Conclusions In patients with left bundle branch block referred for primary percutaneous coronary intervention , the BARCELONA algorithm was specific and highly sensitive for the diagnosis of AMI , leading to a diagnostic accuracy comparable to that obtained by ECG in patients without left bundle branch block.

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