Document Detail


Effect of clopidogrel plus aspirin on tissue perfusion and coronary flow in patients with ST-segment elevation myocardial infarction: a new reperfusion strategy.
MedLine Citation:
PMID:  15976785     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Current reperfusion strategies may fail to achieve optimal tissue perfusion in ST-elevation myocardial infarction (STEMI). We investigated the effect of clopidogrel plus aspirin on tissue perfusion and coronary flow in infarct patients treated with fibrinolytic agents. METHODS: Consecutive 78 patients with STEMI were randomized to receive clopidogrel plus aspirin (clopidogrel group, n = 42) or placebo plus aspirin (placebo group, n = 36) before streptokinase. Maximum and total ST-segment resolutions (sumSTR) were calculated at 90 minutes after fibrinolysis. TIMI flow grade and corrected TIMI frame count in infarct-related artery were evaluated at predischarge. Inhospital ischemic and hemorrhagic events were also analyzed. RESULTS: Baseline characteristics were comparable in both groups. Both mean maximum ST-segment resolution (54.5 +/- 21.3% vs 44.6 +/- 22.0%, P = .047 ) and sumSTR (52.7 +/- 21.1% vs 42.8 +/- 20.7%, P = .041) were slightly higher in the clopidogrel group than placebo group. The rate of complete sumSTR 70% was significantly higher in the clopidogrel group compared with placebo group (31% vs 11%, P = .021). TIMI flows were similar in both groups, but corrected TIMI frame count was significantly lower in the clopidogrel group compared with placebo group (25.5 +/- 10.5 vs 33.5 +/- 11.8 frames, P = .027). Clinical events were comparable in 2 groups; however, there were 1 death caused by heart failure and moderate bleeding in the clopidogrel group. CONCLUSION: Our results suggest that clopidogrel plus aspirin compared with aspirin alone may improve myocardial tissue perfusion and coronary flow in STEMI patients receiving streptokinase.
Authors:
Abdullah Dogan; Mustafa Ozgul; Mehmet Ozaydin; Suleyman M Aslan; Omer Gedikli; Ahmet Altinbas
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  American heart journal     Volume:  149     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2005 Jun 
Date Detail:
Created Date:  2005-06-24     Completed Date:  2005-11-28     Revised Date:  2006-02-27    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1037-42     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, Sevket Demirel Heart Center, Suleyman Demirel University, Isparta, Turkey. adogan35@hotmail.com <adogan35@hotmail.com>
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MeSH Terms
Descriptor/Qualifier:
Aged
Aspirin / administration & dosage*
Coronary Circulation / drug effects
Drug Therapy, Combination
Electrocardiography
Female
Humans
Male
Middle Aged
Myocardial Infarction / drug therapy*,  physiopathology
Regional Blood Flow / drug effects
Ticlopidine / administration & dosage,  analogs & derivatives*
Chemical
Reg. No./Substance:
50-78-2/Aspirin; 55142-85-3/Ticlopidine; 90055-48-4/clopidogrel
Comments/Corrections
Comment In:
Am Heart J. 2005 Jun;149(6):947-9   [PMID:  15976770 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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