| Effect of clopidogrel plus aspirin on tissue perfusion and coronary flow in patients with ST-segment elevation myocardial infarction: a new reperfusion strategy. | |
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MedLine Citation:
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PMID: 15976785 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Abdullah Dogan; Mustafa Ozgul; Mehmet Ozaydin; Suleyman M Aslan; Omer Gedikli; Ahmet Altinbas |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: American heart journal Volume: 149 ISSN: 1097-6744 ISO Abbreviation: Am. Heart J. Publication Date: 2005 Jun |
Date Detail:
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Created Date: 2005-06-24 Completed Date: 2005-11-28 Revised Date: 2006-02-27 |
Medline Journal Info:
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Nlm Unique ID: 0370465 Medline TA: Am Heart J Country: United States |
Other Details:
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Languages: eng Pagination: 1037-42 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiology, Sevket Demirel Heart Center, Suleyman Demirel University, Isparta, Turkey. adogan35@hotmail.com <adogan35@hotmail.com> |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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50-78-2/Aspirin; 55142-85-3/Ticlopidine; 90055-48-4/clopidogrel |
| Comments/Corrections | |
Comment In:
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Am Heart J. 2005 Jun;149(6):947-9
[PMID:
15976770
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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