Document Detail


Frequent reocclusion of patent infarct-related arteries between 4 weeks and 1 year: effects of antiplatelet therapy.
MedLine Citation:
PMID:  7798505     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: This study assessed the effect of the combination of aspirin and dipyridamole on patency of the infarct-related artery between 4 weeks and 1 year after myocardial infarction. BACKGROUND: Patency of the infarct-related artery is an important determinant of prognosis after myocardial infarction. The incidence of late reocclusion and the effects of antiplatelet therapy are unknown. METHODS: To investigate the importance of antiplatelet therapy for the prevention of late reocclusion, 215 patients who had a patent infarct-related artery 4 weeks after myocardial infarction were randomized in a double-blind manner to receive either a combination of 25 mg of aspirin and 200 mg of dipyridamole twice daily or placebo. One hundred fifty-four patients underwent further coronary arteriography 1 year later. RESULTS: At 1 year, 38 (25%) of 154 patients had reocclusion of the infarct-related artery; 18 (23%) of 79 patients receiving aspirin and dipyridamole had late reocclusion versus 20 (27%) of 75 who received placebo (p = NS). The rate of reocclusion was related to the severity of the residual coronary artery stenosis at 4 weeks (< 50% stenosis 9.2%; 50% to 69% stenosis 11.6%; 70% to 89% stenosis 30.4%; > or = 90% stenosis 70%, p < 0.01). The majority of reocclusions were silent, and only 17 (45%) of 38 were clinically associated with further infarction. There were no differences for a hierarchic end point of cardiac death, myocardial infarction or revascularization (14.8% aspirin and dipyridamole vs. 17.8% placebo). CONCLUSIONS: Late reocclusion of the patent infarct-related artery is a frequent event, occurring in 25% of patients. Antiplatelet therapy with the combination of aspirin and dipyridamole does not alter the overall rate of late reocclusion. Other strategies are required to reduce late reocclusion.
Authors:
H D White; J K French; A W Hamer; M A Brown; B F Williams; J A Ormiston; D B Cross
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  25     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1995 Jan 
Date Detail:
Created Date:  1995-01-25     Completed Date:  1995-01-25     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  218-23     Citation Subset:  AIM; IM    
Affiliation:
Cardiology Department, Green Lane Hospital, Auckland, New Zealand.
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MeSH Terms
Descriptor/Qualifier:
Aspirin / administration & dosage
Coronary Angiography
Coronary Disease / complications,  epidemiology,  prevention & control
Coronary Vessels / drug effects*
Dipyridamole / administration & dosage
Double-Blind Method
Drug Therapy, Combination
Female
Follow-Up Studies
Humans
Male
Middle Aged
Myocardial Infarction / drug therapy*,  etiology,  mortality
Platelet Aggregation Inhibitors / therapeutic use*
Prognosis
Recurrence
Risk Factors
Thrombolytic Therapy
Time Factors
Vascular Patency / drug effects*
Chemical
Reg. No./Substance:
0/Platelet Aggregation Inhibitors; 50-78-2/Aspirin; 58-32-2/Dipyridamole

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


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