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

Abstract

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.

Early Use of Aspirin after Symptoms in Patients with ST-Segment Elevation Myocardial Infarction Undergoing Percutaneous Coronary Intervention

“…5 Patients with suspected acute myocardial infarction treated with pre-hospital aspirin range from 19 percent to 78 percent in prior studies from various countries. [14][15][16][17][18][19][20] In the current study, pre-hospital aspirin usage was found to be 38.7 percent. The low level of adherence to standard guidelines of aspirin can be attributed to a number of factors.…”

“…However, in the study by Zijlstra et al found pre-hospital use of aspirin did not differ significantly between males and females (p=0.24). 15 While, Barbash et al revealed proportion of females was significantly higher in late aspirin administration group versus early aspirin administration (p=0.001). 21 Hence, these demographic factors should be considered for the successful and early intervention of aspirin in suspected STEMI cases.…”

“…In the study by Zijlstra et al also found insignificant difference death rate between the in-hospital and pre-hospital use of aspirin. 15 Barbash et al has observed significantly lesser in-hospital complications and mortality in patients who received early aspirin versus patients who received late aspirin. 21 Becker et al also found that mortality rate (OR=0.24, 95% CI=0.22 to 0.26, p=0.0001) and recurrent MI (OR=0.90, 95% CI=0.78 to 1.00) was lower in patients who received early aspirin than late aspirin.…”

“…The pre-hospital use of aspirin is inexpensive, widely applicable and simple therapy in patients with confirmed or suspected acute myocardial infarction. 15 In the present study, we measured the frequency of pre-hospital aspirin use in patients with STEMI, and also assessed its association with demographic and clinical factors.…”

Different perspectives on translational genomics in personalized medicine

“…For example, clopidogrel is an irreversible platelet ADP receptor antagonist which inhibits platelet activation and aggregation and is used for the prevention or the treatment of arterial thrombosis ( 69 ). Aspirin and clopidogrel combination are standard dual antiplatelet therapy in acute myocardial infarction patients and in coronary stent implementation ( 70 ). Clopidogrel is a prodrug that must be converted to an active metabolite by the enzyme CYP2C19 .…”