Dual antiplatelet therapy in patients with ST-segment elevation acute myocardial infarction and thrombolytic treatment

Abstract

Introduction: Acute coronary syndromes are usually due to plaque rupture, platelet activation, and thrombus formation leading to coronary occlusion and myocardial injury. The use of acetylsalicylic acid, clopidogrel and low molecular weight heparin have reduced the risk of death, myocardial infarction and ischemia recurrence

Objective: To describe the clinical course and benefits of dual antiplatelet therapy associated with thrombolytic therapy in patients with ST-segment elevation acute myocardial infarction (STEMI).

Method: A descriptive, cross-sectional, non-randomized, multicenter study was performed between October 2012 and December 2014 at the Intensive Care Units from Arnaldo Milián Castro, Celestino Hernández Robau and Placetas University Hospitals in Villa Clara, Cuba. The study population consisted of 86 patients divided into study and control groups, who met the inclusion criteria.

Results: STEMI was more frequent in males and between 70-75 years. Most frequent risk factors were smoking and hypertension in 57.0% of patients in both groups. The anterior wall location presented more complications; patients with inferior location of the infarction were the most benefited with dual antiplatelet therapy. It was found in the study group that the earlier the treatment, the better the evolution and the lower the in-hospital mortality.

Conclusions: Dual antiplatelet therapy in patients with STEMI, receiving thrombolytic therapy, decreased ischemic complications frequency.