The Effects of Ticlopidine in Acute Myocardial Infarction as an Adjunctive Treatment to Aspirin in an Intermediate Term Setting

Authors: V. GÖKHAN CİN, AHMET TEMİZHAN, HASAN PEKDEMİR, MEHMET TOKAÇ, OKAN TARTANOĞLU

Abstract: Antiplatelet therapy reduces the risk of subsequent ischemic events in patients suffering from acute myocardial infarction (AMI). In this respect, the multi-agent therapy to be used along with aspirin remains to be determined. In this study, ticlopidine was tried in AMI for its potential additive effects over aspirin. Ninety patients with similar clinical characteristics were involved and were followed up for 3 and 6 months. All patients were assigned to receive ticlopidine plus aspirin or aspirin alone. Major cardiac events such as death and reinfarction were primary end-points whereas the need for revascularization was the secondary end-point at 3 and 6 months. Although no variable was significantly different, it was noteworthy that the ticlopidine group showed less need for revascularization (mainly coronary bypass surgery at 3 and 6 months (15.9% vs. 30.4%, 20.5% vs. 30.4%) and reinfarction rates (4.5% vs. 10.9% and 6.8% vs. 13%). This study was one of the few to evaluate the effects of adjunctive ticlopidine treatment in AMI. Despite the lack of significant superiority over aspirin alone, the additional effects of ticlopidine could be a reduction in reinfarction rates and the need for bypass surgery at 3- and 6-months if more patients were involved. Nevertheless, comprehensive, large-scale studies are essential to disclose the net effect.

Keywords: Acute myocardial infarction, aspirin, ticlopidine

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