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Oyetayo OO, Slicker K, De La Rosa L, et al. Dual antiplatelet compared to triple antithrombotic therapy in anterior wall acute myocardial infarction complicated by depressed left ventricular ejection fraction. Proc (Bayl Univ Med Cent). 2015;28(4):445-9doi: 10.1080/08998280.2015.11929303.
Oyetayo, O. O., Slicker, K., De La Rosa, L., Lane, W., Langsjoen, D., Patel, C., Brough, K., Michel, J., & Chiles, C. (2015). Dual antiplatelet compared to triple antithrombotic therapy in anterior wall acute myocardial infarction complicated by depressed left ventricular ejection fraction. Proceedings (Baylor University. Medical Center), 28(4), 445-9. https://doi.org/10.1080/08998280.2015.11929303
Oyetayo, Ola O, et al. "Dual antiplatelet compared to triple antithrombotic therapy in anterior wall acute myocardial infarction complicated by depressed left ventricular ejection fraction." Proceedings (Baylor University. Medical Center) vol. 28,4 (2015): 445-9. doi: https://doi.org/10.1080/08998280.2015.11929303
Oyetayo OO, Slicker K, De La Rosa L, Lane W, Langsjoen D, Patel C, Brough K, Michel J, Chiles C. Dual antiplatelet compared to triple antithrombotic therapy in anterior wall acute myocardial infarction complicated by depressed left ventricular ejection fraction. Proc (Bayl Univ Med Cent). 2015 Oct;28(4):445-9. doi: 10.1080/08998280.2015.11929303. PMID: 26424937; PMCID: PMC4569220.
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Proc (Bayl Univ Med Cent). 2015 Oct;28(4):445-9. doi: 10.1080/08998280.2015.11929303.

Dual antiplatelet compared to triple antithrombotic therapy in anterior wall acute myocardial infarction complicated by depressed left ventricular ejection fraction.

Proceedings (Baylor University. Medical Center)

Ola O Oyetayo, Kipp Slicker, Lisa De La Rosa, Wesley Lane, Dane Langsjoen, Chhaya Patel, Kevin Brough, Jeffrey Michel, Christopher Chiles

Affiliations

  1. Department of Pharmacy Practice, College of Pharmacy, Texas A&M Health Science Center and Baylor Scott & White Health, Temple, Texas (Oyetayo); the Division of Cardiology (Slicker, De La Rosa, Michel, Chiles) and Department of Internal Medicine (Lane, Langsjoen, Patel, Brough), College of Medicine, Texas A&M Health Science Center, and Baylor Scott & White Health, Temple, Texas.

PMID: 26424937 PMCID: PMC4569220 DOI: 10.1080/08998280.2015.11929303

Abstract

Current guidelines recommend triple antithrombotic therapy (TT) consisting of warfarin, aspirin, and a P2Y12 inhibitor following an anterior ST elevation myocardial infarction (STEMI) complicated by extensive wall motion abnormalities. This recommendation, however, is based on data collected before percutaneous coronary intervention (PCI) became the standard of care for the treatment of STEMI. We designed a retrospective study of patients who received PCI for anterior STEMI over an 8-year period to compare rates of thromboembolic and bleeding events between patients receiving dual antiplatelet therapy (DAPT) and those receiving TT, including warfarin. Patients were included if the predischarge echocardiogram showed extensive wall motion abnormality and an ejection fraction ≤35%. Patients with known left ventricular thrombus were excluded. A total of 124 patients met the criteria, with 80 patients in the DAPT group and 44 in the TT group. The median age was 58 years in the TT group and 64 years in the DAPT group (P < 0.04), with an average ejection fraction of 31%. Thromboembolic events occurred in 4 patients (5%) in the DAPT group compared with 3 patients (6.8%) in the TT group (P = 0.70). Bleeding occurred in 2 patients in the DAPT group and 4 patients in the TT group (2.5% in DAPT vs. 9.1% in TT group, P = 0.18). No differences in rates of clinical embolism or left ventricular thrombus were found. Our data support recent findings that warfarin may not be indicated for patients following PCI for anterior STEMI, even when significant wall motion abnormalities and reduced ejection fraction ≤35% are present.

References

  1. J Am Coll Cardiol. 1997 Oct;30(4):962-9 - PubMed
  2. Chest. 2012 Feb;141(2 Suppl):e637S-68S - PubMed
  3. Eur Heart J. 2003 Oct;24(20):1815-23 - PubMed
  4. Am J Cardiol. 2010 Jun 15;105(12):1844 - PubMed
  5. J Thromb Thrombolysis. 2000 Oct;10(2):133-6 - PubMed
  6. J Thromb Thrombolysis. 2010 Aug;30(2):127-32 - PubMed
  7. Cardiovasc Ultrasound. 2006 Apr 06;4:20 - PubMed
  8. N Engl J Med. 2012 May 17;366(20):1859-69 - PubMed
  9. Lancet. 2013 Mar 30;381(9872):1107-15 - PubMed
  10. J Intern Med. 1993 Feb;233(2):139-43 - PubMed
  11. N Engl J Med. 1981 Aug 6;305(6):297-302 - PubMed
  12. JACC Cardiovasc Interv. 2015 Jan;8(1 Pt B):155-62 - PubMed
  13. J Am Coll Cardiol. 1993 Oct;22(4):1004-9 - PubMed
  14. J Am Coll Cardiol. 1990 Mar 15;15(4):790-800 - PubMed
  15. Circulation. 2008 Jan 15;117(2):296-329 - PubMed
  16. Circulation. 2009 Mar 31;119(12):1616-24 - PubMed
  17. J Am Coll Cardiol. 2013 Jan 29;61(4):e78-140 - PubMed
  18. Am Heart J. 2009 Jun;157(6):1074-80 - PubMed
  19. Can J Cardiol. 2013 Feb;29(2):204-12 - PubMed
  20. Coron Artery Dis. 2005 Aug;16(5):275-9 - PubMed
  21. Eur J Radiol. 2012 Dec;81(12):3900-4 - PubMed

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