Postoperative The Efficacy of a Regular Loading Dose of Ticagrelor with a 100 units/kg Dose of Unfractionated Heparin on Reperfusion (According to TIMI Flow Sensor) in Patients with ST Elevation Myocardial Infraction
Keywords:
Coronary artery disease, myocardial infraction, risk factors, Primary percutaneous coronary intervention, Antiplatelet drugs, Fibrinolytic therapy .Abstract
Background: Acute ST-segment elevation myocardial infarction (STEMI) is one of the most important causes of mortality around the globe. The disease occurs following acute thrombotic occlusion of an epicardial coronary artery. Timely reperfusion through primary percutaneous coronary intervention (PPCI) is the most important treatment to improve the prognosis of patients with STEMI Platelet activation, followed by aggregation, plays a key role in the process of STEMI. Administration of platelet P2Y12 inhibitors on top of aspirin before PPCI is considered an important therapeutic strategy that helps restores the perfusion to the ischemic area and prevents stent thrombosis .
Objective: To study the effectiveness of ticagrelor at the usual loading dose with unfractionated heparin in improving reperfusion of the affected artery in patients with acute myocardial infarction with ST-segment elevation, compared with clopidogrel with heparin at the usual loading dose, according to the flow grade index (TIMI) calculated during coronary imaging, in addition to studying the effectiveness of ticagrelor in improving the ejection fraction after six weeks of percutaneous coronary intervention .
Data Collection: Data regarding the baseline demographics comprising age, sex, history of hypertension (HTN), diabetes mellitus (DM), dyslipidemia (DLP), and current cigarette smoking were collected. Baseline angiographic variables included pain-to-wire time, culprit vessel, initial TIMI fow. Ejection fraction was calculated in all patients on admission and after six weeks.
Methods: patients with acute STEMI in whom PPCI was indicated and consented to participate in the study were included. The diagnosis of acute STEMI was made according to the electrocardiograms prepared at admission to the emergency department . After STEMI was confrmed, patients were given a loading dose of clopidogrel (600 mg) or ticagrelor (180 mg) based on the discretion of the interventional cardiologist in charge of PPCI and prepared for emergency angiography and angioplasty. A loading dose of 325 milligrams of aspirin was prescribed for all patients .
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