Neuronal Signaling myocardial infarction in patients with STEMI PPCI

Pretreatment Thrombozytenreaktivit Th in patients with STEMI appear to seriously adversely Mighty, the speed of time-dependent Independent inhibition of Blutpl Ttchen after clopidogrel. In terms of Neuronal Signaling clinical outcome studies with, stratifying the analysis of observations results Alignment tion Revascularization and Stents in the trial of the Acute myocardial infarction in patients with STEMI PPCI 3602 after dose thienopyridine loading showed that 600 mg compared with a dose of 300 mg of clopidogrel lower the mortality rates of 30 days, t, myocardial infarction, stent thrombosis and without gr ere increased bleeding was associated ht. Reduce clopidogrel use in optimal dose to recurrent events / platelet aggregation inhibitor optimal strategy for interventions current OASIS 7 trial, comparing clopidogrel double or standard doses on the basis of aspirin therapy, there were 6346 with STEMI usually presented treatment with PPCI. In 30 days there was a 37% reduction in the risk of myocardial infarction in patients treated with clopidogrel double dose, but no benefit in mortality was observed. Korea in the register of acute myocardial infarction in 1447 patients with PPCI and 1217 300 mg and 600 mg loading dose of clopidogrel, there is no difference in efficacy and safety between the two groups found. So far, no study, a decrease in mortality T with clopidogrel has been shown when used as part of PPCI. Even after a dose of 600 mg clopidogrel, the full anticoagulant effect of the drug is only reached after 2 h, and individual variability with broad t. Clopidogrel has no time to be effective, if PPCI is performed, in many cases Cases was given after the procedure is completed. Accordingly, a time window in which it remains in a reduced efficiency responder. In particular, the value of pretreatment with clopidogrel for PCI au S with STEMI has been called into question, w While the evidence for early clopidogrel succeeded in R S of the patients with PPCI only exists in the form of registration of data and analysis of subgroups.
In a meta-analysis of 38 treatment groups, including normal was the 8429 patients Anf ngliche Durchl Permeability h Forth in the treatment groups in which the patientsreceived pretreatment with clopidogrel compared with those in which patients do not return U clopidogrel before initial coronary angiography and was followed by improved results. Has entered into a prospective registry of 292 patients clopidogrel pretreatment PPCI in the emergency department or coronary Ridaforolimus care unit Born an improvement of myocardial perfusion and a significant reduction in the incidence of reinfarction at 30 days compared with clopidogrel after PCI, w While in another register 2014 patients treated with PPCI 600 mg clopidogrel, the l singer duration of treatment was significantly improved Durchl liquid and less re-infarction / Isch chemistry, including stent thrombosis associated with no increased HTES risk of bleeding or differences in mortality t. Clopidogrel pr Hospital-Ren prime PCI in patients with acute myocardial infarction randomized study analyzed the effects of improving the early administration of 600 mg clopidogrel at discharge in patients with STEMI, 654 administered. In a comparison of clopidogrel is not allowed before the first angiography. The results are expected to Shor.