Frequent reocclusion of patent infarct-related arteries between 4 weeks and 1 year: Effects of antiplatelet therapy

Objectives. This study assessed the effect of the combination of aspirin and dipyridamole on patency of the infarct-related artery between 4 weeks and 1 year after myocardial infarction. Background. Patency of the infarct-related artery is an important determinant of prognosis after myocardial infar...

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Veröffentlicht in:Journal of the American College of Cardiology 1995-01, Vol.25 (1), p.218-223
Hauptverfasser: White, Harvey D, French, John K, Hamer, Andrew W, Brown, Michael A, Williams, Barbara F, Ormiston, John A, Cross, David B
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container_issue 1
container_start_page 218
container_title Journal of the American College of Cardiology
container_volume 25
creator White, Harvey D
French, John K
Hamer, Andrew W
Brown, Michael A
Williams, Barbara F
Ormiston, John A
Cross, David B
description Objectives. This study assessed the effect of the combination of aspirin and dipyridamole on patency of the infarct-related artery between 4 weeks and 1 year after myocardial infarction. Background. Patency of the infarct-related artery is an important determinant of prognosis after myocardial infarction. The incidence of late reocclusion and the effects of antiplatelet therapy are unknown. Methods. To investigate the importance of antiplatelet therapy for the prevention of late reocclusion, 215 patients who had a patent infarct-related artery 4 weeks after myocardial infarction were randomized in a double-blind manner to receive either a combination of 25 mg of aspirin and 200 mg of dipyridamole twice daily or placebo. One hundred fifty-four patients underwent further coronary arteriography 1 year later. Results. At 1 year, 38 (25%) of 154 patients had reocclusion of the infarct-related artery; 18 (23%) of 79 patients receiving aspirin and dipyridamole had late reocclusion versus 20 (27%) of 75 who received placebo (p = NS). The rate of reocclusion was related to the severity of the residual coronary artery stenosis at 4 weeks (
doi_str_mv 10.1016/0735-1097(94)00331-J
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This study assessed the effect of the combination of aspirin and dipyridamole on patency of the infarct-related artery between 4 weeks and 1 year after myocardial infarction. Background. Patency of the infarct-related artery is an important determinant of prognosis after myocardial infarction. The incidence of late reocclusion and the effects of antiplatelet therapy are unknown. Methods. To investigate the importance of antiplatelet therapy for the prevention of late reocclusion, 215 patients who had a patent infarct-related artery 4 weeks after myocardial infarction were randomized in a double-blind manner to receive either a combination of 25 mg of aspirin and 200 mg of dipyridamole twice daily or placebo. One hundred fifty-four patients underwent further coronary arteriography 1 year later. Results. At 1 year, 38 (25%) of 154 patients had reocclusion of the infarct-related artery; 18 (23%) of 79 patients receiving aspirin and dipyridamole had late reocclusion versus 20 (27%) of 75 who received placebo (p = NS). The rate of reocclusion was related to the severity of the residual coronary artery stenosis at 4 weeks (&lt;50% stenosis 9.2%; 50% to 69% stenosis 11.6%; 70% to 89% stenosis 30.4%; ≥ 90% stenosis 70%, p &lt; 0.01). The majority of reocclusions were silent, and only 17 (45%) of 38 were clinically associated with further infarction. There were no differences for a hierarchic end point of cardiac death, myocardial infarction or revascularization (14.8% aspirin and dipyridamole vs. 17.8% placebo). Conclusions. Late reocclusion of the patent infarct-related artery is a frequent event, occurring in 25% of patients. Antiplatelet therapy with the combination of aspirin and dipyridamole does not alter the overall rate of late reocclusion. Other strategies are required to reduce late reocclusion.</description><identifier>ISSN: 0735-1097</identifier><identifier>EISSN: 1558-3597</identifier><identifier>DOI: 10.1016/0735-1097(94)00331-J</identifier><identifier>PMID: 7798505</identifier><identifier>CODEN: JACCDI</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Aspirin - administration &amp; dosage ; Biological and medical sciences ; Blood. Blood coagulation. Reticuloendothelial system ; Coronary Angiography ; Coronary Disease - complications ; Coronary Disease - epidemiology ; Coronary Disease - prevention &amp; control ; Coronary Vessels - drug effects ; Dipyridamole - administration &amp; dosage ; Double-Blind Method ; Drug Therapy, Combination ; Female ; Follow-Up Studies ; Humans ; Male ; Medical sciences ; Middle Aged ; Myocardial Infarction - drug therapy ; Myocardial Infarction - etiology ; Myocardial Infarction - mortality ; Pharmacology. Drug treatments ; Platelet Aggregation Inhibitors - therapeutic use ; Prognosis ; Recurrence ; Risk Factors ; Thrombolytic Therapy ; Time Factors ; Vascular Patency - drug effects</subject><ispartof>Journal of the American College of Cardiology, 1995-01, Vol.25 (1), p.218-223</ispartof><rights>1995</rights><rights>1995 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c420t-450543117941942cefbcdf1f85424a8dfad1cf555e99e319b150f861aae4d2c43</citedby><cites>FETCH-LOGICAL-c420t-450543117941942cefbcdf1f85424a8dfad1cf555e99e319b150f861aae4d2c43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/073510979400331J$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>309,310,314,776,780,785,786,3537,4036,4037,23909,23910,25118,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=3385901$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/7798505$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>White, Harvey D</creatorcontrib><creatorcontrib>French, John K</creatorcontrib><creatorcontrib>Hamer, Andrew W</creatorcontrib><creatorcontrib>Brown, Michael A</creatorcontrib><creatorcontrib>Williams, Barbara F</creatorcontrib><creatorcontrib>Ormiston, John A</creatorcontrib><creatorcontrib>Cross, David B</creatorcontrib><title>Frequent reocclusion of patent infarct-related arteries between 4 weeks and 1 year: Effects of antiplatelet therapy</title><title>Journal of the American College of Cardiology</title><addtitle>J Am Coll Cardiol</addtitle><description>Objectives. This study assessed the effect of the combination of aspirin and dipyridamole on patency of the infarct-related artery between 4 weeks and 1 year after myocardial infarction. Background. Patency of the infarct-related artery is an important determinant of prognosis after myocardial infarction. The incidence of late reocclusion and the effects of antiplatelet therapy are unknown. Methods. To investigate the importance of antiplatelet therapy for the prevention of late reocclusion, 215 patients who had a patent infarct-related artery 4 weeks after myocardial infarction were randomized in a double-blind manner to receive either a combination of 25 mg of aspirin and 200 mg of dipyridamole twice daily or placebo. One hundred fifty-four patients underwent further coronary arteriography 1 year later. Results. At 1 year, 38 (25%) of 154 patients had reocclusion of the infarct-related artery; 18 (23%) of 79 patients receiving aspirin and dipyridamole had late reocclusion versus 20 (27%) of 75 who received placebo (p = NS). The rate of reocclusion was related to the severity of the residual coronary artery stenosis at 4 weeks (&lt;50% stenosis 9.2%; 50% to 69% stenosis 11.6%; 70% to 89% stenosis 30.4%; ≥ 90% stenosis 70%, p &lt; 0.01). The majority of reocclusions were silent, and only 17 (45%) of 38 were clinically associated with further infarction. There were no differences for a hierarchic end point of cardiac death, myocardial infarction or revascularization (14.8% aspirin and dipyridamole vs. 17.8% placebo). Conclusions. Late reocclusion of the patent infarct-related artery is a frequent event, occurring in 25% of patients. Antiplatelet therapy with the combination of aspirin and dipyridamole does not alter the overall rate of late reocclusion. Other strategies are required to reduce late reocclusion.</description><subject>Aspirin - administration &amp; dosage</subject><subject>Biological and medical sciences</subject><subject>Blood. Blood coagulation. Reticuloendothelial system</subject><subject>Coronary Angiography</subject><subject>Coronary Disease - complications</subject><subject>Coronary Disease - epidemiology</subject><subject>Coronary Disease - prevention &amp; control</subject><subject>Coronary Vessels - drug effects</subject><subject>Dipyridamole - administration &amp; dosage</subject><subject>Double-Blind Method</subject><subject>Drug Therapy, Combination</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Myocardial Infarction - drug therapy</subject><subject>Myocardial Infarction - etiology</subject><subject>Myocardial Infarction - mortality</subject><subject>Pharmacology. Drug treatments</subject><subject>Platelet Aggregation Inhibitors - therapeutic use</subject><subject>Prognosis</subject><subject>Recurrence</subject><subject>Risk Factors</subject><subject>Thrombolytic Therapy</subject><subject>Time Factors</subject><subject>Vascular Patency - drug effects</subject><issn>0735-1097</issn><issn>1558-3597</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1995</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMFuEzEQhi0EakPhDajkA6rgsNQT21m7h0qoaoGqUi9wthx7LEw33q3tgPL2eEmUI6eRZr5_NPMR8g7YJ2CwumQ9lx0w3X_Q4iNjnEN3_4IsQErVcan7l2RxRE7J61J-McZWCvQJOel7rSSTC1LuMj5vMVWacXRu2JY4JjoGOtk6d2MKNrvaZRxaw1ObK-aIha6x_kFMVNBWngq1yVOgO7T5it6GgK6WeY1NNU5zdMBK60_Mdtq9Ia-CHQq-PdQz8uPu9vvN1-7h8cu3m88PnRNLVjvRDhQcoNcCtFg6DGvnAwQlxVJY5YP14IKUErVGDnoNkgW1AmtR-KUT_Ixc7PdOeWw_lmo2sTgcBptw3BbT90ytlNANFHvQ5bGUjMFMOW5s3hlgZnZtZpFmFmm0MP9cm_sWOz_s36436I-hg9w2f3-Y2-LsELJNLpYjxrmSmkHDrvcYNhe_I2ZTXMTk0MfcNBo_xv_f8RcuGpu7</recordid><startdate>199501</startdate><enddate>199501</enddate><creator>White, Harvey D</creator><creator>French, John K</creator><creator>Hamer, Andrew W</creator><creator>Brown, Michael A</creator><creator>Williams, Barbara F</creator><creator>Ormiston, John A</creator><creator>Cross, David B</creator><general>Elsevier Inc</general><general>Elsevier Science</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>199501</creationdate><title>Frequent reocclusion of patent infarct-related arteries between 4 weeks and 1 year: Effects of antiplatelet therapy</title><author>White, Harvey D ; French, John K ; Hamer, Andrew W ; Brown, Michael A ; Williams, Barbara F ; Ormiston, John A ; Cross, David B</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c420t-450543117941942cefbcdf1f85424a8dfad1cf555e99e319b150f861aae4d2c43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1995</creationdate><topic>Aspirin - administration &amp; dosage</topic><topic>Biological and medical sciences</topic><topic>Blood. Blood coagulation. Reticuloendothelial system</topic><topic>Coronary Angiography</topic><topic>Coronary Disease - complications</topic><topic>Coronary Disease - epidemiology</topic><topic>Coronary Disease - prevention &amp; control</topic><topic>Coronary Vessels - drug effects</topic><topic>Dipyridamole - administration &amp; dosage</topic><topic>Double-Blind Method</topic><topic>Drug Therapy, Combination</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Myocardial Infarction - drug therapy</topic><topic>Myocardial Infarction - etiology</topic><topic>Myocardial Infarction - mortality</topic><topic>Pharmacology. Drug treatments</topic><topic>Platelet Aggregation Inhibitors - therapeutic use</topic><topic>Prognosis</topic><topic>Recurrence</topic><topic>Risk Factors</topic><topic>Thrombolytic Therapy</topic><topic>Time Factors</topic><topic>Vascular Patency - drug effects</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>White, Harvey D</creatorcontrib><creatorcontrib>French, John K</creatorcontrib><creatorcontrib>Hamer, Andrew W</creatorcontrib><creatorcontrib>Brown, Michael A</creatorcontrib><creatorcontrib>Williams, Barbara F</creatorcontrib><creatorcontrib>Ormiston, John A</creatorcontrib><creatorcontrib>Cross, David B</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American College of Cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>White, Harvey D</au><au>French, John K</au><au>Hamer, Andrew W</au><au>Brown, Michael A</au><au>Williams, Barbara F</au><au>Ormiston, John A</au><au>Cross, David B</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Frequent reocclusion of patent infarct-related arteries between 4 weeks and 1 year: Effects of antiplatelet therapy</atitle><jtitle>Journal of the American College of Cardiology</jtitle><addtitle>J Am Coll Cardiol</addtitle><date>1995-01</date><risdate>1995</risdate><volume>25</volume><issue>1</issue><spage>218</spage><epage>223</epage><pages>218-223</pages><issn>0735-1097</issn><eissn>1558-3597</eissn><coden>JACCDI</coden><abstract>Objectives. This study assessed the effect of the combination of aspirin and dipyridamole on patency of the infarct-related artery between 4 weeks and 1 year after myocardial infarction. Background. Patency of the infarct-related artery is an important determinant of prognosis after myocardial infarction. The incidence of late reocclusion and the effects of antiplatelet therapy are unknown. Methods. To investigate the importance of antiplatelet therapy for the prevention of late reocclusion, 215 patients who had a patent infarct-related artery 4 weeks after myocardial infarction were randomized in a double-blind manner to receive either a combination of 25 mg of aspirin and 200 mg of dipyridamole twice daily or placebo. One hundred fifty-four patients underwent further coronary arteriography 1 year later. Results. At 1 year, 38 (25%) of 154 patients had reocclusion of the infarct-related artery; 18 (23%) of 79 patients receiving aspirin and dipyridamole had late reocclusion versus 20 (27%) of 75 who received placebo (p = NS). The rate of reocclusion was related to the severity of the residual coronary artery stenosis at 4 weeks (&lt;50% stenosis 9.2%; 50% to 69% stenosis 11.6%; 70% to 89% stenosis 30.4%; ≥ 90% stenosis 70%, p &lt; 0.01). The majority of reocclusions were silent, and only 17 (45%) of 38 were clinically associated with further infarction. There were no differences for a hierarchic end point of cardiac death, myocardial infarction or revascularization (14.8% aspirin and dipyridamole vs. 17.8% placebo). Conclusions. Late reocclusion of the patent infarct-related artery is a frequent event, occurring in 25% of patients. Antiplatelet therapy with the combination of aspirin and dipyridamole does not alter the overall rate of late reocclusion. Other strategies are required to reduce late reocclusion.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>7798505</pmid><doi>10.1016/0735-1097(94)00331-J</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record>
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subjects Aspirin - administration & dosage
Biological and medical sciences
Blood. Blood coagulation. Reticuloendothelial system
Coronary Angiography
Coronary Disease - complications
Coronary Disease - epidemiology
Coronary Disease - prevention & control
Coronary Vessels - drug effects
Dipyridamole - administration & dosage
Double-Blind Method
Drug Therapy, Combination
Female
Follow-Up Studies
Humans
Male
Medical sciences
Middle Aged
Myocardial Infarction - drug therapy
Myocardial Infarction - etiology
Myocardial Infarction - mortality
Pharmacology. Drug treatments
Platelet Aggregation Inhibitors - therapeutic use
Prognosis
Recurrence
Risk Factors
Thrombolytic Therapy
Time Factors
Vascular Patency - drug effects
title Frequent reocclusion of patent infarct-related arteries between 4 weeks and 1 year: Effects of antiplatelet therapy
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