The use of clopidogrel in the treatment of acute myocardial infarction with ST elevation
Article Sidebar
Main Article Content
Abstract
Objective: To evaluate the effectiveness of clopidogrel compared to other antiplatelet agents, demonstrating its use in different populations and its association with mortality. Methods: Searches were carried out in the PubMed and Virtual Health Library (VHL) databases and included studies published between 2018-2023, controlled clinical trials, observational studies, full and free texts and excluded off-topic and duplicate articles. Results: 25 articles were included for the narrative synthesis, where through analysis of the studies, it was observed that clopidogrel, despite not being the most recommended antiplatelet currently, is the most used due to the financial costs and its reliability in use, and that factors such as age over 75 years, drug interactions and chronic drug use present favorable outcomes. Final considerations: It can be considered that the use of clopidogrel in acute myocardial infarction with ST elevation presents a certain disadvantage when compared to other antiplatelet agents, however, its use is described reliably and considered a good inhibitor of the P2Y12 receptor. The present studies were not able to reliably prove its superiority or inferiority compared to other medicines, since the population, culture and countries were different.
Article Details
Copyright © | All rights reserved.
The journal holds the exclusive copyright for the publication of this article under the terms of Brazilian law 9610/98.
Partial reproduction
The use of parts of the texts, figures and questionnaire of the article is free, being mandatory the citation of the authors and journal.
Total reproduction
It is expressly prohibited and must be authorized by the journal.
References
2. ABTAN J, et al. Periprocedural outcomes according to timing of clopidogrel loading dose in patients who did not receive P2Y12 inhibitor pretreatment. Circ Cardiovasc Interv. 2019; 12(3): e007811.
3. AKITA K, et al. Impact of reduced-dose prasugrel vs. standard-dose clopidogrel on in-hospital outcomes of percutaneous coronary intervention in 62,737 patients with acute coronary syndromes: a nationwide registry study in Japan. Eur Heart J Cardiovasc Pharmacother., 2019.
4. ALMENDRO-DELIA M, et al. Comparative safety and effectiveness of ticagrelor versus clopidogrel in patients with acute coronary syndrome: an on-treatment analysis from a multicenter registry. Front Cardiovasc Med., 2022; 9.
5. BERWANGER O, et al. Use of ticagrelor alongside fibrinolytic therapy in patients with ST-segment elevation myocardial infarction: practical perspectives based on data from the TREAT study. Clin Cardiol., 2018; 41(10): 1322-1327.
6. CALDEIRA D, et al. Adjuvant antithrombotic therapy in ST-elevation myocardial infarction: contemporaneous Portuguese cross-sectional data. Rev Port Cardiol., 2019; 38(11): 809-814.
7. DE LUCA L, et al. Comparison of P2Y12 receptor inhibitors in patients with ST-elevation myocardial infarction in clinical practice: a propensity score analysis of five contemporary European registries. Eur Heart J Cardiovasc Pharmacother., 2021; 7(2): 94-103.
8. ESTEVE-PASTOR MA, et al. Temporal trends in the use of antiplatelet therapy in patients with acute coronary syndromes. J Cardiovasc Pharmacol Ther., 2018; 23(1): 57-65.
9. FARIDI K, et al. Physician and hospital utilization of P2Y12 inhibitors in ST-segment–elevation myocardial infarction in the United States. Circ Cardiovasc Qual Outcomes, 2020; 13(3).
10. GAGER GM, et al. Ticagrelor and prasugrel are independent predictors of improved long‐term survival in ACS patients. Eur J Clin Investig., 2020; 50(11).
11. Hautamäki M, et al. Prehospital adenosine diphosphate receptor blocker use, culprit artery flow, and mortality in STEMI: the MADDEC study. Clin Drug Investig., 2021.
12. HULOT JS, et al. Routine CYP2C19 genotyping to adjust thienopyridine treatment after primary PCI for STEMI. JACC Cardiovasc Interv., 2020; 13(5): 621-630.
13. LAGHLAM D, et al. Évolution démographique, caractéristiques et suivi clinique intrahospitalier des sujets âgés traités par angioplastie primaire pour syndrome coronarien aigu avec sus-décalage du segment ST. Ann Cardiol Angeiol., 2019; 68(1): 6-12.
14. LI XY, et al. Switching from ticagrelor to clopidogrel in patients with ST‐segment elevation myocardial infarction undergoing successful percutaneous coronary intervention in real‐world China: occurrences, reasons, and long‐term clinical outcomes. Clin Cardiol., 2018; 41(11): 1446-1454.
15. LIN TT, et al. Single and dual antiplatelet therapy in elderly patients of medically managed myocardial infarction. BMC Geriatr., 2018; 18.
16. PARK DW, et al. Clinically significant bleeding with ticagrelor versus clopidogrel in Korean patients with acute coronary syndromes intended for invasive management. Circulation, 2019; 140(23): 1865-1877.
17. PEREIRA NETO AH, POLANCZYK C. Tempos de atendimento e desfechos no infarto agudo do miocárdio com supradesnivelamento ST. Rev Soc Bras Clin Med., 2021;20-28.
18. PRAMI T, et al. Concomitant use of drugs known to cause interactions with oral antiplatelets—polypharmacy in acute coronary syndrome outpatients in Finland. Eur J Clin Pharmacol., 2019; 76(2): 257-265.
19. PUFULETE M, et al. Real-world bleeding in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI) and prescribed different combinations of dual antiplatelet therapy (DAPT) in England: a population-based cohort study emulating a “target trial”. Open Heart, 2022; 9(2): e001999.
20. REGEV E, et al. Acute myocardial infarction occurring while on chronic clopidogrel therapy (“clopidogrel failure”) is associated with high incidence of clopidogrel poor responsiveness and stent thrombosis. PLoS One, 2018; 13(4): e0195504.
21. SAWHNEY JPS, et al. Short- and long-term follow-up of antithrombotic management patterns in patients hospitalized with acute coronary syndrome: Indian subgroup of EPICOR Asia study. Indian Heart J., 2015; 71(1): 25-31.
22. SCANAVINI-FILHO MA, et al. Effects of ticagrelor and clopidogrel on coronary microcirculation in patients with acute myocardial infarction. Adv Ther., 2022; 39(4): 1832-1843.
23. SINNAEVE P, et al. Subcutaneous selatogrel inhibits platelet aggregation in patients with acute myocardial infarction. J Am Coll Cardiol., 2020; 75(20): 2588-2597.
24. SUKMAWAN R, et al. Increase in the risk of clopidogrel resistance and consequent TIMI flow impairment by DNA hypomethylation of CYP2C19 gene in STEMI patients undergoing primary percutaneous coronary intervention (PPCI). Pharmacol Res Perspect., 2021; 9(2).
25. VÖLZ S, et al. Ticagrelor is not superior to clopidogrel in patients with acute coronary syndromes undergoing PCI: a report from Swedish Coronary Angiography and Angioplasty Registry. J Am Heart Assoc., 2020; 9(14).
26. YAN XQ, et al. Platelet-fibrin clot strength measured by thromboelastography could predict hypercoagulability and antiplatelet effects in patients after percutaneous coronary intervention. Ann Palliat Med., 2021; 10(3): 2448457-2442457.