PMID- 18217148
OWN - NLM
STAT- MEDLINE
DCOM- 20080221
LR  - 20181201
IS  - 0340-6245 (Print)
IS  - 0340-6245 (Linking)
VI  - 99
IP  - 1
DP  - 2008 Jan
TI  - Clopidogrel in addition to aspirin reduces in-hospital major cardiac and 
      cerebrovascular events in unselected patients with acute ST segment elevation 
      myocardial.
PG  - 155-60
LID - 10.1160/TH07-09-0556 [doi]
AB  - We sought to assess the effect of clopidogrel on in-hospital events in unselected 
      patients with acute ST elevation myocardial infarction (STEMI). In a 
      retrospective analysis of consecutive patients enrolled in the Acute Coronary 
      Syndromes (ACOS) registry with acute STEMI we compared outcomes of either 
      adjunctive therapy with aspirin alone or aspirin plus clopidogrel within 24 hours 
      after admission.A total of 7,559 patients were included in this analysis, of whom 
      3,541 were treated with aspirin alone, and 4,018 with dual antiplatelet therapy. 
      The multivariable analysis with adjustment for baseline characteristics and 
      treatments showed that the rate of in-hospital MACCE (death, non-fatal 
      reinfarction, non-fatal stroke) was significantly lower in the aspirin plus 
      clopidogrel group,compared to the aspirin alone group in the entire cohort and 
      all three reperfusion strategy groups (entire group odds ratio 0.60, 95% CI 
      0.49-0.72 , no reperfusion OR 0.69,95% CI 0.51-0.94,fibrinolysis OR 0.62,95% CI 
      0.44-0.88, primary PCI OR 0.54, 95% CI 0.39-0.74). There was a significant 
      increase in major bleeding complications with clopidogrel (7.1% vs. 3.4%, 
      p<0.001). In clinical practice early adjunctive therapy with clopidogrel in 
      addition to aspirin in patients with STEMI is associated with a significant 
      reduction of in-hospital MACCE regardless of the initial reperfusion strategy. 
      This advantage was associated with an increase in major bleeding complications.
FAU - Zeymer, Uwe
AU  - Zeymer U
AD  - Herzzentrum Ludwigshafen, Medizinische Klinik B, Ludwigshafen, Germany. 
      Uwe.Zeymer@t-online.de
FAU - Gitt, Anselm
AU  - Gitt A
FAU - Junger, Claus
AU  - Junger C
FAU - Bauer, Timm
AU  - Bauer T
FAU - Heer, Tobias
AU  - Heer T
FAU - Koeth, Oliver
AU  - Koeth O
FAU - Mark, B
AU  - Mark B
FAU - Zahn, Ralf
AU  - Zahn R
FAU - Senges, Jochen
AU  - Senges J
FAU - Gottwik, M
AU  - Gottwik M
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - Germany
TA  - Thromb Haemost
JT  - Thrombosis and haemostasis
JID - 7608063
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - A74586SNO7 (Clopidogrel)
RN  - OM90ZUW7M1 (Ticlopidine)
RN  - R16CO5Y76E (Aspirin)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - *Angioplasty, Balloon, Coronary/adverse effects
MH  - Aspirin/adverse effects/*therapeutic use
MH  - Cerebrovascular Disorders/etiology/mortality/*prevention & control
MH  - Clopidogrel
MH  - Drug Therapy, Combination
MH  - Female
MH  - Heart Diseases/etiology/mortality/*prevention & control
MH  - Hemorrhage/chemically induced
MH  - Hospital Mortality
MH  - Hospitalization
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/complications/*drug therapy/mortality/therapy
MH  - Odds Ratio
MH  - Platelet Aggregation Inhibitors/adverse effects/*therapeutic use
MH  - Research Design
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Secondary Prevention
MH  - Stroke/prevention & control
MH  - *Thrombolytic Therapy/adverse effects
MH  - Ticlopidine/adverse effects/*analogs & derivatives/therapeutic use
MH  - Time Factors
MH  - Treatment Outcome
EDAT- 2008/01/25 09:00
MHDA- 2008/02/22 09:00
CRDT- 2008/01/25 09:00
PHST- 2008/01/25 09:00 [pubmed]
PHST- 2008/02/22 09:00 [medline]
PHST- 2008/01/25 09:00 [entrez]
AID - 08010155 [pii]
AID - 10.1160/TH07-09-0556 [doi]
PST - ppublish
SO  - Thromb Haemost. 2008 Jan;99(1):155-60. doi: 10.1160/TH07-09-0556.