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Netherlands Heart Journal
Published in: Netherlands Heart Journal 6/2018

Open Access 01-06-2018 | Review Article

Optimal pharmacological therapy in ST-elevation myocardial infarction—a review

A review of antithrombotic therapies in STEMI

Authors: R. S. Hermanides, S. Kilic, A. W. J. van ’t Hof

Published in: Netherlands Heart Journal | Issue 6/2018

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Abstract

Antithrombotic therapy is an essential component in the optimisation of clinical outcomes in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention. There are currently several intravenous anticoagulant drugs available for primary percutaneous coronary intervention. Dual antiplatelet therapy comprising aspirin and P2Y12 inhibitor represents the cornerstone treatment for STEMI. However, these effective treatment strategies may be associated with bleeding complications. Compared with clopidogrel, prasugrel and ticagrelor are more potent and predictable, which translates into better clinical outcomes. Therefore, these agents are the first-line treatment in primary percutaneous coronary intervention. However, patients can still experience adverse ischaemic events, which might be in part attributed to alternative pathways triggering thrombosis. In this review, we provide a critical and updated review of currently available antithrombotic therapies used in patients with STEMI undergoing primary PCI. Finding a balance that minimises both thrombotic and bleeding risk is difficult, but crucial. Further randomised trials for this optimal balance are needed.
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Metadata
Title
Optimal pharmacological therapy in ST-elevation myocardial infarction—a review
A review of antithrombotic therapies in STEMI
Authors
R. S. Hermanides
S. Kilic
A. W. J. van ’t Hof
Publication date
01-06-2018
Publisher
Bohn Stafleu van Loghum
Published in
Netherlands Heart Journal / Issue 6/2018
Print ISSN: 1568-5888
Electronic ISSN: 1876-6250
DOI
https://doi.org/10.1007/s12471-018-1112-6

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