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Comparison between ticlopidine and clopidogrel in patients with ST-segment elevation myocardial infarction treated

Giuseppe De Luca1, Harry Suryapranata, Arnoud W J van 't Hof

  • 1Department of Cardiology, ISALA Klinieken, Hospital De Weezenlanden, Zwolle, The Netherlands. g.deluca@diagram-zwolle.nl

Thrombosis and Haemostasis
|June 4, 2004
PubMed

Insights

For ST-segment elevation myocardial infarction (STEMI) patients receiving coronary stents, clopidogrel and ticlopidine showed similar long-term clinical outcomes. Both antiplatelet drugs are effective when added to aspirin after primary stenting.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Optimal antiplatelet therapy following coronary stent implantation remains debated.
  • Choosing between ticlopidine and clopidogrel as an adjunct to aspirin is a key clinical question.

Purpose of the Study:

  • To compare the efficacy and safety of clopidogrel versus ticlopidine in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary stenting.

Main Methods:

  • Prospective data collection from 883 consecutive STEMI patients treated with primary stenting between April 1997 and October 2001.
  • Comparison of 523 patients on clopidogrel with 360 patients on ticlopidine.
  • Analysis of clinical, angiographic, and follow-up data at 30 days and 1 year.

Main Results:

  • Patients receiving clopidogrel demonstrated a significantly higher rate of successful reperfusion (80.7% vs. 73.1%, p=0.008).
  • No significant differences in 30-day or 1-year clinical outcomes were observed between the clopidogrel and ticlopidine groups.
  • These findings persisted after adjusting for age, successful reperfusion, and statin therapy.

Conclusions:

  • Clopidogrel and ticlopidine exhibit comparable long-term clinical outcomes when used as adjunctive antiplatelet therapy in STEMI patients undergoing primary stenting.
  • The choice between these agents may not significantly impact long-term patient outcomes despite differences in initial reperfusion rates.

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