Heart Attack Treatment (cont.)
Thienopyridines
Thienopyridines such as ticlopidine (Ticlid) and clopidogrel (Plavix)
inhibit the ADP receptor on the surface of platelets. Inhibiting the ADP
receptors on the platelets prevent the platelets from aggregating and causing
blood clots to form. The theinopyridines are more potent anti-platelet agents
than aspirin. Clopidogrel (Plavix) is used far more commonly than ticlopidine
(Ticlid) because ticlopidine can, in rare instances, cause low platelet and/or
white blood cell counts. Clopidogrel plays an important role in the treatment of
heart attacks and is used in the following situations:
- Clopidogrel is used instead of aspirin in patients who
have an allergy to aspirin.
- Clopidogrel often is given together with aspirin in
treating heart attacks. Studies have shown that the combination of aspirin and
clopidogrel is more effective than aspirin alone in improving survival and
limiting damage to heart muscle among patients with heart attacks.
- Clopidogrel is given together with aspirin to patients
undergoing PTCA with or without coronary stenting (see later discussion).
Studies have shown that the combination of aspirin and clopidogrel is more
effective than aspirin alone in preventing formation of blood clots that can
re-occlude the coronary artery unblocked by PTCA and in preventing blood clots
within recently placed stents.
- After a heart attack or after PTCA, aspirin is given indefinitely. The
optimal duration of clopidogrel has not been established, and duration of use by
physicians varies from weeks to months.
Patients who receive the combination of clopidogrel and aspirin are more
likely than patients who receive aspirin alone to develop complications of major
bleeding following coronary artery bypass surgery. Therefore, ideally
clopidogrel should be stopped three to seven days before surgery.
Next: Glycoprotein IIb/IIIa inhibitors »
- ACE Inhibitors - Read about ACE inhibitors like Altace, lisinopril, enalapril, ramparil, Zestril and more. Information includes side effects, drug interactions, and pregnancy safety information.
- Coronary Artery Bypass Graft - Read about heart bypass surgery (coronary artery bypass graft surgery, CABG) including how coronary artery disease is diagnosed, treated, recovery time, risks and complications, and the long term results after CABG.
- Congestive Heart Failure - Read about congestive heart failure symptoms like fatigue, abdomen, leg and ankle swelling, shortness of breath, sleeplessness, increased urination, nausea, abdominal pain, and decreased appetite.
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