Dumitrescu S.I. 1,2, Cristian G. 1,2, Nicolaescu Tania 1, Preda Ana Maria 1, Voicu V. 3
1 Army’s Clinic Emergency Center for Cardiovascular Diseases “Vasile Candea”
2 Titu Maiorescu, University, Faculty of Medicine
3 Romanian Academy
Abstract
Antiplatelet therapy in ST elevation myocardial infarction represents the cornerstone of adjuvant pharmacological measures in order to increase the patency of infarct related artery and to obtain myocardial reperfusion. Additionally, there is the most important available treatment for maintaining the results of primary percutaneous coronary interventions and preventing the stent thrombosis. The widespread research in the field resulted in the last few years in the development of new molecules that have solid clinical evidence. Aspirin remains the unchallenged partner of the new antiplatelet agents, being recommended in all patients with acute coronary syndrome with ST segment elevation, regardless of the therapeutic approach chosen. Clopidogrel was surpassed in the clinical trials by the new antiplatelet drugs (ticagrelor and prasugrel) but it should be noted that none of this more potent agents should be used in patients with previous stroke or in patients with moderate to severe liver. The optimal duration of dual antiplatelet treatment and reduction of bleeding risk remain challenging issues, where decision should be individualized.