APRICOTAntithrombotics in the Prevention of Reocclusion InCoronary Thrombolysis | |
| Authors: | (a) Meijer A, Verheugt FWA, Werter CJPJ, Lie KI, van der Pol JMJ, van Eenige MJ
(b) Veen G, Meyer A, Verheugt FWA, Werter CJPJ, de Swart H, Lie KI, van der Pol JMJ, Michels HR, van Eenige MJ (c) Meijer A, Verheugt FWA, van Eenige MJ, Werter CJPJ |
|---|---|
| Titles: | (a) Aspirin versus Coumadin in the prevention of reocclusion and recurrent ischemia after successful thrombolysis: a prospective placebo-controlled angiographic study. Results of the APRICOT study
(b) Culprit lesion morphology and stenosis severity in the prediction of reocclusion after coronary thrombolysisiction of reocclusion after coronary thrombolysis: angiographic results of the APRICOT study (c) Left ventricular function at 3 months after successful thrombolysis. Impact of reocclusion without reinfarction on ejection fraction, regional function, and remodeling |
| References: | (a) Circulation 1993;87:1524-30
(b) J Am Coll Cardiol 1993;22:1755-62 (c) Circulation 1994;90:1706-14 |
| Disease: | AMI |
| Purpose: | To assess the effect of aspirin or warfarin on reocclusion and recurrent ischaemia after thrombolysis |
| Study Design: | Randomised, placebo-controlled |
| Follow-up: | 3 months |
| Patients: | 300 patients, aged < 71 years, with chest pain > 30 min < 4 h and ST-segment elevation indicative of MI. Patients were eligible when the infarct-related artery was patent with residual grade 1-3 stenosis, as determined by angiography |
| Treatmentregimen: | Continuation of iv heparin plus warfarin adjusted to international normalised ratio of 2.8-4.0 (open-label); aspirin, 325 mg/day, or placebo (double-blind) |
| Results: | Reocclusion rates at 3 months: aspirin 25%; warfarin 30%; placebo 32%. Compared to placebo, aspirin significantly reduced reinfarction and r%. Compared to placebo, aspirin significantly reduced reinfarction and revascularisation rates. The efficacy of warfarin seemed less than that of aspirin. Angiographic features of the lesion after successful thrombolysis significantly predicted the risk of reocclusion. In a subset analysis, persistent patency at 3 months after anterior infarction significantly improved ejection fraction. Reocclusion prevented recovery of infarct zone contractility |
 |
||||||
|
||||||
|
||||||
|
||||||