The prevention of atherothrombotic events (cardiovascular (CV) death, myocardial infarction (MI) or stroke) after an acute coronary syndrome in adult patients with elevated cardiac biomarkers and no prior stroke or transient ischaemic attack (TIA) when co-administered with acetylsalicylic acid (ASA) alone or with ASA plus clopidogrel or ticlopidine
Platelet inhibition during and after ACS to prevent recurrent ischemic events is a cornerstone of treatment for patients after myocardial infarction (MI).2 Current American Cardiology Association and European Society of Cardiology guidelines recommend patients with coronary artery disease who have had a recent MI continue DAPT with aspirin and a P2Y12 blocker (ie, clopidogrel, ticlopidine
, ticagrelor, prasugrel, or cangrelor) for 12 months following ACS to reduce recurrent ischemia.
The treatment cohort consisted of adults (aged ≥20 years) who had received at least one dose of any of the antiplatelet agent (aspirin, clopidogrel, or ticlopidine
) within 3 months before the time of hospitalization for IE.
and clopidogrel block platelet activation by ADP and are considered to be marginally more effective than aspirin.
* 16.6% with 100 mg aspirin (or ticlopidine
, an antiplatelet drug, for aspirin- intolerant subjects),
Postoperatively, 72 patients required antiplatelet therapy (41 aspirin, 24 clopidogrel, 1 ticlopidine
, 6 aspirin plus clopidogrel) and 17 patients started anticoagulants after surgery.
is available only in 250 mg dose.
The prevalence of taking ulcerogenic drugs (NSAID, aspirin, clopidogrel, ticlopidine
, and steroids) was 4.9% in patients with LC.
The patient's physician was consulted, and none of the medication being administered to the patient was suspended, including acetylsalicylic and ticlopidine
His medications included bisoprolol (2,5 mg/day), alfuzosin (10 mg/day), enalapril (20 mg/day), hydrochlorothiazide (12,5 mg/day), ticlopidine
(250 mg/day), and pantoprazole (20 mg/day).
All patients received oral aspirin (100 mg/day) plus clopidogrel (75 mg/day) or ticlopidine
(250 mg twice a day), starting at least three days prior to the procedure.
The COMPASS findings follow a 2012 published report from the ATLAS ACS 2-TIMI 51 trial showing that treatment with the same low-dose rivaroxaban regimen plus aspirin and a thienopyridine (clopidogrel or ticlopidine
) reduced the same combined triple endpoint by a statistically significant 16%, compared with aspirin and a thienopyridine alone, in patients with a recent acute coronary syndrome event (N Engl J Med.