Yonsei Med J.  2017 Sep;58(5):959-967. 10.3349/ymj.2017.58.5.959.

Sarpogrelate Based Triple Antiplatelet Therapy Improved Left Ventricular Systolic Function in Acute Myocardial Infarction: Retrospective Study

• Choi JH
• Cho JR
• Park SM
• Shaha KB
• Pierres F
• Sumiya T
• Chun KJ
• Kang MK
• Choi S
• Lee N

• KMID: 2418931
• DOI: http://doi.org/10.3349/ymj.2017.58.5.959

Abstract

PURPOSE
The purpose of this study was to assess the potential benefit of a 5-hydroxytryptamine receptor antagonist, sarpogrelate-based triple antiplatelet therapy (TAPT) in comparison with dual antiplatelet therapy (DAPT) in patients undergoing primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI).
MATERIALS AND METHODS
119 patients of STEMI were retrospectively assessed. All patients received aspirin and clopidogrel per standard of care. Among them, 53 patients received an additional loading dose of sarpogrelate and a maintenance dose for 6 months post-PCI (TAPT group), while others did not (DAPT group).
RESULTS
The rates of complete ST-segment resolution at 30 minutes post-PCI and post-procedural thrombolysis in myocardial infarction flow were not significantly different between the two groups (52.8% vs. 48.5%, p=0.200; 92.5% vs. 89.4%, p=0.080). In addition, no significant differences were observed between the two groups with regard to 30-day and 12-month clinical outcomes (cardiac death, myocardial infarction, stent thrombosis, target vessel revascularization, and severe bleeding). Meanwhile, improvement in left ventricular (LV) systolic function was observed in the TAPT group [ΔLV ejection fraction (LVEF)=17.1±9.4%, p<0.001; Δglobal longitudinal strain (GLS)=−9.4±4.2% , p<0.001] at 6 months, whereas it was not in the DAPT group (ΔLVEF= 8.8±6.5%, p=0.090; ΔGLS=−4.6±3.4%, p=0.106). In multivariate analyses, TAPT was an independent predictor for LV functional recovery (odds ratio, 2.61; 95% confidence interval, 1.16-5.87; p=0.003).
CONCLUSION
Sarpogrelate-based TAPT improved LV systolic function at 6 months in STEMI patients undergoing primary PCI.

Keyword

Antiplatelet therapy; left ventricular function; acute myocardial infarction

MeSH Terms

Biomarkers/metabolism
Endpoint Determination
Female
Humans
Male
Middle Aged
Myocardial Infarction/complications/*drug therapy/*physiopathology
Platelet Aggregation Inhibitors/pharmacology/*therapeutic use
Retrospective Studies
ST Elevation Myocardial Infarction/complications/drug therapy/physiopathology
Succinates/pharmacology/*therapeutic use
Systole/drug effects
Thrombolytic Therapy
Treatment Outcome
Ventricular Function, Left/*drug effects
Biomarkers
Platelet Aggregation Inhibitors
Succinates

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