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Antiplatelet Agents in the Treatment of ST-Segment Elevation Myocardial Infarction

Peter R Sinnaeve, MD, PhD, and Frans J Van de Werf, MD, PhD

ST-segment elevation myocardial infarction (STEMI) is caused by the occlusion of a major coronary artery. This event is generally triggered by rupture or erosion of a vulnerable plaque, with subsequent formation of an occlusive thrombus. Rapid and complete restoration of coronary blood flow is essential in preventing myocardial necrosis, as early reperfusion of the infarct-related artery limits infarct size and improves outcome. Prevention of reocclusion and reinfarction is equally important, regardless of whether reperfusion has been achieved by primary percutaneous coronary intervention (PCI) or fibrinolysis. Antithrombin and antiplatelet agents are therefore administered to patients with STEMI to improve and sustain epicardial and tissue reperfusion and to prevent new ischemic events. In this review, the role of antiplatelet agents in the management of patients with STEMI is discussed.

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