Notes:

Antiplatelet Trialists’ Collaboration:

• Nonfatal reinfarction: reduced by 31% for prior MI, 54% for acute MI
• Nonfatal stroke: reduced by 39%
• Death: reduced by 12% for prior MI, 23% for acute MI
• Major bleeds: not mentioned.  Other trials show about a 25% increase
• Although the granulocytopenia caused by ticlopidine is reversible if Dx’d, if not Dx’d, it can be fatal.
• If you do Rx ticlopidine, you’ll need to check a white counts q 2 wks x 3 months.
• The reason that Dipyridamole (Persantine)+ ASA is effective at preventing adverse events post-MI is the ASA: Dipyridamole provides no additional benefit.

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This presentation was authored by Dr. Brian Gage of the Washington University School of Medicine.