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.
Aspirin ; Humans ; Multivariate Analysis ; Myocardial Infarction* ; Percutaneous Coronary Intervention ; Retrospective Studies* ; Serotonin ; Standard of Care ; Stents ; Thrombosis ; Ventricular Function, Left

Introduction: Endothelial progenitor cells (EPC) have a role in the maintenance and promotion of vascular repair and are negatively correlated with coronary atherosclerosis. Goal: To culture of EPC-CFUs during coronary atherosclerosis, evaluate endothelial nitric oxide synthetase (eNOS) enzyme levels in the culture. Materials and Methods: The 10 ml blood was drawn from the peripheral vein of 12 man patients that stable angina 4, acute myocardial infarction (AMI) 4 and healthy people 4. Peripheral blood mononuclear cells were isolated by Ficoll density-gradient centrifugation and EPC-CFUs was assayed after two platings and a 6 day culture on fibronectin coated, 72 well plates, as described. eNOS enzyme titers were determined by ELISA according to the protocol in the cells culture. Results: The people were 52±2.12 years. The number of EPC-CFUs increases with accordance of patients with stable angina, AMI, healthy people with the statistical significance (F=17.3, p<0.001): stable angina (2.6±0.47 colony/well), AMI (6.7±0.81 colony/well), healthy people (10.5±1.34 colony/well). Furthermore, ANOVA test of eNOS enzyme levels in patients with stable angina (5.2±0.61 pg/ml), AMI (8.7±1.49 pg/ml) and healthy people (13.7±2.48 pg/ml). The significant difference (F=6.2, p=0.003) was observed among the three groups. The number of EPC-CFUs had direct significantly correlation (r=0.621, p<0.001) with the eNOS enzyme levels of this culture. Conclusion: Number of EPC-CFUs and eNOS enzyme levels decrease at patient with stable angina, indicate more than endothelial dysfunction. Ethical approval The ethics committee of Mongolian National University of Medical Sciences (ID: 6/3/201506, approved on Jan 01, 2015)