From the Research
The BIFFL guidelines are not directly related to the provided evidence, which focuses on cardiovascular diseases and treatments, and therefore, the most recent and highest quality study on cardiovascular disease management should be prioritized to improve patient outcomes in terms of morbidity, mortality, and quality of life. The most recent study on cardiovascular disease management is from 2022, which explores the clinical efficacy of tirofiban combined with ticagrelor and aspirin in treating acute myocardial infarction by percutaneous coronary intervention 1.
- This study found that the combination of tirofiban, ticagrelor, and aspirin can effectively reduce the incidence of no reflow or slow blood flow, improve myocardial perfusion function, and have marked curative effects.
- The study also found that patients who received this combination therapy had lower rates of major adverse cardiovascular events (MACE) and adverse reactions compared to those who received conventional ticagrelor and aspirin dual treatment.
- Another study from 2020 found that removing the P2Y12 inhibitor after a short-duration DAPT appears to be safe in the low-risk population, while removing aspirin and continuing the P2Y12 inhibitor as monotherapy would be the preferred strategy in intermediate- to high-risk patients to mitigate the bleeding risk 2.
- A study from 2016 found that patients with sepsis who developed acute myocardial infarction had higher in-hospital mortality rates, and invasive management was associated with lower mortality rates compared to conservative management 3.
- A study from 2012 found that high-dose aspirin (>200 mg daily) was associated with higher rates of major bleeding and adverse cardiovascular events compared to low-dose aspirin (≤200 mg daily) in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention 4. In conclusion, the most effective treatment strategy for patients with acute myocardial infarction is to use a combination of tirofiban, ticagrelor, and aspirin, and to prioritize individualized treatment approaches based on patient risk factors and bleeding risks.