[The Use of Clopidogrel in Conjunction With Thrombolytic Therapy in PatientsWith ST-Elevation Acute Myocardial Infarction.].

Clopidogrel (300 mg before initiation of thrombolysis and 75 mg/day thereafter) was given to 46 of 131 patients with streptokinase treated ST-elevation acute myocardial infarction. Mortality and efficacy of thrombolysis were similar in 2 groups, however deaths of acute heart failure were distributed unevenly (0 in clopidogrel group and 8 or 9.4% among other patients, p <0.03). Clopidogrel treated compared with other patients had significantly higher left ventricular ejection fraction on days 1-2 of disease (52.5+/-2.2 and 45.9+/-2.0%, respectively, p<0.03). Number of bleedings did not differ significantly between 2 groups. Thus patients addition of clopidogrel to aspirin and thrombolysis with streptokinase was associated with better myocardial contractile function and lower mortality due to acute heart failure.