What is the dual platelet therapy standard of care in STEMI?

The standard of care for dual antiplatelet therapy in ST-Elevation Myocardial Infarction (STEMI) involves the use of aspirin and clopidogrel. This combination effectively inhibits platelet aggregation, reducing the risk of thrombus formation in the coronary arteries following an acute myocardial infarction.

Aspirin works by irreversibly inhibiting cyclooxygenase-1 (COX-1), leading to decreased production of thromboxane A2, which is a potent promoter of platelet aggregation. Clopidogrel, on the other hand, is a P2Y12 receptor antagonist. It blocks the adenosine diphosphate (ADP) receptor on platelets, further inhibiting their activation and aggregation. Together, these medications provide a synergistic effect, significantly enhancing the anticoagulant properties necessary for patients during and after a STEMI event.

The other medications listed fall within other therapeutic categories and do not combine the necessary platelet inhibition required for immediate management of STEMI. Heparin and enoxaparin are anticoagulants that may be used for additional anticoagulation but do not serve as primary agents in dual antiplatelet therapy. Warfarin and dabigatran are also