Abstract: Objective: Acute coronary syndrome is a clinical
condition encompassing ST segments elevation myocardial
infraction, Non ST segment is elevation myocardial infraction and un
stable angina is characterized by ruptured coronary plaque, stress and
myocardial injury. Angina pectoris is a pressure like pain in the chest
that is induced by exertion or stress and relived with in the minute
after cessation of effort or using sublingual nitroglycerin. The present
research was undertaken to study the drug utilization pattern of
antiplatelet drugs for the ischemic heart disease in a tertiary care
hospital. Method: The present study is retrospective drug utilization
study and study period is 6months. The data is collected from the
discharge case sheet of general medicine department from medical
department Rajiv Gandhi institute of medical sciences, Kadapa. The
tentative sample size fixed was 250 patients. Out of 250 cases 19
cases was excluded because of unrelated data. Results: A total of 250
prescriptions were collected for the study according to the inclusion
criteria 233 prescriptions were diagnosed with ischemic heart disease
17 prescriptions were excluded due to unrelated information. out of
233 prescriptions 128 are male (54.9%) and 105 patients are were
female (45%). According to the gender distribution, the prevalence of
ischemic heart disease in males are 90 (70.31%) and females are 39
(37.1%). In the same way the prevalence of ischemic heart disease
along with cerebrovascular disease in males are 39 (29.6%) and
females are 66 (62.6%). Conclusion: We found that 94.8% of drug
utilization of antiplatelet drugs was achieved in the Rajiv Gandhi
institute of medical sciences, Kadapa from 2011-2012.
Abstract: The concept of myocardial injury, although first recognized from animal studies, is now recognized as a clinical phenomenon that may result in microvascular damage, no-reflow phenomenon, myocardial stunning, myocardial hibernation and ischemic preconditioning. The final consequence of this event is left ventricular (LV) systolic dysfunction leading to increased morbidity and mortality. The typical clinical case of reperfusion injury occurs in acute myocardial infarction (MI) with ST segment elevation in which an occlusion of a major epicardial coronary artery is followed by recanalization of the artery. This may occur spontaneously or by means of thrombolysis and/or by primary percutaneous coronary intervention (PCI) with efficient platelet inhibition by aspirin (acetylsalicylic acid), clopidogrel and glycoprotein IIb/IIIa inhibitors. In recent years, percutaneous coronary intervention (PCI) has become a well-established technique for the treatment of coronary artery disease. PCI improves symptoms in patients with coronary artery disease and it has been increasing safety of procedures. However, peri- and post-procedural myocardial injury, including angiographical slow coronary flow, microvascular embolization, and elevated levels of cardiac enzyme, such as creatine kinase and troponin-T and -I, has also been reported even in elective cases. Furthermore, myocardial reperfusion injury at the beginning of myocardial reperfusion, which causes tissue damage and cardiac dysfunction, may occur in cases of acute coronary syndrome. Because patients with myocardial injury is related to larger myocardial infarction and have a worse long-term prognosis than those without myocardial injury, it is important to prevent myocardial injury during and/or after PCI in patients with coronary artery disease. To date, many studies have demonstrated that adjunctive pharmacological treatment suppresses myocardial injury and increases coronary blood flow during PCI procedures. In this review, we highlight the usefulness of pharmacological treatment in combination with PCI in attenuating myocardial injury in patients with coronary artery disease.