The timing of administering aspirin and nitroglycerin in patients with STEMI ECG changes alter patient outcome

Dublin Core

Title

The timing of administering aspirin and nitroglycerin in patients with STEMI ECG changes alter patient outcome

Subject

aspirin, nitroglycerin, patients , STEMI, ECG

Description

Background: Both chewed aspirin and sublingual nitroglycerin are fast acting medications and reach therapeutic
levels within a few minutes. Current guidelines for managing acute coronary syndrome (ACS) do not recognize the
importance of the order or timing of administering aspirin and nitroglycerin. This retrospective study aimed to
examine if there was any benefit to the timing of giving aspirin before or after nitroglycerin in cases of ACS.
Methods: From the large National Emergency Medical Services Information System (NEMSIS) 2017 Version
database, 2594 patients with acute coronary syndrome were identified (based on chest pain and their ECG finding)
that received aspirin plus nitroglycerin in prehospital settings. Based on which medication was given first, the
patients were separated in 2 groups: an aspirin-first and a nitroglycerin-first group. The 2246 patients who received
aspirin first were further stratified based on the time between administration of aspirin and the first dose of
nitroglycerin. The other 348 patients who received nitroglycerin first were similarly stratified.
Results: In patients with STEMI ischemia, giving nitroglycerin 10 min after aspirin dosing (compared to giving them
simultaneously) leads to a greater than 20% reduction in need for additional nitroglycerin, a greater than 7%
decrease in subjective pain experienced by the patient and reduced need for additional opioids. The aspirin-first
group in total, had a 39.6% decrease in subjective pain experience after giving additional nitroglycerin compared to
nitroglycerin-first group.
Conclusion: In patients with ACS, this study found that giving nitroglycerin 10 min after aspirin was associated with
a reduction in subjective pain scores, as well as a reduced need for additional nitroglycerin or opioids. Future
prospective trials examining the timing of aspirin vs. nitroglycerin are needed to confirm these findings.

Creator

Kristijan B. Todoroski

Publisher

BMC Emergency Medicine

Date

(2021) 21:137

Contributor

Fajar bagus W

Format

PDF

Language

English

Type

Text

Files

Tags

,Repository, Repository Horizon University Indonesia, Repository Universitas Horizon Indonesia, Horizon.ac.id, Horizon University Indonesia, Universitas Horizon Indonesia, HorizonU, Repo Horizon , ,Repository, Repository Horizon University Indonesia, Repository Universitas Horizon Indonesia, Horizon.ac.id, Horizon University Indonesia, Universitas Horizon Indonesia, HorizonU, Repo Horizon , ,Repository, Repository Horizon University Indonesia, Repository Universitas Horizon Indonesia, Horizon.ac.id, Horizon University Indonesia, Universitas Horizon Indonesia, HorizonU, Repo Horizon , ,Repository, Repository Horizon University Indonesia, Repository Universitas Horizon Indonesia, Horizon.ac.id, Horizon University Indonesia, Universitas Horizon Indonesia, HorizonU, Repo Horizon , ,Repository, Repository Horizon University Indonesia, Repository Universitas Horizon Indonesia, Horizon.ac.id, Horizon University Indonesia, Universitas Horizon Indonesia, HorizonU, Repo Horizon ,

Citation

Kristijan B. Todoroski, “The timing of administering aspirin and nitroglycerin in patients with STEMI ECG changes alter patient outcome,” Repository Horizon University Indonesia, accessed November 10, 2024, https://repository.horizon.ac.id/items/show/3922.