Evaluation of Dual Antiplatelet Therapy in Patients with Myocardial Infarction: Safety and Efficacy Analysis

Abstract

Myocardial infarction (MI) is a major cardiovascular emergency associated with myocardial ischemia and necrosis resulting from reduced coronary blood flow. Dual antiplatelet therapy (DAPT), consisting of aspirin combined with a P2Y12 inhibitor, is routinely used to prevent recurrent ischemic events, although bleeding remains an important safety concern. This prospective observational study evaluated the prescribing patterns, efficacy, safety, medication adherence, and adverse drug reactions associated with DAPT among patients with MI. The study was conducted over six months in the Department of Cardiology of a tertiary care teaching hospital and included 100 patients receiving DAPT. Demographic, clinical, treatment, adherence, and adverse drug reaction data were collected using a structured case record form. Medication adherence was assessed using the Morisky Medication Adherence Scale, while adverse drug reactions were evaluated using the WHO–UMC causality assessment scale. The mean patient age was 62.68 ± 10.15 years, 65% were aged above 60 years, and 75% were male. Aspirin plus clopidogrel was the most frequently prescribed regimen (43%), followed by aspirin plus prasugrel (31%) and aspirin plus ticagrelor (26%). Moderate adherence predominated, while adverse drug reactions occurred in 70% of patients, mainly bleeding-related events. Individualized DAPT selection based on thrombotic and bleeding risks may improve safety, adherence, and secondary prevention outcomes following MI.