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Combined antiplatelet therapy with ticlopidine and aspirin. A simplified approach to intracoronary stent management.
- Source :
-
European heart journal [Eur Heart J] 1996 Sep; Vol. 17 (9), pp. 1373-80. - Publication Year :
- 1996
-
Abstract
- Intravascular metallic stents are increasingly used in the non-surgical management of coronary atherosclerosis. Despite intensive anticoagulation, subacute stent thrombosis, which usually has serious clinical consequences, and major haemorrhagic complications remain major problems after stent implantation. In addition, conventional management with anticoagulant therapy requires prolonged hospitalization. In a prospective multicentre study, we investigated the efficacy of a combination of two antiplatelet agents, ticlopidine 500 mg daily and aspirin 200 mg daily, without oral anticoagulation after stent implantation. Since November 1993, 529 consecutive patients, in whom 545 vessels were successfully stented with conventional (non-heparin coated) stents have been enrolled. Stenting was performed as a bailout procedure for failed angioplasty in 112 patients, for a suboptimal result after angioplasty in 314 patients, and electively in the remaining 103 patients. Coronary events related, or possibly related, to stent thrombosis occurred in 5.4% of patients stented as a bailout procedure and in 1.8% of patients stented for a suboptimal result. Serious bleeding complications occurred in 5.4% of patients stented as a bailout procedure and 1.5% of patients stented for a suboptimal result. Neither stent thrombosis nor serious bleeding complications were seen in patients stented electively. Ticlopidine therapy was discontinued in 1.9% of patients due to neutropenia (0.6%) or rash (1.3%). Mean hospital stay decreased from 6.16 +/- 2.14 days to 4.2 +/- 2.15 days during the study period. A combination of two antiplatelet agents can be employed in the vast majority of patients after coronary stent implantation. Subacute stent thrombosis rates and bleeding complications compare favourably with those reported using conventional therapy and the duration of hospitalization is reduced.
- Subjects :
- Adult
Aged
Angioplasty, Balloon, Coronary methods
Aspirin administration & dosage
Chi-Square Distribution
Coronary Artery Disease drug therapy
Coronary Artery Disease therapy
Coronary Thrombosis etiology
Drug Therapy, Combination
Female
Humans
Incidence
Male
Middle Aged
Platelet Aggregation Inhibitors administration & dosage
Prospective Studies
Ticlopidine administration & dosage
Treatment Outcome
Angioplasty, Balloon, Coronary instrumentation
Aspirin therapeutic use
Coronary Thrombosis epidemiology
Platelet Aggregation Inhibitors therapeutic use
Stents adverse effects
Ticlopidine therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 0195-668X
- Volume :
- 17
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- European heart journal
- Publication Type :
- Academic Journal
- Accession number :
- 8880023
- Full Text :
- https://doi.org/10.1093/oxfordjournals.eurheartj.a015072