Τίτλος:
Antiplatelet is superior to anticoagulant treatment after coronary stenting: Fewer coronary and other events within 30 days after stenting
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Stent prosthesis is a high efficacious method with low complication rates. However, the ideal adjunctive therapy following stent implantation remains controversial. The authors compared the effectiveness and complication rates of aspirin-ticlopidine antiplatelet therapy vs anticoagulant therapy with acenocoumarol within 30 days following stent prosthesis. They prospectively studied 404 patients following stent prosthesis while randomly receiving anticoagulant (Group A: 201 patients) vs antiplatelet treatment (Group B: 203 patients). Groups A and B were similar in demographic data (age, gender) stent location, clinical presentation, indication of stenting, and type of implanted stent. Chi-square test, t test, and Wilcoxon test for two samples were used for statistical analysis of the results. Stent implantation was attempted in 434 cases. This was successful in 70/85 (82%) of the bailout, 122/135 (90%) of the suboptimal, and 212/214 (99%) of the elective cases. In 201 patients anticoagulant treatment with acenocoumarol was administered for 4 weeks (group A) while 203 received antiplatelet treatment with ticlopidine (group B). The need for reintervention was less and total cardiac events were fewer in group B than in group A: three (1.5%) and nine (4.4%) vs 18 (9%) and 29 (14.4%) p < 0.0008 and p < 0.006 respectively. Hemorrhagic complications and total noncardiac events were fewer in group B than in group A: six (3%) and six (3%) vs 18 (9%) and 19 (9.5%) p < 0.01 and p < 0.007 respectively. The length of hospital stay was shorter in group B than in A, p < 0.0001. In conclusion, in this study of intracoronary stenting the authors had a high success rate in 434 attempted cases. Antiplatelet therapy was accompanied by fewer cardiac and noncardiac 1 month events when compared with anticoagulant therapy, supporting its role as the adjunctive treatment of choice post-stenting for the time being.
Συγγραφείς:
Foussas, S.
Fakiolas, C.
Alexopoulos, D.
Pissimisis, E.
Stefanadis, C.
Stefanidis, A.
Olympios, C.
Zairis, M.
Voudris, V.
Pavlides, G.
Hatzimiltiadis, S.
Vitakis, S.
Sionis, D.
Louridas, G.
Vavouranakis, E.
Cokkinos, D.
Vrahatis, A.
Toutouzas, P.
Περιοδικό:
International Angiology
Εκδότης:
Westminster Publications Inc.
Λέξεις-κλειδιά:
acenocoumarol; acetylsalicylic acid; anticoagulant agent; antithrombocytic agent; heparin; ticlopidine, adjuvant therapy; adult; aged; anticoagulant therapy; article; bleeding; clinical trial; coronary stent; drug efficacy; female; heart infarction; hospitalization; human; implantation; length of stay; major clinical study; male; mortality; multicenter study
DOI:
10.1177/000331970005100403
