[Coronary artery stenting without antivitamin K. Results after a month]

Arch Mal Coeur Vaiss. 1996 Mar;89(3):291-7.
[Article in French]

Abstract

This paper reports experience with a new antithrombotic agent prescribed to reduce the incidence of subacute occlusions during the first month after coronary stenting. Therefore, a powerful association of platelet antiaggregant agents was tested. From December 1992 to October 1994, coronary stenting was successfully achieved in 1,294 patients (1,118 men, average age 60.5 +/- 10 years) who were then treated with the association of ticlopidine 0.25 g/day and aspirin 0.10 g/day for one month. This was covered with anticoagulation with a low molecular weight heparin for a variable period (one month, two weeks, then one week), according to the different phases of the study protocol. In all, 1487 stents were successfully implanted (1,330 Palmaz Schatz; 63 Cook; 80 Wictor; 13 AVE and 1 Strecker) in 1,326 vessels (520 left anterior descending, 208 left circumflex, 475 right coronary, 16 left main coronary arteries and 107 venous grafts) using balloon catheters of 2.5 mm to 5 mm diameter for average 3.45 +/- 0.4 mm). Major complications in the first month included 9 deaths (0.7%), 22 occlusions (1.7%): 14 myocardial infarcts (1%) and 11 aorto-coronary bypass procedures (0.85%). There were 136 local haematomas or false aneurysms (10.5%), 42 of which (3.25%) required blood transfusion or surgical repair. This multicenter trial of a protocol associating platelet antiaggregant agents and low molecular weight heparin for one month showed a low incidence of subocclusion after coronary stenting (1.7 +/= 2.5%) and should enable interventional cardiologists to widen the indications for coronary stenting.

Publication types

  • Clinical Trial
  • English Abstract
  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Angioplasty, Balloon, Coronary*
  • Anticoagulants / therapeutic use
  • Aspirin / therapeutic use
  • Coronary Disease / therapy*
  • Drug Therapy, Combination
  • Female
  • Follow-Up Studies
  • Heparin, Low-Molecular-Weight / therapeutic use*
  • Humans
  • Male
  • Middle Aged
  • Platelet Aggregation Inhibitors / therapeutic use
  • Stents*
  • Thrombolytic Therapy*
  • Thrombosis / mortality
  • Thrombosis / prevention & control
  • Ticlopidine / therapeutic use
  • Treatment Outcome

Substances

  • Anticoagulants
  • Heparin, Low-Molecular-Weight
  • Platelet Aggregation Inhibitors
  • Ticlopidine
  • Aspirin