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Combination therapy with clopidogrel and aspirin after coronary stenting
Author(s) -
Kolansky Daniel M.,
Klugherz Bruce D.,
Curran Sean C.,
Herrmann Howard C.,
Magness Kathleen,
Wilensky Robert L.,
Hirshfeld John W.
Publication year - 2000
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/1522-726x(200007)50:3<276::aid-ccd2>3.0.co;2-p
Subject(s) - medicine , clopidogrel , ticlopidine , aspirin , coronary stent , stent , thrombosis , myocardial infarction , cardiology , coronary thrombosis , surgery , combination therapy , angioplasty , adverse effect , restenosis
Combination antiplatelet therapy using aspirin and ticlopidine has been the standard of care for prevention of subacute thrombosis following coronary stent implantation. However, the use of ticlopidine is associated with a significant risk of adverse hematologic side effects. Clopidogrel is an inhibitor of ADP‐induced platelet aggregation that has a better safety profile than ticlopidine. We examined the 30‐day clinical outcome following coronary stent implantation in 253 consecutive patients treated with clopidogrel and aspirin. Follow‐up was achieved in 99% of patients and four adverse events were documented. Two patients had angiographically confirmed subacute stent thrombosis (0.8%), and both of these patients underwent successful repeat angioplasty at the stent site. There were two patient deaths during follow‐up (0.8%). One was sudden within 1 week of stent placement and the other occurred in a patient with multisystem organ failure after an extensive myocardial infarction that antedated the stent procedure, with no clinical evidence for stent thrombosis. The combined frequency of subacute stent thrombosis and death was 1.6%. This is comparable to prior studies using the combination of ticlopidine and aspirin following stenting. Therefore, clopidogrel in combination with aspirin appears to be a safe and effective therapy in the prevention of subacute thrombosis following coronary stent implantation. Cathet. Cardiovasc. Intervent. 50:276–279, 2000. © 2000 Wiley‐Liss, Inc.