Document Detail


Meta-analysis of trials comparing oral anticoagulation and aspirin versus dual antiplatelet therapy after coronary stenting. Clues for the management of patients with an indication for long-term anticoagulation undergoing coronary stenting.
MedLine Citation:
PMID:  16020950     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The combination of oral anticoagulation (OAC) and aspirin was the antithrombotic treatment initially adopted after coronary stenting (PCI-S). Although dual antiplatelet therapy with aspirin and a thienopyridine subsequently proved safer and more effective, OAC and aspirin combination is still used in patients with an indication for long-term OAC undergoing PCI-S. The absolute (AR) and relative (RR) risk of cardiac events and hemorrhagic/vascular complications of OAC and aspirin versus antiplatelet therapy were evaluated in a meta-analysis of four historical clinical trials. In 2,436 patients, the RR of a 30-day primary composite endpoint of death, myocardial infarction and the need for revascularization was significantly reduced by antiplatelet therapy (RR 0.41; 95% CI 0.25-0.69), whereas the RR of stent thrombosis (RR 0.26; 95% CI 0.06-1.14) and major bleeding (RR 0.36; 95% CI 0.14-1.02) was not statistically different. The 30-day AR of death, myocardial infarction, need for revascularization, major bleedings and vascular complications with OAC and aspirin were 0.65, 3.8, 4.2, 6.4 and 6.6%, respectively. In conclusion, due to the low AR of adverse events, the combination of OAC and aspirin appears an acceptable treatment after PCI-S in patients in whom long-term OAC is deemed mandatory.
Authors:
Andrea Rubboli; Milena Milandri; Cristina Castelvetri; Benilde Cosmi
Publication Detail:
Type:  Comparative Study; Journal Article; Meta-Analysis     Date:  2005-07-12
Journal Detail:
Title:  Cardiology     Volume:  104     ISSN:  0008-6312     ISO Abbreviation:  Cardiology     Publication Date:  2005  
Date Detail:
Created Date:  2005-08-22     Completed Date:  2006-02-03     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  1266406     Medline TA:  Cardiology     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  101-6     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2005 S. Karger AG, Basel.
Affiliation:
Cardiac Catheterization Laboratory, Division of Cardiology, Maggiore Hospital, Bologna, Italy. andrearubboli@libero.it
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MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Angioplasty, Transluminal, Percutaneous Coronary*
Anticoagulants / administration & dosage*,  adverse effects
Aspirin / administration & dosage*,  adverse effects
Coronary Stenosis / mortality,  therapy*
Drug Therapy, Combination
Follow-Up Studies
Humans
Long-Term Care
Multicenter Studies as Topic
Myocardial Infarction / mortality,  therapy
Myocardial Revascularization / mortality
Platelet Aggregation Inhibitors / administration & dosage*,  adverse effects
Randomized Controlled Trials as Topic
Stents*
Ticlopidine / administration & dosage*,  adverse effects,  analogs & derivatives*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Platelet Aggregation Inhibitors; 50-78-2/Aspirin; 55142-85-3/Ticlopidine; 90055-48-4/clopidogrel

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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