| 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. | |
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MedLine Citation:
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PMID: 16020950 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Andrea Rubboli; Milena Milandri; Cristina Castelvetri; Benilde Cosmi |
Publication Detail:
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Type: Comparative Study; Journal Article; Meta-Analysis Date: 2005-07-12 |
Journal Detail:
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Title: Cardiology Volume: 104 ISSN: 0008-6312 ISO Abbreviation: Cardiology Publication Date: 2005 |
Date Detail:
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Created Date: 2005-08-22 Completed Date: 2006-02-03 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 1266406 Medline TA: Cardiology Country: Switzerland |
Other Details:
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Languages: eng Pagination: 101-6 Citation Subset: IM |
Copyright Information:
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Copyright (c) 2005 S. Karger AG, Basel. |
Affiliation:
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Cardiac Catheterization Laboratory, Division of Cardiology, Maggiore Hospital, Bologna, Italy. andrearubboli@libero.it |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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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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