Document Detail


Ticlopidine and subcutaneous heparin as an alternative regimen following coronary stenting.
MedLine Citation:
PMID:  8062368     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Subacute thrombosis of coronary stents may occur up to the end of the first month after their implantation and remains the major problem associated with the technique. A cohort of 238 patients with placement of one or more stents in 244 arteries was monitored for this period. All patients were given 500 mg/day of ticlopidine (started 3 days before) and a push dose of 10,000 IU of heparin during the procedure, then 1,000-1,500 IU/hr for 20 hr. Following removal of the arterial introducer, they were kept on subcutaneous heparin for 1 week and ticlopidine (500 mg/day) for 3-6 months. Nine patients (3.8%) showed evidence of thrombosis at 7 days. The overall thrombosis rate at 30 days was 4.2% (3.5% for elective stents, as compared with 7.9% associated with occlusive dissections). Emergency treatment by further angioplasty (8 cases) and intracoronary thrombolysis (5 cases) was undertaken. Complications were as follows: 5 deaths (2%), 3 MI (1.2%), 2 non-Q MI (1.7%). Three predictive factors for subacute thrombosis were identified: age < 70 (p = 0.00006), unstable angina (p = 0.006) and arterial diameter less than 3 mm (p = 0.043). The peripheral vascular complication rate was 4.6%. This study suggests that preventive treatment with ticlopidine appears to reduce the incidence of subacute thrombosis of stents in patients > 70 years of age. Furthermore, the combination of ticlopidine and heparin facilitates laboratory monitoring after stenting. Stenting is thought to represent definitive treatment in situations where placement for occlusive dissection is the indication.
Authors:
P Barragan; J Sainsous; M Silvestri; J L Bouvier; B Comet; J B Siméoni; C Charmasson; M Bremondy
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Catheterization and cardiovascular diagnosis     Volume:  32     ISSN:  0098-6569     ISO Abbreviation:  Cathet Cardiovasc Diagn     Publication Date:  1994 Jun 
Date Detail:
Created Date:  1994-09-22     Completed Date:  1994-09-22     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7508512     Medline TA:  Cathet Cardiovasc Diagn     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  133-8     Citation Subset:  IM    
Affiliation:
Centre Cardio-vasculaire les Alpilles/Les Alpilles Cardiovascular Center, Marseilles, France.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Angioplasty, Transluminal, Percutaneous Coronary*
Coronary Thrombosis / prevention & control*,  therapy
Female
Heparin / therapeutic use*
Humans
Male
Middle Aged
Prospective Studies
Stents* / adverse effects
Ticlopidine / therapeutic use*
Chemical
Reg. No./Substance:
55142-85-3/Ticlopidine; 9005-49-6/Heparin

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


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