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Titolo:
INFLUENCE OF DIFFERENT ANTITHROMBOTIC THE RAPIES ON THE INCIDENCE OF SUBACUTE CORONARY STENT OCCLUSIONS, HEMORRHAGIC COMPLICATIONS AND LENGTH OF IN-HOSPITAL STAY
Autore:
FACCHINI M; MUNTWYLER J; SCHUIKI E; RICKLI H; KIOWSKI W; AMANN FW;
Indirizzi:
UNIV SPITAL ZURICH,ABT KARDIOL,RAMISTR 100 CH-8091 ZURICH SWITZERLAND
Titolo Testata:
Schweizerische medizinische Wochenschrift
fascicolo: 3, volume: 128, anno: 1998,
pagine: 72 - 79
SICI:
0036-7672(1998)128:3<72:IODATR>2.0.ZU;2-W
Fonte:
ISI
Lingua:
GER
Soggetto:
INTRACORONARY ULTRASOUND; BALLOON ANGIOPLASTY; THREATENED CLOSURE; ARTERY DISEASE; THROMBOSIS; PLACEMENT; IMPLANTATION; MULTICENTER; TICLOPIDINE; PLATELETS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
34
Recensione:
Indirizzi per estratti:
Citazione:
M. Facchini et al., "INFLUENCE OF DIFFERENT ANTITHROMBOTIC THE RAPIES ON THE INCIDENCE OF SUBACUTE CORONARY STENT OCCLUSIONS, HEMORRHAGIC COMPLICATIONS AND LENGTH OF IN-HOSPITAL STAY", Schweizerische medizinische Wochenschrift, 128(3), 1998, pp. 72-79

Abstract

Background: The clinical benefit of coronary stenting is reduced by the risk of thrombotic stent occlusion as well as hemorrhagic complications of intensive antithrombotic therapy We compared the influence of different antithrombotic therapies on the incidence of postinterventional complications and in-hospital stay duration. Methods: After successful placement of a coronary stent, 334 consecutive patients were given different antithrombotic treatments in addition to aspirin 100 mg/d indefinitely: (1) phenprocoumon for 3 months (n = 47), (2) low molecular weight heparin 2 x 100 U/kg/d s.c. for 4 weeks (n = 90), (3) ticlopidine 2 x 250 mg/d and low molecular weight heparin 2 x 100 U/kg/d s.c. for 4 weeks (n = 72) and (4) ticlopidine 2 x 250 mg/d for 4 weeks (n= 125). Results: Major events were subacute stent thrombosis in 17 patients (5%), and severe hemorrhagic complication in 20 patients (5,9%). The incidence of subacute stent thrombosis in groups 1 to 4 was 10.6%, 11%, 1.4% and 0.8% respectively. The use of ticlopidine was associated with a significant lowering of stent occlusions in univariate and multivariate analysis (p = 0.0013). Additional uni- and multivariate predictors were stent placement as a ''bail-out'' procedure (p = 0.033)and in patients with acute coronary syndrome (p = 0.049). Anticoagulant therapy was associated with a higher incidence of severe hemorrhagic complications (p < 0.01) and a prolonged in-hospital stay (p = 0.01). Conclusions: These results confirm that antithrombotic therapy with aspirin and ticlopidine combines low rates of subacute stent occlusionand hemorrhagic complications. Treatment with phenprocoumon and low molecular weight heparin does not improve the rate of subacute stent seclusion but increases hemorrhagic complications. Very low rates of stent occlusion permit short in-hospital stays with concomitant reductionin cost.

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Documento generato il 28/03/20 alle ore 14:16:45