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Titolo:
RANDOMIZED MULTICENTER COMPARISON OF CONVENTIONAL ANTICOAGULATION VERSUS ANTIPLATELET THERAPY IN UNPLANNED AND ELECTIVE CORONARY STENTING -THE FULL ANTICOAGULATION VERSUS ASPIRIN AND TICLOPIDINE (FANTASTIC) STUDY
Autore:
BERTRAND ME; LEGRAND V; BOLAND J; FLECK E; BONNIER J; EMMANUELSON H; VROLIX M; MISSAULT L; CHIERCHIA S; CASACCIA M; NICCOLI L; OTO A; WHITE C; WEBBPEPLOE M; VANBELLE E; MCFADDEN EP;
Indirizzi:
HOP CARDIOL,DEPT CARDIOL B,BLVD PROF J LECLERCQ F-59037 LILLE FRANCE CHU SART TILMAN B-4000 LIEGE BELGIUM HOP CITADELLE B-4000 LIEGE BELGIUM ST JANS HOSP,OCMW B-3600 GENK BELGIUM ACAD ZIEKENHAUS ST JAN B-8000 BRUGGE BELGIUM DEUTSCH HERZZENTRUM BERLIN D-13353 BERLIN GERMANY OSPED SAN RAFFAELE I-20090 MILAN ITALY AZIENDA OSPIDALIERA F GIOVAN I-10100 TURIN ITALY OSPEDALIERA SPECIALE CIVILLI I-25123 BRESCIA ITALY CATHARINA HOSP NL-5623 EJ EINDHOVEN NETHERLANDS SAHLGRENS UNIV HOSP S-41345 GOTHENBURG SWEDEN HACETTEPE UNIV HOSP TR-0610 ANKARA TURKEY HCI MED CLYDEBANK G81 4HX SCOTLAND ST THOMAS HOSP LONDON SE1 7EH ENGLAND
Titolo Testata:
Circulation
fascicolo: 16, volume: 98, anno: 1998,
pagine: 1597 - 1603
SICI:
0009-7322(1998)98:16<1597:RMCOCA>2.0.ZU;2-Z
Fonte:
ISI
Lingua:
ENG
Soggetto:
INTRAVASCULAR ULTRASOUND GUIDANCE; BALLOON ANGIOPLASTY; ARTERY DISEASE; IMPLANTATION; THROMBOSIS; PLACEMENT;
Keywords:
STENTS; ANTIPLATELET AGENTS; ANTICOAGULANTS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
14
Recensione:
Indirizzi per estratti:
Citazione:
M.E. Bertrand et al., "RANDOMIZED MULTICENTER COMPARISON OF CONVENTIONAL ANTICOAGULATION VERSUS ANTIPLATELET THERAPY IN UNPLANNED AND ELECTIVE CORONARY STENTING -THE FULL ANTICOAGULATION VERSUS ASPIRIN AND TICLOPIDINE (FANTASTIC) STUDY", Circulation, 98(16), 1998, pp. 1597-1603

Abstract

Background-Dual therapy with ticlopidine and aspirin has been shown to be as effective as or more effective than conventional anticoagulation in patients with an optimal result after implantation of intracoronary metallic stents. However, the safety and efficacy of antiplatelet therapy alone in an unselected population has not been evaluated. Methods-Patients were randomized to conventional anticoagulation or to treatment with antiplatelet therapy alone. Indications for stenting were classified as elective (decided before the procedure) or unplanned (tosalvage failed angioplasty or to optimize the results of balloon angioplasty). After stenting, patients received aspirin and either ticlopidine or conventional anticoagulation (heparin or oral anticoagulant). The primary end point was the occurrence of bleeding or peripheral vascular complications; secondary end points were cardiac events (death, infarction, or stent occlusion) and duration of hospitalization. Results-In 13 centers, 236 patients were randomized to anticoagulation and 249 to antiplatelet therapy. Stenting was elective in 58% of patients and unplanned in 42%. Stent implantation was successfully achieved in 99% of patients. A primary end point occurred in 33 patients (13.5%) in the antiplatelet group and 48 patients (21%) in the anticoagulation group (odds ratio=0.6 [95% CI 0.36 to 0.98], P=0.03). Major cardiac-related events in electively stented patients were less common (odds ratio=0.23 [95% CI 0.05 to 0.91], P=0.01) in the antiplatelet group (3 of123, 2.4%) than the anticoagulation group (11 of ill, 9.9%). Hospitalstay was significantly shorter in the antiplatelet group (4.3 +/- 3.6versus 6.4 +/- 3.7 days, P=0.0001). Conclusions-Antiplatelet therapy after coronary stenting significantly reduced rates of bleeding and subacute stent occlusion compared with conventional anticoagulation.

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Documento generato il 24/09/20 alle ore 21:03:00