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Titolo:
Incidence of thrombotic occlusion and major adverse cardiac events betweentwo and four weeks after coronary stent placement: Analysis of 5,678 patients with a four-week ticlopidine regimen
Autore:
Schuhlen, H; Kastrati, A; Pache, J; Dirschinger, J; Schomig, A;
Indirizzi:
Klinikum Rechts Isar, Med Klin, D-81675 Munich, Germany Klinikum Rechts Isar Munich Germany D-81675 lin, D-81675 Munich, Germany Tech Univ Munich, Deutsch Herzzentrum, D-8000 Munich, Germany Tech Univ Munich Munich Germany D-8000 rzzentrum, D-8000 Munich, Germany
Titolo Testata:
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
fascicolo: 8, volume: 37, anno: 2001,
pagine: 2066 - 2073
SICI:
0735-1097(20010615)37:8<2066:IOTOAM>2.0.ZU;2-F
Fonte:
ISI
Lingua:
ENG
Soggetto:
INTRAVASCULAR ULTRASOUND GUIDANCE; IIB/IIIA RECEPTOR BLOCKADE; HIGH-RISK PATIENTS; ANTIPLATELET THERAPY; THROMBOCYTOPENIC PURPURA; ARTERY STENTS; RESTENOSIS RATE; CLOPIDOGREL; ASPIRIN; ANTICOAGULATION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
33
Recensione:
Indirizzi per estratti:
Indirizzo: Schuhlen, H Klinikum Rechts Isar, Med Klin, Ismaninger Str 22, D-81675 Munich, Germany Klinikum Rechts Isar Ismaninger Str 22 Munich Germany D-81675
Citazione:
H. Schuhlen et al., "Incidence of thrombotic occlusion and major adverse cardiac events betweentwo and four weeks after coronary stent placement: Analysis of 5,678 patients with a four-week ticlopidine regimen", J AM COL C, 37(8), 2001, pp. 2066-2073

Abstract

Objectives We attempted to make a comprehensive assessment of the risk of stent failure (death, myocardial infarction or angiographically documented occlusion), differentiating early (first and second weeks) and late (third and fourth weeks) events. Background The risk of stent failure decreases rapidly within the first week. It has been suggested that the risk rate for late events is close to 0%and that the thienopyridine regimen (ticlopidine or clopidogrel) could be safely reduced from four to two weeks, minimizing the risk of hematologicalcomplications. Methods We analyzed 5,678 patients with successful coronary stent placement and a four-week ticlopidine regimen. Results The rate of stent failure was 2.5% at four weeks, with 112 early (2.0%) and 30 late events (0.5%). Multivariate analysis identified differentrisk factors fur early versus late events. While variables on stenosis severity and procedural results that can he influenced by the operator were identified as independent risk factors for early events (percent stenosis before and after the procedure, residual dissection, length of stented segment), more clinical variables were associated with late events (age, reduced left ventricular function, systemic hypertension as a protective factor). The late-event rate was <0.1% in the absence of these factors, but it was 2.5% with all three risk factors present. ConclusionsThe risk of late stent failure is low with a four-week ticlopidine regimen. However, high-risk subgroups have a risk of 2.5%. As this rateis presumably higher if thienopyridines are discontinued after two weeks, these data suggest that a risk stratification Co a two- or four-week regimen is preferable to a general reduction. (J Am Coll Cardiol 2001;37: 2066-73) (C) 2001 by the American College of Cardiology.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 30/11/20 alle ore 12:22:12