Clinical Outcome at Six Months of Coronary Stenting Followed by Ticlopidine Monotherapy

Elsner, Mathias; Peifer, Alfred; Drexler, M; Wenzel, Christian; Hebbeker, Christian; Kasper, Wolfgang

doi:10.1016/s0002-9149(97)00866-7

Cited by 8 publications

(2 citation statements)

References 28 publications

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“…The surveyed institutes are considered to represent the major hospitals in Japan actively treating AMI patients with PCI, because the average volume of emergency PCI for AMI of 187 cases per 3 years (62.4 cases / year per institute) in the present study is much higher than the average annual volume of 26.8 cases per institute in the Japanese Coronary Intervention Study 4 and the 12.3 cases per institute in the survey by Watanabe et al 3 The incidence of subacute stent thrombosis of 3.0% in the present study was slightly higher than the previously reported rate of 0.5-2.5% [27][28][29][30][31][32] and can be explained by the fact that all stenting procedures were emergencies for AMI and not all patients were taking ticlopidine after the procedure.…”

Section: Present Studycontrasting

confidence: 64%

“…[23][24][25][26] However, more recent methods using intravascular ultrasound, high-pressure post-dilatation, and an anti-platelet regimen with aspirin and ticlopidine have lead to a dramatic reduction in the rate of thrombosis to 0.5-2.5% [27][28][29][30][31][32] and most events occur within 5 days of the procedure. 31,32 The predisposing factors of stent thrombosis that have been identified in previous studies 29,31 include low ejection fraction, absence of hypertension, a combination of different stents, longer stent length, residual dissections, slow flow, and final lumen diameter, but no study has identified ETT or training as a predisposing or triggering factor.…”

Section: Predisposing Factors To Stent Thrombosismentioning

confidence: 99%

See 1 more Smart Citation

Safety and Implementation of Exercise Testing and Training After Coronary Stenting in Patients With Acute Myocardial Infarction.

Goto

Sumida

Ueshima

et al. 2002

Circ J

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n recent years, emergency percutaneous coronary intervention (PCI) using coronary stenting has rapidly become the treatment modality for patients with acute myocardial infarction (AMI). 1,2 In Japan, Watanabe et al reported that a multicenter survey showed 47.9% of 32,857 patients with AMI were treated by PCI in 1998PCI in -1999 The Japanese Coronary Intervention Study group reported that 37% of 2,673 patients with AMI who underwent PCI were treated with coronary stents in 1997, 4 and that the use of coronary stenting among all PCI procedures sharply increased from 39.5% in 1997 to 55.3% in 1999. 5 A recent report from the national registry in the USA showed that more than 70% of all PCI procedures involved placement of one or more coronary stents. 6 Exercise testing (ETT) is widely used as a routine method for detecting residual ischemia, assessment of exercise capacity and for the prognostic stratification of patients with AMI. The practice guidelines for patient management of AMI recommend a predischarge submaximal ETT to be performed at 4-6 days and a symptom-limited maximal ETT at 14-21 days after AMI. [7][8][9] Comprehensive (phase II) cardiac rehabilitation including exercise training (ie, exercise cardiac rehabilitation (ECR)) has been shown to improve functional capacity and quality of life and to reduce cardiovascular and total mortality in patients with AMI. 10,11 Therefore, both ETT and ECR are the standard modalities of post-AMI clinical assessment and treatment. 7 However, there are anecdotal case reports of thrombotic coronary occlusion associated with ETT after successful coronary stenting. [12][13][14] It is known that acute exercise can lead to a transient prothrombotic state in patients with coronary artery disease, 15 and questions have been raised about the safety of ETT after coronary stenting 12 because the true incidence of coronary thrombosis associated with ETT and ECR remains unclear. The guidelines do not have a specific statement about the safety or appropriate timing of ETT and ECR for patients with AMI who underwent coronary stenting. [7][8][9] In one study of the feasibility and safety of early ETT after AMI, patients who underwent PCI were excluded. 16 Thus, there is not general consensus on the safety and appropriate timing of ETT and ECR for patients with AMI who underwent coronary stenting. Accordingly, the purpose of the present study was to determine the incidence of subacute stent thrombosis related to ETT or exercise training and to obtain information about appropriate (safe The purpose of this study was to determine the incidence of subacute stent thrombosis related to exercise testing (ETT) or exercise training in cardiac rehabilitation (exercise cardiac rehabilitation (ECR)) and to clarify the appropriate timing of ETT and ECR in patients with acute myocardial infarction (AMI) treated with coronary stenting, because the safety and appropriate timing of ETT and ECR after coronary stenting for AMI have not been established. Forty-six institutes performing emergency percu...

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