1998
DOI: 10.1161/01.cir.98.20.2126
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Randomized Evaluation of Anticoagulation Versus Antiplatelet Therapy After Coronary Stent Implantation in High-Risk Patients

Abstract: High-risk patients should be treated with A+T rather than A+OAC after coronary stenting because the bleeding and vascular complications are significantly reduced and there is a marked trend suggesting a decrease in cardiac events.

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Cited by 408 publications
(163 citation statements)
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References 30 publications
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“…Prior registries 12,13 and several randomized trials 11,14,15,18 have shown the dramatic reduction in stent thrombosis afforded by the use of aspirin and ticlopidine after successful high-pressure stent implantation. The large sample size of our study allows a reliable estimate of the true stent thrombosis risk and analysis of the factors that may influence this risk.…”
Section: Discussionmentioning
confidence: 99%
“…Prior registries 12,13 and several randomized trials 11,14,15,18 have shown the dramatic reduction in stent thrombosis afforded by the use of aspirin and ticlopidine after successful high-pressure stent implantation. The large sample size of our study allows a reliable estimate of the true stent thrombosis risk and analysis of the factors that may influence this risk.…”
Section: Discussionmentioning
confidence: 99%
“…The incidence of stent thrombosis is between 0.6% and 2.2% for low-risk patients undergoing elective stenting, 4,21 but in higher-risk patients, it is 5.6%. 6 One approach to this problem is to coat stents with an immobilized antithrombotic agent. HA, a high-molecular-weight nonsulfated glycosaminoglycan, is a ubiquitous component of extracellular matrix 22 and has been shown to inhibit platelet aggregation and adhesion 16 and to prolong the bleeding time at high concentrations.…”
Section: Discussionmentioning
confidence: 99%
“…4,5 However, the incidence of stent thrombosis is substantially increased in higher-risk patients. 6 In addition, aspirin and ticlopidine may produce significant side effects. 7 These findings suggest a need for further improvements in antithrombotic strategies associated with coronary stenting.…”
mentioning
confidence: 99%
“…Ticlopidine or clopidogrel is structurally related thienopyridine derivates and they exert their antiplatelet effects by inhibiting the adenosine diphosphate dependent pathway of platelet activation (Sharis et al 1998). Trials have shown the superiority of the combination antiplatelet regimen of aspirin and thienopyridines over aspirin alone, or aspirin plus oral anticoagulation with warfarin in preventing stent thrombosis, not only in patients with optimal stent deployment but also in patients who are at high risk of stent thrombosis (Schomig et al 1996;Schuhlen et al 1997;Bertrand et al 1998;Leon et al 1998;Urban et al 1998). Regardless of the stimulus for their activation, the aggregation of platelets that leads to thrombus formation is finally regulated through their membrane binding sites for fibrinogen in the glycoprotein IIb/IIIa receptor complex.…”
Section: Discussionmentioning
confidence: 99%