Timing of coronary stent thrombosis in patients treated with ticlopidine and aspirin

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A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
04:30

A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis

Published on: May 14, 2013

S H Wilson1, C S Rihal, M R Bell

  • 1Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota 55905, USA.

The American Journal of Cardiology
|April 6, 1999
PubMed

Insights

Coronary stent thrombosis occurs significantly earlier with aspirin and ticlopidine (median 12 hours) compared to aspirin and coumadin (median 4 days). This finding highlights critical timing differences in stent thrombosis for patients receiving different anticoagulant therapies.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Stent thrombosis is a serious complication following coronary stent implantation.
  • The peak incidence of stent thrombosis in patients on aspirin and coumadin is observed 5-6 days post-procedure.
  • Limited data exists on the timing of stent thrombosis in patients treated with aspirin and ticlopidine.

Purpose of the Study:

  • To compare the timing of coronary stent thrombosis in patients treated with aspirin and ticlopidine versus those treated with aspirin and coumadin.
  • To investigate the influence of abciximab on the timing of stent thrombosis in patients on aspirin and ticlopidine.

Main Methods:

  • Retrospective analysis of a databank.
  • Identification of 39 patients who experienced stent thrombosis after coronary stent implantation.
  • Comparison of thrombosis timing between patients receiving ticlopidine/aspirin (n=21) and coumadin/aspirin (n=18) therapy.

Main Results:

  • The median time to stent thrombosis was significantly shorter in the ticlopidine/aspirin group (12 hours) compared to the coumadin/aspirin group (4 days) (p < 0.0001).
  • No significant difference in thrombosis timing was observed between patients on ticlopidine/aspirin with or without abciximab (median 17 hours vs. 11 hours, p = 0.57).

Conclusions:

  • Coronary stent thrombosis occurs much earlier after the procedure in patients treated with ticlopidine and aspirin compared to those on anticoagulation therapy (coumadin and aspirin).
  • The findings underscore the importance of considering the specific antithrombotic regimen when assessing the risk and timing of stent thrombosis.

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