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Coronary stenting (Cordis) without anticoagulation

S W Park1, S J Park, M K Hong

  • 1Department of Internal Medicine, University of Ulsan, College of Medicine, Seoul, Korea.

The American Journal of Cardiology
|April 1, 1997
PubMed
Summary
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Aspirin and ticlopidine combination therapy after Cordis coronary stent implantation significantly reduced stent thrombosis compared to aspirin alone. This antiplatelet regimen is a promising alternative to anticoagulation.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Biomaterials Science

Background:

  • The Cordis coronary stent is a flexible, balloon-expandable, radiopaque tantalum stent used in interventional cardiology.
  • Subacute thrombosis and clinical outcomes after coronary stenting are influenced by antithrombotic regimens.
  • Optimizing antithrombotic therapy is crucial for improving patient outcomes following stent implantation.

Purpose of the Study:

  • To evaluate the impact of different antithrombotic regimens on subacute thrombosis and short-term clinical courses after Cordis coronary stent implantation.
  • To compare the efficacy and safety of combined aspirin and ticlopidine therapy versus aspirin alone and aspirin, ticlopidine, and warfarin regimens.

Main Methods:

  • A prospective study involving 275 patients undergoing 356 Cordis stent implantations.

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  • Patients were divided into three groups based on post-stent antithrombotic regimen: Group 1 (aspirin, ticlopidine, warfarin), Group 2 (aspirin, ticlopidine), and Group 3 (aspirin alone).
  • Outcomes assessed included procedural success rates and the incidence of stent thrombosis.

    • Main Results:

    • Overall procedural success rates were high across all groups (97.7% to 100%).
    • The incidence of stent thrombosis was lowest in the aspirin and ticlopidine group (0%), intermediate in the aspirin, ticlopidine, and warfarin group (1.2%), and highest in the aspirin alone group (6.8%).
    • Aspirin monotherapy was associated with a significantly higher rate of stent thrombosis.

    Conclusions:

    • The Cordis coronary stent is effective for various clinical indications, including unstable angina and acute myocardial infarction.
    • Antiplatelet therapy with aspirin and ticlopidine is a safe and effective alternative to anticoagulation after Cordis stenting, reducing thrombosis risk.
    • Aspirin monotherapy post-Cordis stenting is associated with a substantial risk of stent thrombosis and should be used cautiously.