Related Experiment Video
Updated: Aug 7, 2026
A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
A clinical trial comparing three antithrombotic-drug regimens after coronary-artery stenting. Stent Anticoagulation
M B Leon1, D S Baim, J J Popma
1Cardiology Research Foundation, Washington Hospital Center, DC 20010, USA.
Insights
Aspirin and ticlopidine significantly reduced stent thrombosis after coronary stenting compared to aspirin alone or aspirin with warfarin. However, this combination therapy increased hemorrhagic complications versus aspirin alone.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Coronary stenting necessitates antithrombotic drugs to prevent stent thrombosis.
- Comparing aspirin alone, aspirin with warfarin, and aspirin with ticlopidine is crucial for optimizing post-stenting care.
Purpose of the Study:
- To compare the efficacy and safety of three antithrombotic drug regimens in preventing stent thrombosis after coronary stenting.
Main Methods:
- 1653 patients undergoing successful coronary stenting were randomized into three groups: aspirin alone, aspirin plus warfarin, or aspirin plus ticlopidine.
- The primary endpoint was a composite of death, target lesion revascularization, angiographically evident thrombosis, or myocardial infarction within 30 days.
Main Results:
- Aspirin and ticlopidine showed the lowest rate of stent thrombosis (0.5%) compared to aspirin alone (3.6%) and aspirin with warfarin (2.7%) (P=0.001).
- Hemorrhagic complications were higher with aspirin and warfarin (6.2%) and aspirin and ticlopidine (5.5%) than with aspirin alone (1.8%) (P<0.001).
- Vascular surgical complications were significantly higher in the combination therapy groups (2.0%) versus aspirin alone (0.4%) (P=0.01).
Conclusions:
- Aspirin and ticlopidine significantly lowered stent thrombosis rates post-coronary stenting.
- While effective in preventing stent thrombosis, aspirin and ticlopidine increase hemorrhagic risks compared to aspirin alone.
Background:
Antithrombotic drugs are used after coronary-artery stenting to prevent stent thrombosis. We compared the efficacy and safety of three antithrombotic-drug regimens - aspirin alone, aspirin and warfarin, and aspirin and ticlopidine - after coronary stenting.
Methods:
Of 1965 patients who underwent coronary stenting at 50 centers, 1653 (84.1 percent) met angiographic criteria for successful placement of the stent and were randomly assigned to one of three regimens: aspirin alone (557 patients), aspirin and warfarin (550 patients), or aspirin and ticlopidine (546 patients). All clinical events reflecting stent thrombosis were included in the prespecified primary end point: death, revascularization of the target lesion, angiographically evident thrombosis, or myocardial infarction within 30 days.
Results:
The primary end point was observed in 38 patients: 20 (3.6 percent) assigned to receive aspirin alone, 15 (2.7 percent) assigned to receive aspirin and warfarin, and 3 (0.5 percent) assigned to receive aspirin and ticlopidine (P=0.001 for the comparison of all three groups). Hemorrhagic complications occurred in 10 patients (1.8 percent) who received aspirin alone, 34 (6.2 percent) who received aspirin and warfarin, and 30 (5.5 percent) who received aspirin and ticlopidine (P<0.001 for the comparison of all three groups); the incidence of vascular surgical complications was 0.4 percent (2 patients), 2.0 percent (11 patients), and 2.0 percent (11 patients), respectively (P=0.01). There were no significant differences in the incidence of neutropenia or thrombocytopenia (overall incidence, 0.3 percent) among the three treatment groups.
Conclusions:
As compared with aspirin alone and a combination of aspirin and warfarin, treatment with aspirin and ticlopidine resulted in a lower rate of stent thrombosis, although there were more hemorrhagic complications than with aspirin alone. After coronary stenting, aspirin and ticlopidine should be considered for the prevention of the serious complication of stent thrombosis.
Related Concept Videos
01:23Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:26Atherosclerosis III: Management
01:27Peripheral Artery Disease III: Interprofessional Care
01:29Venous Thrombosis III: Interprofessional Care