Clopidogrel as adjunctive antiplatelet therapy during coronary stenting
OBJECTIVES We examined the procedural and 30-day clinical outcomes among patients receiving aspirin and either ticlopidine or clopidogrel during coronary stenting. BACKGROUND Ticlopidine-plus-aspirin has become standard antiplatelet therapy for the prevention of thrombotic complications after corona...
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| Veröffentlicht in: | Journal of the American College of Cardiology 1999-12, Vol.34 (7), p.1884-1890 |
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| container_title | Journal of the American College of Cardiology |
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| creator | Mishkel, Gregory J Aguirre, Frank V Ligon, Robert W Rocha-Singh, Krishna J Lucore, Charles L |
| description | OBJECTIVES
We examined the procedural and 30-day clinical outcomes among patients receiving aspirin and either ticlopidine or clopidogrel during coronary stenting.
BACKGROUND
Ticlopidine-plus-aspirin has become standard antiplatelet therapy for the prevention of thrombotic complications after coronary stenting. Clopidogrel has a similar mechanism of action as ticlopidine, but both its efficacy and its safety as a pharmacologic adjunct to coronary stenting have not been well described.
METHODS
This single-center, prospective analysis examined the in-hospital procedural and 30-day clinical outcomes among 875 consecutive patients undergoing coronary stenting who received adjunctive aspirin and either clopidogrel (n = 514; 58.7%) or ticlopidine (n = 361; 41.3%) therapy.
RESULTS
Procedural success rates were similar among the clopidogrel- (99.6%) and ticlopidine-treated patients (99.4%). Subacute stent thrombosis (i.e., >24 h ≤30 days) occurred in one clopidogrel-treated (0.2%) and in one ticlopidine-treated (0.3%) patient (p = 0.99). By 30 days following the index procedure, the combined rates of death, nonfatal myocardial infarction and need for target vessel revascularization were similar among patients who received either clopidogrel (2.1%) or ticlopidine (1.4%; p = 0.57) therapy.
CONCLUSIONS
In this analysis the antiplatelet combination therapy of aspirin-plus-clopidogrel was an effective regimen for preventing thrombotic complications and major adverse cardiovascular events among a broad spectrum of patients undergoing coronary artery stenting. |
| doi_str_mv | 10.1016/S0735-1097(99)00443-X |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_69333365</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S073510979900443X</els_id><sourcerecordid>69333365</sourcerecordid><originalsourceid>FETCH-LOGICAL-c472t-b16d73a291b0c28e48fe9a8bc79c5e18dcdddd7894d05fb369d4ed8829b72a963</originalsourceid><addsrcrecordid>eNqFkD1PwzAQhi0EoqXwE0AZEIIhYCdxYk8IVVCQKjEAUjfLsS_FVZoE26nUf4_7IWDjlrvhubtXD0LnBN8STPK7N1ykNCaYF9ec32CcZWk8O0BDQimLU8qLQzT8QQboxLkFxjhnhB-jAcGUhYkN0WRct53R7dxCHUkXSb3oG-XNCiLZeNPV0kMNPvKfYGW3jnRvTTOPVGvbRtp15DwErJmfoqNK1g7O9n2EPp4e38fP8fR18jJ-mMYqKxIflyTXRSoTTkqsEgYZq4BLVqqCKwqEaaVDFYxnGtOqTHOuM9CMJbwsEsnzdISudnc723714LxYGqegrmUDbe9EztNQOQ0g3YHKts5ZqERnzTJEFgSLjUGxNSg2egTnYmtQzMLexf5BXy5B_9naKQvA5R6QTsm6srJRxv1yhNM8TQJ2v8Mg2FgZsMIpA40CbSwoL3Rr_knyDaD7ju8</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>69333365</pqid></control><display><type>article</type><title>Clopidogrel as adjunctive antiplatelet therapy during coronary stenting</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>ScienceDirect Journals (5 years ago - present)</source><source>Alma/SFX Local Collection</source><creator>Mishkel, Gregory J ; Aguirre, Frank V ; Ligon, Robert W ; Rocha-Singh, Krishna J ; Lucore, Charles L</creator><creatorcontrib>Mishkel, Gregory J ; Aguirre, Frank V ; Ligon, Robert W ; Rocha-Singh, Krishna J ; Lucore, Charles L ; for Prairie Cardiovascular Consultants Ltd</creatorcontrib><description>OBJECTIVES
We examined the procedural and 30-day clinical outcomes among patients receiving aspirin and either ticlopidine or clopidogrel during coronary stenting.
BACKGROUND
Ticlopidine-plus-aspirin has become standard antiplatelet therapy for the prevention of thrombotic complications after coronary stenting. Clopidogrel has a similar mechanism of action as ticlopidine, but both its efficacy and its safety as a pharmacologic adjunct to coronary stenting have not been well described.
METHODS
This single-center, prospective analysis examined the in-hospital procedural and 30-day clinical outcomes among 875 consecutive patients undergoing coronary stenting who received adjunctive aspirin and either clopidogrel (n = 514; 58.7%) or ticlopidine (n = 361; 41.3%) therapy.
RESULTS
Procedural success rates were similar among the clopidogrel- (99.6%) and ticlopidine-treated patients (99.4%). Subacute stent thrombosis (i.e., >24 h ≤30 days) occurred in one clopidogrel-treated (0.2%) and in one ticlopidine-treated (0.3%) patient (p = 0.99). By 30 days following the index procedure, the combined rates of death, nonfatal myocardial infarction and need for target vessel revascularization were similar among patients who received either clopidogrel (2.1%) or ticlopidine (1.4%; p = 0.57) therapy.
CONCLUSIONS
In this analysis the antiplatelet combination therapy of aspirin-plus-clopidogrel was an effective regimen for preventing thrombotic complications and major adverse cardiovascular events among a broad spectrum of patients undergoing coronary artery stenting.</description><identifier>ISSN: 0735-1097</identifier><identifier>EISSN: 1558-3597</identifier><identifier>DOI: 10.1016/S0735-1097(99)00443-X</identifier><identifier>PMID: 10588198</identifier><identifier>CODEN: JACCDI</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject><![CDATA[Administration, Oral ; Aged ; Angioplasty, Balloon, Coronary - methods ; Aspirin - administration & dosage ; Aspirin - therapeutic use ; Biological and medical sciences ; Blood. Blood coagulation. Reticuloendothelial system ; Clopidogrel ; Coronary Angiography ; Coronary Thrombosis - etiology ; Coronary Thrombosis - prevention & control ; Drug Therapy, Combination ; Female ; Hospital Mortality ; Humans ; Length of Stay ; Male ; Medical sciences ; Middle Aged ; Odds Ratio ; Pharmacology. Drug treatments ; Platelet Aggregation Inhibitors - administration & dosage ; Platelet Aggregation Inhibitors - therapeutic use ; Platelet Glycoprotein GPIIb-IIIa Complex - antagonists & inhibitors ; Prospective Studies ; Safety ; Stents - adverse effects ; Ticlopidine - administration & dosage ; Ticlopidine - analogs & derivatives ; Ticlopidine - therapeutic use ; Treatment Outcome]]></subject><ispartof>Journal of the American College of Cardiology, 1999-12, Vol.34 (7), p.1884-1890</ispartof><rights>1999 American College of Cardiology</rights><rights>2000 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c472t-b16d73a291b0c28e48fe9a8bc79c5e18dcdddd7894d05fb369d4ed8829b72a963</citedby><cites>FETCH-LOGICAL-c472t-b16d73a291b0c28e48fe9a8bc79c5e18dcdddd7894d05fb369d4ed8829b72a963</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0735-1097(99)00443-X$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,3541,27915,27916,45986</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1195632$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10588198$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mishkel, Gregory J</creatorcontrib><creatorcontrib>Aguirre, Frank V</creatorcontrib><creatorcontrib>Ligon, Robert W</creatorcontrib><creatorcontrib>Rocha-Singh, Krishna J</creatorcontrib><creatorcontrib>Lucore, Charles L</creatorcontrib><creatorcontrib>for Prairie Cardiovascular Consultants Ltd</creatorcontrib><title>Clopidogrel as adjunctive antiplatelet therapy during coronary stenting</title><title>Journal of the American College of Cardiology</title><addtitle>J Am Coll Cardiol</addtitle><description>OBJECTIVES
We examined the procedural and 30-day clinical outcomes among patients receiving aspirin and either ticlopidine or clopidogrel during coronary stenting.
BACKGROUND
Ticlopidine-plus-aspirin has become standard antiplatelet therapy for the prevention of thrombotic complications after coronary stenting. Clopidogrel has a similar mechanism of action as ticlopidine, but both its efficacy and its safety as a pharmacologic adjunct to coronary stenting have not been well described.
METHODS
This single-center, prospective analysis examined the in-hospital procedural and 30-day clinical outcomes among 875 consecutive patients undergoing coronary stenting who received adjunctive aspirin and either clopidogrel (n = 514; 58.7%) or ticlopidine (n = 361; 41.3%) therapy.
RESULTS
Procedural success rates were similar among the clopidogrel- (99.6%) and ticlopidine-treated patients (99.4%). Subacute stent thrombosis (i.e., >24 h ≤30 days) occurred in one clopidogrel-treated (0.2%) and in one ticlopidine-treated (0.3%) patient (p = 0.99). By 30 days following the index procedure, the combined rates of death, nonfatal myocardial infarction and need for target vessel revascularization were similar among patients who received either clopidogrel (2.1%) or ticlopidine (1.4%; p = 0.57) therapy.
CONCLUSIONS
In this analysis the antiplatelet combination therapy of aspirin-plus-clopidogrel was an effective regimen for preventing thrombotic complications and major adverse cardiovascular events among a broad spectrum of patients undergoing coronary artery stenting.</description><subject>Administration, Oral</subject><subject>Aged</subject><subject>Angioplasty, Balloon, Coronary - methods</subject><subject>Aspirin - administration & dosage</subject><subject>Aspirin - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Blood. Blood coagulation. Reticuloendothelial system</subject><subject>Clopidogrel</subject><subject>Coronary Angiography</subject><subject>Coronary Thrombosis - etiology</subject><subject>Coronary Thrombosis - prevention & control</subject><subject>Drug Therapy, Combination</subject><subject>Female</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Odds Ratio</subject><subject>Pharmacology. Drug treatments</subject><subject>Platelet Aggregation Inhibitors - administration & dosage</subject><subject>Platelet Aggregation Inhibitors - therapeutic use</subject><subject>Platelet Glycoprotein GPIIb-IIIa Complex - antagonists & inhibitors</subject><subject>Prospective Studies</subject><subject>Safety</subject><subject>Stents - adverse effects</subject><subject>Ticlopidine - administration & dosage</subject><subject>Ticlopidine - analogs & derivatives</subject><subject>Ticlopidine - therapeutic use</subject><subject>Treatment Outcome</subject><issn>0735-1097</issn><issn>1558-3597</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkD1PwzAQhi0EoqXwE0AZEIIhYCdxYk8IVVCQKjEAUjfLsS_FVZoE26nUf4_7IWDjlrvhubtXD0LnBN8STPK7N1ykNCaYF9ec32CcZWk8O0BDQimLU8qLQzT8QQboxLkFxjhnhB-jAcGUhYkN0WRct53R7dxCHUkXSb3oG-XNCiLZeNPV0kMNPvKfYGW3jnRvTTOPVGvbRtp15DwErJmfoqNK1g7O9n2EPp4e38fP8fR18jJ-mMYqKxIflyTXRSoTTkqsEgYZq4BLVqqCKwqEaaVDFYxnGtOqTHOuM9CMJbwsEsnzdISudnc723714LxYGqegrmUDbe9EztNQOQ0g3YHKts5ZqERnzTJEFgSLjUGxNSg2egTnYmtQzMLexf5BXy5B_9naKQvA5R6QTsm6srJRxv1yhNM8TQJ2v8Mg2FgZsMIpA40CbSwoL3Rr_knyDaD7ju8</recordid><startdate>19991201</startdate><enddate>19991201</enddate><creator>Mishkel, Gregory J</creator><creator>Aguirre, Frank V</creator><creator>Ligon, Robert W</creator><creator>Rocha-Singh, Krishna J</creator><creator>Lucore, Charles L</creator><general>Elsevier Inc</general><general>Elsevier Science</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19991201</creationdate><title>Clopidogrel as adjunctive antiplatelet therapy during coronary stenting</title><author>Mishkel, Gregory J ; Aguirre, Frank V ; Ligon, Robert W ; Rocha-Singh, Krishna J ; Lucore, Charles L</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c472t-b16d73a291b0c28e48fe9a8bc79c5e18dcdddd7894d05fb369d4ed8829b72a963</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>Administration, Oral</topic><topic>Aged</topic><topic>Angioplasty, Balloon, Coronary - methods</topic><topic>Aspirin - administration & dosage</topic><topic>Aspirin - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Blood. Blood coagulation. Reticuloendothelial system</topic><topic>Clopidogrel</topic><topic>Coronary Angiography</topic><topic>Coronary Thrombosis - etiology</topic><topic>Coronary Thrombosis - prevention & control</topic><topic>Drug Therapy, Combination</topic><topic>Female</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>Length of Stay</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Odds Ratio</topic><topic>Pharmacology. Drug treatments</topic><topic>Platelet Aggregation Inhibitors - administration & dosage</topic><topic>Platelet Aggregation Inhibitors - therapeutic use</topic><topic>Platelet Glycoprotein GPIIb-IIIa Complex - antagonists & inhibitors</topic><topic>Prospective Studies</topic><topic>Safety</topic><topic>Stents - adverse effects</topic><topic>Ticlopidine - administration & dosage</topic><topic>Ticlopidine - analogs & derivatives</topic><topic>Ticlopidine - therapeutic use</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mishkel, Gregory J</creatorcontrib><creatorcontrib>Aguirre, Frank V</creatorcontrib><creatorcontrib>Ligon, Robert W</creatorcontrib><creatorcontrib>Rocha-Singh, Krishna J</creatorcontrib><creatorcontrib>Lucore, Charles L</creatorcontrib><creatorcontrib>for Prairie Cardiovascular Consultants Ltd</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American College of Cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mishkel, Gregory J</au><au>Aguirre, Frank V</au><au>Ligon, Robert W</au><au>Rocha-Singh, Krishna J</au><au>Lucore, Charles L</au><aucorp>for Prairie Cardiovascular Consultants Ltd</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clopidogrel as adjunctive antiplatelet therapy during coronary stenting</atitle><jtitle>Journal of the American College of Cardiology</jtitle><addtitle>J Am Coll Cardiol</addtitle><date>1999-12-01</date><risdate>1999</risdate><volume>34</volume><issue>7</issue><spage>1884</spage><epage>1890</epage><pages>1884-1890</pages><issn>0735-1097</issn><eissn>1558-3597</eissn><coden>JACCDI</coden><abstract>OBJECTIVES
We examined the procedural and 30-day clinical outcomes among patients receiving aspirin and either ticlopidine or clopidogrel during coronary stenting.
BACKGROUND
Ticlopidine-plus-aspirin has become standard antiplatelet therapy for the prevention of thrombotic complications after coronary stenting. Clopidogrel has a similar mechanism of action as ticlopidine, but both its efficacy and its safety as a pharmacologic adjunct to coronary stenting have not been well described.
METHODS
This single-center, prospective analysis examined the in-hospital procedural and 30-day clinical outcomes among 875 consecutive patients undergoing coronary stenting who received adjunctive aspirin and either clopidogrel (n = 514; 58.7%) or ticlopidine (n = 361; 41.3%) therapy.
RESULTS
Procedural success rates were similar among the clopidogrel- (99.6%) and ticlopidine-treated patients (99.4%). Subacute stent thrombosis (i.e., >24 h ≤30 days) occurred in one clopidogrel-treated (0.2%) and in one ticlopidine-treated (0.3%) patient (p = 0.99). By 30 days following the index procedure, the combined rates of death, nonfatal myocardial infarction and need for target vessel revascularization were similar among patients who received either clopidogrel (2.1%) or ticlopidine (1.4%; p = 0.57) therapy.
CONCLUSIONS
In this analysis the antiplatelet combination therapy of aspirin-plus-clopidogrel was an effective regimen for preventing thrombotic complications and major adverse cardiovascular events among a broad spectrum of patients undergoing coronary artery stenting.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>10588198</pmid><doi>10.1016/S0735-1097(99)00443-X</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| issn | 0735-1097 1558-3597 |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; ScienceDirect Journals (5 years ago - present); Alma/SFX Local Collection |
| subjects | Administration, Oral Aged Angioplasty, Balloon, Coronary - methods Aspirin - administration & dosage Aspirin - therapeutic use Biological and medical sciences Blood. Blood coagulation. Reticuloendothelial system Clopidogrel Coronary Angiography Coronary Thrombosis - etiology Coronary Thrombosis - prevention & control Drug Therapy, Combination Female Hospital Mortality Humans Length of Stay Male Medical sciences Middle Aged Odds Ratio Pharmacology. Drug treatments Platelet Aggregation Inhibitors - administration & dosage Platelet Aggregation Inhibitors - therapeutic use Platelet Glycoprotein GPIIb-IIIa Complex - antagonists & inhibitors Prospective Studies Safety Stents - adverse effects Ticlopidine - administration & dosage Ticlopidine - analogs & derivatives Ticlopidine - therapeutic use Treatment Outcome |
| title | Clopidogrel as adjunctive antiplatelet therapy during coronary stenting |
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