TY - JOUR
T1 - Dual Antiplatelet Therapy After Percutaneous Coronary Intervention With Stent Implantation in Patients Taking Chronic Oral Anticoagulation
AU - Rogacka, Renata
AU - Chieffo, Alaide
AU - Michev, Iassen
AU - Airoldi, Flavio
AU - Latib, Azeem
AU - Cosgrave, John
AU - Montorfano, Matteo
AU - Carlino, Mauro
AU - Sangiorgi, Giuseppe M.
AU - Castelli, Alfredo
AU - Godino, Cosmo
AU - Magni, Valeria
AU - Aranzulla, Tiziana C.
AU - Romagnoli, Enrico
AU - Colombo, Antonio
PY - 2008/2
Y1 - 2008/2
N2 - Objectives: The purpose of this study was to evaluate the safety of dual antiplatelet therapy in patients in whom long-term anticoagulation (AC) with warfarin is recommended. Background: The optimal antithrombotic strategy after percutaneous coronary intervention (PCI) for patients receiving AC is unclear. Methods: Consecutive patients who underwent stent implantation and were discharged on triple therapy (defined as the combination of aspirin and thienopyridines and AC) were analyzed. Results: Of the 127 patients with 224 lesions, 86.6% were men, with a mean age of 69.9 ± 8.8 years. Drug-eluting stents (DES) were positioned in 71 (55.9%), and bare-metal stents (BMS) were positioned in 56 (44.1%) patients. Atrial fibrillation (AF) was the main indication (59.1%) for AC treatment. The mean triple therapy duration was 5.6 ± 4.6 months, and clinical follow-up was 21.0 ± 19.8 months. During the triple therapy period, 6 patients (4.7%) developed major bleeding complications; 67% occurred within the first month. No significant differences between DES and BMS were observed in the incidence of major (5.6% vs. 3.6%, respectively, p = 1.0) and minor (1.4% vs. 3.6%, respectively, p = 0.57) bleeding and mortality (5.6% vs. 1.8%, respectively, p = 0.39). A significant difference was observed in favor of DES in target vessel revascularization (14.1% vs. 26.8%, p = 0.041). Conclusions: While receiving triple therapy, major bleeding occurred in 4.7% of patients; one-half of the events were lethal, and most occurred within the first month.
AB - Objectives: The purpose of this study was to evaluate the safety of dual antiplatelet therapy in patients in whom long-term anticoagulation (AC) with warfarin is recommended. Background: The optimal antithrombotic strategy after percutaneous coronary intervention (PCI) for patients receiving AC is unclear. Methods: Consecutive patients who underwent stent implantation and were discharged on triple therapy (defined as the combination of aspirin and thienopyridines and AC) were analyzed. Results: Of the 127 patients with 224 lesions, 86.6% were men, with a mean age of 69.9 ± 8.8 years. Drug-eluting stents (DES) were positioned in 71 (55.9%), and bare-metal stents (BMS) were positioned in 56 (44.1%) patients. Atrial fibrillation (AF) was the main indication (59.1%) for AC treatment. The mean triple therapy duration was 5.6 ± 4.6 months, and clinical follow-up was 21.0 ± 19.8 months. During the triple therapy period, 6 patients (4.7%) developed major bleeding complications; 67% occurred within the first month. No significant differences between DES and BMS were observed in the incidence of major (5.6% vs. 3.6%, respectively, p = 1.0) and minor (1.4% vs. 3.6%, respectively, p = 0.57) bleeding and mortality (5.6% vs. 1.8%, respectively, p = 0.39). A significant difference was observed in favor of DES in target vessel revascularization (14.1% vs. 26.8%, p = 0.041). Conclusions: While receiving triple therapy, major bleeding occurred in 4.7% of patients; one-half of the events were lethal, and most occurred within the first month.
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U2 - 10.1016/j.jcin.2007.11.004
DO - 10.1016/j.jcin.2007.11.004
M3 - Article
C2 - 19393145
AN - SCOPUS:41249083896
SN - 1936-8798
VL - 1
SP - 56
EP - 61
JO - JACC: Cardiovascular Interventions
JF - JACC: Cardiovascular Interventions
IS - 1
ER -