Comparison of Two Antiplatelet Regimens (Aspirin Alone Versus Aspirin + Ticlopidine or Clopidogrel) After Intracoronary Implantation of a Carbofilm-Coated Stent

Antonio Luca Bartorelli, Corrado Tamburino, Daniela Trabattoni, Alfredo Galassi, Roberto Serdoz, Imad Sheiban, Giancarlo Piovaccari, Marco Zimarino, Alberto Benassi, Carlo Di Mario, Pietro Sangiorgio, Sergio Chierchia, Bernhard Reimers

Research output: Contribution to journalArticlepeer-review

Abstract

Stent thrombosis (ST) is an infrequent (0.5% to 1.5%) complication of intracoronary stenting, with severe clinical consequences. This multicenter, randomized study evaluated the clinical outcome in 479 patients (598 lesions treated) who underwent elective coronary stenting with a Carbofilm-coated stent (CarboStent) who met prespecified eligibility criteria and were randomly assigned to receive aspirin alone (n = 235) or aspirin plus a thienopyridine antiplatelet regimen (n = 244). Clinical, angiographic, and procedural characteristics were similar between groups. The primary end point was the incidence of 30-day ST; secondary end points included major vascular or bleeding complications within 30 days and death, acute myocardial infarction, and target vessel revascularization at 6 months. ST occurred in 4 patients (1.4%) in the aspirin-only group and in 1 patient (0.3%) in the aspirin-plus-thienopyridine group (relative risk 0.23, 95% confidence interval 0.03 to 2.08, p = NS). After careful review of cases, 89 patients (19%) with protocol deviations were identified. When they were excluded from the analysis, no ST was observed in either group. Secondary end points were reached by 4% of the aspirin-alone group and 8% of the aspirin-plus-thienopyridine group (relative risk 2.35, 95% confidence interval 0.94 to 5.85, p = NS). In conclusion, after optimal intracoronary implantation of the CarboStent, antiplatelet therapy with aspirin alone was safe and provided efficacy comparable to aspirin plus a thienopyridine in the prevention of ST.

Original languageEnglish
Pages (from-to)1062-1066
Number of pages5
JournalThe American Journal of Cardiology
Volume99
Issue number8
DOIs
Publication statusPublished - Apr 15 2007

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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