Effectiveness of clopidogrel and aspirin versus ticlopidine and aspirin in preventing stent thrombosis after coronary stent implantation

Issam Moussa, Mathew Oetgen, Gary Roubin, Antonio Colombo, Xangdong Wang, Sriram Iyer, Roberta Maida, Michael Collins, Edward Kreps, Jeffrey W. Moses

Research output: Contribution to journalArticlepeer-review

Abstract

Background - Ticlopidine has been shown to reduce the incidence of stent thrombosis compared with warfarin, but it may cause serious hematological side effects. Clopidogrel, a new thienopyridine derivative, may be a safe alternative to ticlopidine. The aim of this study was to compare the safety and efficacy of clopidogrel and aspirin with those of ticlopidine and aspirin in patients undergoing coronary stent implantation. Methods and Results - The population of this study consisted of 2 groups: patients who underwent coronary stenting and were treated with ticlopidine and aspirin (TA group, n=1406), and patients who underwent coronary stenting followed by treatment with clopidogrel and aspirin (CA group, n=283). At 1-month follow-up, there was no difference in stem thrombosis (1.5% versus 1.4%, P=1.0) or major adverse cardiac events (3.1% versus 2.4%, P=0.85) between the TA and CA groups, respectively. The probability of any side effect (neutropenia, diarrhea, rash) was significantly higher in the TA group (10.6% versus 5.3%, P=0.006; relative risk, 0.53; CI, 0.32 to 0.86). Conclusions - These data suggest that clopidogrel may be an effective pharmacological regimen after coronary stent implantation. Furthermore, the simpler dosing regimen, the absence of neutropenia, and the lower frequency of other side effects make it a safe alternative to ticlopidine.

Original languageEnglish
Pages (from-to)2364-2366
Number of pages3
JournalCirculation
Volume99
Issue number18
Publication statusPublished - May 11 1999

Keywords

  • Clopidogrel
  • Stents
  • Ticlopidine

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

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