Timing of coronary stent thrombosis in patients treated with prophylactic tirofiban

Abid R. Assali, Stefano Sdringola, Mohammad Ghani, Lynette A. Westbrook, H. Vernon Anderson, George Schroth, Kenichi Fujise, Richard W. Smalling, Oscar R. Rosales

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background. Acute and subacute stent thromboses (ASST) are the major thrombotic complications of coronary stenting. The time course of ASST seems to be related to the type of antithrombotic therapy (four days in patients treated with aspirin and coumadin compared to 12 hours with the use of aspirin and ticlopidine). In this report, we compared the timing of ASST in patients treated with aspirin, ticlopidine/clopidogrel, heparin and tirofiban with that in patients treated with the same drugs but without tirofiban. Methods. Retrospective analysis of the Hermann intervention database between January 1997 and October 1999 was performed. We identified 13 patients who required reintervention in the first week after a successful coronary stenting (≥ 1 stent). Four patients were treated with tirofiban (Group 1) and 9 were not (Group 2). Results. The median time from stent deployment to ASST was 7 hours (interquartile range, 2.5-33 hours) in group 2 compared to 84.5 hours (interquartile range, 56-124.5 hours) in group 1. The mean time from stent deployment to ASST was 90.3 ± 43.1 hours in group 1 versus 12.8 ± 15.3 hours in group 2 (p = 0.0005). All episodes of ASST occurred ≥ 3 days in patients treated with tirofiban, whereas they occurred in the first 2 days in all patients not treated with tirofiban. Conclusion. Prophylactic tirofiban treatment delays the time to stent thrombosis after successful coronary artery stent implantation for more than two days. Patients at high risk for stent thrombosis treated with short-acting glycoprotein IIb/IIIa platelet receptor inhibitors may warrant close follow-up during the first week after stenting.

Original languageEnglish (US)
Pages (from-to)460-463
Number of pages4
JournalJournal of Invasive Cardiology
Volume12
Issue number9
StatePublished - Sep 2000
Externally publishedYes

Fingerprint

tirofiban
Coronary Thrombosis
Stents
Thrombosis
Aspirin
Ticlopidine
clopidogrel

Keywords

  • Coronary stenting
  • Timing
  • Tirofiban

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Assali, A. R., Sdringola, S., Ghani, M., Westbrook, L. A., Vernon Anderson, H., Schroth, G., ... Rosales, O. R. (2000). Timing of coronary stent thrombosis in patients treated with prophylactic tirofiban. Journal of Invasive Cardiology, 12(9), 460-463.

Timing of coronary stent thrombosis in patients treated with prophylactic tirofiban. / Assali, Abid R.; Sdringola, Stefano; Ghani, Mohammad; Westbrook, Lynette A.; Vernon Anderson, H.; Schroth, George; Fujise, Kenichi; Smalling, Richard W.; Rosales, Oscar R.

In: Journal of Invasive Cardiology, Vol. 12, No. 9, 09.2000, p. 460-463.

Research output: Contribution to journalArticle

Assali, AR, Sdringola, S, Ghani, M, Westbrook, LA, Vernon Anderson, H, Schroth, G, Fujise, K, Smalling, RW & Rosales, OR 2000, 'Timing of coronary stent thrombosis in patients treated with prophylactic tirofiban', Journal of Invasive Cardiology, vol. 12, no. 9, pp. 460-463.
Assali AR, Sdringola S, Ghani M, Westbrook LA, Vernon Anderson H, Schroth G et al. Timing of coronary stent thrombosis in patients treated with prophylactic tirofiban. Journal of Invasive Cardiology. 2000 Sep;12(9):460-463.
Assali, Abid R. ; Sdringola, Stefano ; Ghani, Mohammad ; Westbrook, Lynette A. ; Vernon Anderson, H. ; Schroth, George ; Fujise, Kenichi ; Smalling, Richard W. ; Rosales, Oscar R. / Timing of coronary stent thrombosis in patients treated with prophylactic tirofiban. In: Journal of Invasive Cardiology. 2000 ; Vol. 12, No. 9. pp. 460-463.
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abstract = "Background. Acute and subacute stent thromboses (ASST) are the major thrombotic complications of coronary stenting. The time course of ASST seems to be related to the type of antithrombotic therapy (four days in patients treated with aspirin and coumadin compared to 12 hours with the use of aspirin and ticlopidine). In this report, we compared the timing of ASST in patients treated with aspirin, ticlopidine/clopidogrel, heparin and tirofiban with that in patients treated with the same drugs but without tirofiban. Methods. Retrospective analysis of the Hermann intervention database between January 1997 and October 1999 was performed. We identified 13 patients who required reintervention in the first week after a successful coronary stenting (≥ 1 stent). Four patients were treated with tirofiban (Group 1) and 9 were not (Group 2). Results. The median time from stent deployment to ASST was 7 hours (interquartile range, 2.5-33 hours) in group 2 compared to 84.5 hours (interquartile range, 56-124.5 hours) in group 1. The mean time from stent deployment to ASST was 90.3 ± 43.1 hours in group 1 versus 12.8 ± 15.3 hours in group 2 (p = 0.0005). All episodes of ASST occurred ≥ 3 days in patients treated with tirofiban, whereas they occurred in the first 2 days in all patients not treated with tirofiban. Conclusion. Prophylactic tirofiban treatment delays the time to stent thrombosis after successful coronary artery stent implantation for more than two days. Patients at high risk for stent thrombosis treated with short-acting glycoprotein IIb/IIIa platelet receptor inhibitors may warrant close follow-up during the first week after stenting.",
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AU - Assali, Abid R.

AU - Sdringola, Stefano

AU - Ghani, Mohammad

AU - Westbrook, Lynette A.

AU - Vernon Anderson, H.

AU - Schroth, George

AU - Fujise, Kenichi

AU - Smalling, Richard W.

AU - Rosales, Oscar R.

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N2 - Background. Acute and subacute stent thromboses (ASST) are the major thrombotic complications of coronary stenting. The time course of ASST seems to be related to the type of antithrombotic therapy (four days in patients treated with aspirin and coumadin compared to 12 hours with the use of aspirin and ticlopidine). In this report, we compared the timing of ASST in patients treated with aspirin, ticlopidine/clopidogrel, heparin and tirofiban with that in patients treated with the same drugs but without tirofiban. Methods. Retrospective analysis of the Hermann intervention database between January 1997 and October 1999 was performed. We identified 13 patients who required reintervention in the first week after a successful coronary stenting (≥ 1 stent). Four patients were treated with tirofiban (Group 1) and 9 were not (Group 2). Results. The median time from stent deployment to ASST was 7 hours (interquartile range, 2.5-33 hours) in group 2 compared to 84.5 hours (interquartile range, 56-124.5 hours) in group 1. The mean time from stent deployment to ASST was 90.3 ± 43.1 hours in group 1 versus 12.8 ± 15.3 hours in group 2 (p = 0.0005). All episodes of ASST occurred ≥ 3 days in patients treated with tirofiban, whereas they occurred in the first 2 days in all patients not treated with tirofiban. Conclusion. Prophylactic tirofiban treatment delays the time to stent thrombosis after successful coronary artery stent implantation for more than two days. Patients at high risk for stent thrombosis treated with short-acting glycoprotein IIb/IIIa platelet receptor inhibitors may warrant close follow-up during the first week after stenting.

AB - Background. Acute and subacute stent thromboses (ASST) are the major thrombotic complications of coronary stenting. The time course of ASST seems to be related to the type of antithrombotic therapy (four days in patients treated with aspirin and coumadin compared to 12 hours with the use of aspirin and ticlopidine). In this report, we compared the timing of ASST in patients treated with aspirin, ticlopidine/clopidogrel, heparin and tirofiban with that in patients treated with the same drugs but without tirofiban. Methods. Retrospective analysis of the Hermann intervention database between January 1997 and October 1999 was performed. We identified 13 patients who required reintervention in the first week after a successful coronary stenting (≥ 1 stent). Four patients were treated with tirofiban (Group 1) and 9 were not (Group 2). Results. The median time from stent deployment to ASST was 7 hours (interquartile range, 2.5-33 hours) in group 2 compared to 84.5 hours (interquartile range, 56-124.5 hours) in group 1. The mean time from stent deployment to ASST was 90.3 ± 43.1 hours in group 1 versus 12.8 ± 15.3 hours in group 2 (p = 0.0005). All episodes of ASST occurred ≥ 3 days in patients treated with tirofiban, whereas they occurred in the first 2 days in all patients not treated with tirofiban. Conclusion. Prophylactic tirofiban treatment delays the time to stent thrombosis after successful coronary artery stent implantation for more than two days. Patients at high risk for stent thrombosis treated with short-acting glycoprotein IIb/IIIa platelet receptor inhibitors may warrant close follow-up during the first week after stenting.

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