Cordis Coronary Stenting without Anticoagulation: Multicenter Results in Korea

Park, Seong Wook; Park, Seung Jung; Hong, Myeong Ki; Kim, Jae Joong

Abstract

BACKGROUND
Systemic anticoagulation therapy has been recommended to prevent subacute thrombosis after intracoronary stening. Recent data, however, suggest that antiplatelet therapy might be an effective alternative to anticoagulation therapy. We evaluated the effect of antithrombotic regimens on subacute thrombosis and short-term clinical course after successful implantation of Cordis coronary stent, which is a flexible, balloon expandable, radiopaque tantalum stent. METHOD: Two hundred and seventy-five consecutive patients with 290 lesions were treated with 356 Cordis stents implantation. According to post-stent antithrombotic regimen, patients were divided into three groups ; 165 patients with 175 lesions received aspirin 200mg/day, ticlopidine 500mg/day and warfarin for one month(Group 1), 66 patients with 69 lesions received aspirin and ticlopidine(Group 2) and 44 patients with 46 lesions received aspirin alone(Group 3) after successful Cordis stenting.
RESULTS
The overall procidural success rates were 97.7% in group 1, 98.6% in group 2 and 100% in group 3. More than 65 percents of the patients were eligible for elective stenting aspirin, ticlopidine and warfarin, 0% in patients with aspirin and ticlopidine, and 6.8% in patients assigned to the treatment with aspirin alone.
CONCLUSION
The Cordis coronary stent is an effective endovascular stent in various clinical indications including unstable angina and acute myocardial infarction. Antiplatelet therapy using aspirin and ticlopidine after successful Cordis coronary stenting is promising alternative to anticoagulation therapy to overcome the drawbacks of stenting. However, post-stent antithrombotic therapy with aspirin alone is associated with significant rate of stent thrombosis.