Early Stent Thrombosis

Cook, Stéphane; Windecker, Stephan

doi:10.1161/circulationaha.108.842757

Cited by 57 publications

(10 citation statements)

References 21 publications

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“…[72][73][74][75] Concomitantly, a number of studies compared a new strategy, aspirin plus ticlopidine, to the previously most successful strategy of aspirin plus warfarin in patients undergoing stent placement. A Cochrane systematic review of four randomized trials including 2,436 patients found that a 30-to 42-day course of ticlopidine plus aspirin vs warfarin plus aspirin reduced the 30-to 42-day risk of nonfatal MI (RR, 0.50; 95% CI, 0.30-0.83; number needed to treat, 55) and revascularization (RR, 0.29; 95% CI, 0.16-0.56; number needed to treat, 33), with a possible reduction in major bleeding (RR, 0.36; 95% CI, 0.14-1.02).…”

Section: Short-term Dual Antiplatelet Therapy (Thienopyridine and Aspmentioning

confidence: 99%

Primary and Secondary Prevention of Cardiovascular Disease

Vandvik

Lincoff

Gore

et al. 2012

Chest

415

118

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Section: Short-term Dual Antiplatelet Therapy (Thienopyridine and Aspmentioning

confidence: 99%

Primary and Secondary Prevention of Cardiovascular Disease

Vandvik

Lincoff

Gore

et al. 2012

Chest

415

118

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“…Not taking this phenomenon into account may lead to stent undersizing, a predictor of clinical events. 4,5 The goal of this study is to investigate the influence of acute changes in coronary pressure on the dimensions of the epicardial coronary arteries. Coronary vasomotion was offset by administration of nitrates and resting coronary blood flow was assumed to remain constant.…”

mentioning

confidence: 99%

Pressure–Diameter Relationship in Human Coronary Arteries

Müller

Pyxaras²,

Trana³

et al. 2012

Circ: Cardiovascular Interventions

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Background-To quantify the changes in arterial dimensions after the acute changes in pressure associated with percutaneous coronary intervention (PCI). Methods and Results-Forty-eight patients with one angiographically moderate-to-severe stenosis were included in the study. The pressure proximal and distal to the stenosis and the arterial diameter proximal and distal to the stenosis were measured at baseline, after intracoronary nitrates, and after stent PCI. In addition, in 8 patients distal pressure and coronary diameter were assessed while graded, controlled stenoses were created in the stented segment by progressive inflation of a balloon catheter. The mean diameter of the proximal coronary segment was 2.75±0.08 mm, 2.92±0.08 mm (+7.4%), and 3.10±0.07 mm (+14.7%) at baseline, after nitrates and after PCI, respectively (P<0.001). The mean diameter of the distal coronary segment was 2.07±0.09 mm, 2.23±0.09 mm (+9.7%), and 2.5±0.07 mm (+28.4%) at baseline, after nitrates and after PCI, respectively (P<0.001). The increase in distal diameter correlated significantly with the increase in distal pressure after PCI (r 2 =0.57; P<0.001). When graded stenoses were created, a decrease in diameter of 18±4% was observed with a pressure drop of 43±5 mm Hg. Conclusions-The diameter of coronary arteries markedly varies with their distending pressure. After re-establishment of a normal distending pressure by stenting of severe coronary stenoses, a proportional increase in vessel diameter is observed. This should be taken into account when choosing the stent diameter and is an argument to discourage direct stenting. (Circ Cardiovasc Interv. 2012;5:791-796.)

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“…4 The rate of early stent thrombosis increases along the continuum from elective to primary PCI: 0.4% in elective PCI, 1.4% in urgent PCI for NSTEMI, and 3.1% in primary PCI (Table 1). 10 …”

Section: The Central Role Of Platelets In Outcomes After Pci: Stent Tmentioning

confidence: 99%

Antiplatelet Therapy in Percutaneous Coronary Intervention

Wang

Rao

2016

Interventional Cardiology Clinics

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Platelets play a key role in mediating stent thrombosis, the major cause of ischemic events in the immediate period following percutaneous coronary intervention (PCI). For this reason, antiplatelet therapy, started at the time of PCI and continued for at least 30 days afterwards, is the cornerstone of antithrombotic therapy after PCI. However, the use of antiplatelet agents increase bleeding risk, with more potent antiplatelet agents further increasing bleeding risk. For this reason, balancing prevention of ischemic events with risk of bleeding is fundamental to the effective use of antiplatelet agents. In the past 5 years, potent and fast-acting P2Y12 inhibitors have been introduced, and have augmented the antiplatelet armamentarium available to interventional cardiologists. In this review, we review the preclinical and clinical data surrounding these new agents, and discuss the significant questions and controversies that still exist regarding the optimal antiplatelet strategy.

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Early Stent Thrombosis

Cited by 57 publications

References 21 publications

Primary and Secondary Prevention of Cardiovascular Disease

Primary and Secondary Prevention of Cardiovascular Disease

Pressure–Diameter Relationship in Human Coronary Arteries

Antiplatelet Therapy in Percutaneous Coronary Intervention

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