title: Aspirin alone antiplatelet regimen after intracoronary placement of the Carbostent: the ANTARES study.
abstract: The effect of stent coatings in preventing early thrombotic occlusion remains to be proved. The purpose of this study was to evaluate the safety and efficacy of the Carbostent, a new coronary stent with a nonthrombogenic coating (Carbofilm), in 110 consecutive patients (73.6% men, mean age 61 +/- 9 years) who met prespecified clinical and angiographic inclusion criteria and were treated with aspirin monotherapy after stenting. Stable angina (75.5%), unstable angina (18.2%), and silent ischemia (6.3%) were clinical indications for coronary revascularization. Patients received 10,000 U of heparin and no IIb/IIIa inhibitors or postprocedural heparin. Complex lesion characteristics (B2, C) were present in 39 out of 129 (30.2%) lesions. Mean lesion length was 15.6 +/- 7.4 mm, and 32% of the lesions were >15 mm (range 16-52 mm). Small coronary vessels (<3.0 mm) were treated in 28% of the cases. A total of 165 Carbostent were used in 129 coronary lesions of the 110 patients. Single-vessel stenting was performed in 97 (88%) patients and multivessel stent placement in 13 (12%) patients. The mean length of the stented segment was 21 +/- 13 mm (range 9-95 mm). Procedural and clinical success was achieved in all patients. At 1-month follow-up, there were no stent thrombosis or other major adverse cardiac events. We observed 2 (1.8%) non-Q-wave myocardial infarctions and 2 (1.8%) vascular complications. This study indicates that the Carbostent may prevent stent thrombosis in selected patients treated with aspirin only. A randomized study comparing aspirin alone versus combined ticlopidine and aspirin after Carbostent implantation will be needed to confirm these results.
authors.affiliation: Centro Cardiologico Fondazione Monzino IRCCS, Institute of Cardiology, University of Milan, Via Parea 4, Milan, Italy. albartorelli@cardiologicomonzino.it
authors.forename: Antonio L
authors.initials: AL
authors.lastname: Bartorelli
authors.forename: Daniela
authors.initials: D
authors.lastname: Trabattoni
authors.forename: Piero
authors.initials: P
authors.lastname: Montorsi
authors.forename: Franco
authors.initials: F
authors.lastname: Fabbiocchi
authors.forename: Stefano
authors.initials: S
authors.lastname: Galli
authors.forename: Paolo
authors.initials: P
authors.lastname: Ravagnani
authors.forename: Luca
authors.initials: L
authors.lastname: Grancini
authors.forename: Sergio
authors.initials: S
authors.lastname: Cozzi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Loaldi
mesh_terms: D000328:Adult; D000368:Aged; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000209:etiology; D001241:Aspirin / Q000627:therapeutic use*; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation; D002244:Carbon / Q000627:therapeutic use; D020099:Coated Materials, Biocompatible / Q000627:therapeutic use*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000150:complications / Q000188:drug therapy / Q000601:surgery; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology; D013193:Stainless Steel; D015607:Stents; D013988:Ticlopidine / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D020099:Coated Materials, Biocompatible; D010975:Platelet Aggregation Inhibitors; D013193:Stainless Steel; D002244:Carbon; D013988:Ticlopidine; D001241:Aspirin