Aspirin alone antiplatelet regimen after intracoronary placement of the Carbostent: the ANTARES study.
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.
Bartorelli
Antonio L
AL
Centro Cardiologico Fondazione Monzino IRCCS, Institute of Cardiology, University of Milan, Via Parea 4, Milan, Italy. albartorelli@cardiologicomonzino.it
Trabattoni
Daniela
D
Montorsi
Piero
P
Fabbiocchi
Franco
F
Galli
Stefano
S
Ravagnani
Paolo
P
Grancini
Luca
L
Cozzi
Sergio
S
Loaldi
Alessandro
A
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
D020099:Coated Materials, Biocompatible; D010975:Platelet Aggregation Inhibitors; D013193:Stainless Steel; D002244:Carbon; D013988:Ticlopidine; D001241:Aspirin