A randomized trial assessing the effect of coumarins started before coronary angioplasty on restenosis: results of the 6-month angiographic substudy of the Balloon Angioplasty and Anticoagulation Study (BAAS).
BACKGROUND
Thrombus formation during coronary angioplasty may play a role in the restenosis process.


METHODS
The effect of pretreatment with coumarins on 6-month angiographic outcome was studied. In addition, the effect of "optimal" anticoagulation, defined as an international normalized ratio >70% of the follow-up time in the target range, was studied. A total of 261 patients were assigned to aspirin alone (ASA group) and 270 patients to aspirin plus coumarins started 1 week before the procedure (coumarin group).


RESULTS
The mean international normalized ratio was 2.7 +/- 1.2 at the start of the procedure and 3.1 +/- 0.5 during follow up. Quantitative coronary analysis was performed on 301 lesions in the ASA group and of 297 lesions in the coumarin group. At 6 months, the minimal luminal diameter was similar in the ASA and coumarin groups. Optimal anticoagulation, however, was an independent predictor of a larger minimal luminal diameter at follow up (P =.01).


CONCLUSIONS
Overall, coumarins do not improve angiographic outcome 6 months after coronary angioplasty.
ten Berg
Jurriën M
JM
Department of Interventional Cardiology, St Antonius Hospital, Nieuwegein, The Netherlands. jurtenberg@wxs.nl
Kelder
Johannes C
JC
Suttorp
Maarten Jan
MJ
Verheugt
Freek W A
FW
Plokker
H W Thijs
HW
D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D001241:Aspirin / Q000008:administration & dosage; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control*; D003374:Coumarins / Q000008:administration & dosage*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011292:Premedication; D055502:Secondary Prevention; D016896:Treatment Outcome
D003374:Coumarins; D001241:Aspirin