title: The prevention of minor myocardial injury with ticlopidine pretreatment in patients undergoing elective coronary stenting.
abstract: The aim of the study was to determine whether ticlopidine treatment prior the coronary stenting would be associated with lower rates of procedure-related minor myocardial injury (MMI) in patients undergoing elective coronary stenting. In this retrospective, nonrandomized, uncontrolled study, a total of 153 consecutive patients with a mean age of 63.4+/-8.9 years were divided into two groups based on the duration of ticlopidine treatment: group I (n=81), ticlopidine >/=3 days before the procedure, group II (n=72), on the same day as stent placement. Cardiac troponin T (cTnT) was measured immediately before and 12 h after the procedures. All patients were followed-up during the hospital stay with respect to MMI and major clinical events (MCE). The increase frequency and the amount of cTnT level in group I was found to be significantly lower compared with group II (4 vs. 13; P<0.01, and 0.35+/-0.06 vs. 0.52+/-0.11 ng/ml; P<0.01, respectively). In general, patients with elevated cTnT levels are more likely to have C type lesion and multivessel procedure than those of normal cTnT level (41 vs.10%; P<0.002 and 47 vs. 17%; P<0.009, respectively). Though there was a trend toward increased MCE rates in group II than that of group I, this did not reached statistical significance (3 vs.1; P=NS). The present study shows that an anti-platelet treatment with ticlopidine prior the coronary stenting of adequate duration to allow for the development of maximal inhibition is associated with a markedly decreased incidence of procedure-related MMI. Therefore, ticlopidine pretreatment may be a cost alternative for the prevention of platelet-rich microembolism in patients undergoing elective coronary stenting.
authors.affiliation: Ankara University Faculty of Medicine, Department of Cardiology, Ankara, Turkey. yusufatmaca1@yahoo.com
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Atmaca
authors.forename: Sadi
authors.initials: S
authors.lastname: Gülec
authors.forename: Fatih
authors.initials: F
authors.lastname: Ertas
authors.forename: Gülgün
authors.initials: G
authors.lastname: Pamir
authors.forename: Dervis
authors.initials: D
authors.lastname: Oral
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000379:methods; D016009:Chi-Square Distribution; D003327:Coronary Disease / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015428:Myocardial Reperfusion Injury / Q000517:prevention & control*; D011322:Primary Prevention / Q000379:methods; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D015607:Stents / Q000009:adverse effects*; D013988:Ticlopidine / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D013988:Ticlopidine