Coronary stenting in stable patients: identification of a low-risk subgroup that may not require adjunctive antiplatelet therapy.
The present study prospectively evaluated adjunctive antiplatelet therapy in patients without insulin-requiring diabetes during elective coronary stenting. Three hundred patients were randomized to one of three treatment groups: clopidogrel pretreatment, adjunctive abciximab, or control. Stenting was successful in 98% and no deaths occurred. Thirty-day and 1-year major adverse coronary events (MACEs) was similar in all groups. A subgroup of 109 patients undergoing single-vessel stenting of type A/B1 lesions with short guidewire times had no postprocedure myocardial infarction or 30-day MACE. We conclude that patients with these characteristics may safely undergo elective coronary stenting without adjunctive antiplatelet therapy.
Mann
Tift
T
Wake Heart Center, Raleigh, North Carolina 27610, USA. wakeheartresearch@msn.com
Cubeddu
Roberto J
RJ
Raynor
Laura
L
Bowen
Josie
J
Schneider
Joel E
JE
Rose
Gregory
G
Cubeddu
Gabriela
G
Raza
Jaffar Ali
JA
Jobe
Robert Lee
RL
Newman
William
W
Zellinger
Micheal
M
D000077284:Abciximab; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000379:methods*; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D017024:Chemotherapy, Adjuvant; D000077144:Clopidogrel; D003131:Combined Modality Therapy; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000175:diagnosis; D003925:Diabetic Angiopathies / Q000150:complications / Q000175:diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000008:administration & dosage*; D008297:Male; D011336:Probability; D011446:Prospective Studies; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D015607:Stents; D016019:Survival Analysis; D013988:Ticlopidine / Q000008:administration & dosage* / Q000031:analogs & derivatives; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D007140:Immunoglobulin Fab Fragments; D000077144:Clopidogrel; D013988:Ticlopidine; D000077284:Abciximab