title: Coronary stenting for ST-elevation myocardial infarction vs. other indications in patients on oral anticoagulation: any difference in in-hospital management and outcome?
abstract: OBJECTIVE
  The aim of this paper was to compare the in-hospital management and outcome of patients on oral anticoagulation (OAC) undergoing coronary artery stenting (PCI-S) for ST-elevation myocardial infarction (STEMI) vs. other indications.
  
  
  METHODS
  One hundred and sixteen patients on OAC at the time of PCI-S who were prospectively enrolled in a multi-center, observational registry, were evaluated. Patients were segregated according to whether PCI-S was performed for STEMI (group 1) or other indications, such as non ST-elevation acute coronary syndromes, stable angina, silent ischemia, etc. (group 2), and the pharmacological and procedural management, as well as the in-hospital outcome, were compared.
  
  
  RESULTS
  No significant differences were observed in vascular access site, sheath size and type of stent implanted, nor was significantly different the use of glycoprotein IIb/IIIa inhibitors, and the use and dose of intravenous unfractionated heparin. Although not statistically different, the in-hospital occurrence of death (3.7% vs. 1.1%; OR 3.3; 95% confidence intervals [CI] 0.2-56.0), stent thrombosis (3.7% vs. 1.1%; OR 3.3; 95% CI 0.2-56.0) and major bleeding (7.4% vs. 2.2%; OR 3.4; 95% CI 0.4-25.9) was consistently about 3-fold higher in group 1.
  
  
  CONCLUSIONS
  The in-hospital pharmacological and procedural management of OAC patients undergoing PCI-S for STEMI vs. other indications appears not different. Although not significantly different however, the in-hospital occurrence of major bleeding, as well as of death and stent thrombosis, appears substantially higher in patients treated for STEMI, warranting therefore further larger, prospective studies.
authors: Division of Cardiology and Interventional Center, Santa Maria delle Croci Hospital, Ravenna, Italy. sabinevecchio@gmail.com
authors: S
authors: S
authors: Vecchio
authors: L
authors: L
authors: Zanolla
authors: J
authors: J
authors: Valencia
authors: M
authors: M
authors: Colletta
authors: A
authors: A
authors: Capecchi
authors: N
authors: N
authors: Franco
authors: G
authors: G
authors: Piovaccari
authors: M
authors: M
authors: Margheri
authors: G
authors: G
authors: Di Pasquale
authors: A
authors: A
authors: Rubboli
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000601:surgery*; D011446:Prospective Studies; D015607:Stents
chemical_list: D000925:Anticoagulants