Coronary stenting in stable patients: Identification of a low-risk subgroup that may not require adjunctive antiplatelet therapy

• Published in: Catheterization and cardiovascular interventions 2003-04, Vol.58 (4), p.459-466
• Main Authors: Mann, Tift, Cubeddu, Roberto J., Raynor, Laura, Bowen, Josie, Schneider, Joel E., Rose, Gregory, Cubeddu, Gabriela, Ali Raza, Jaffar, Jobe, Robert Lee, Newman, William, Zellinger, Micheal
• Format: Article
• Language: English
• Subjects: abciximab; Aged; Angioplasty, Balloon, Coronary - adverse effects; Angioplasty, Balloon, Coronary - methods; Antibodies, Monoclonal - administration & dosage; Biological and medical sciences; Blood. Blood coagulation. Reticuloendothelial system; Chemotherapy, Adjuvant; Combined Modality Therapy; Coronary Angiography; coronary artery disease; Coronary Disease - diagnostic imaging; Coronary Disease - etiology; Coronary Disease - therapy; coronary intervention; coronary intervention, abciximab; Diabetes Mellitus, Type 1 - complications; Diabetes Mellitus, Type 1 - diagnosis; Diabetic Angiopathies - complications; Diabetic Angiopathies - diagnosis; Female; Follow-Up Studies; Humans; Immunoglobulin Fab Fragments - administration & dosage; Male; Medical sciences; Pharmacology. Drug treatments; Probability; Prospective Studies; Reference Values; Risk Assessment; Severity of Illness Index; Stents; Survival Analysis; Ticlopidine - administration & dosage; Ticlopidine - analogs & derivatives; Treatment Outcome
• ISSN: 1522-1946; 1522-726X
• DOI: 10.1002/ccd.10479

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. Cathet Cardiovasc Intervent 2003;58: 459–466. © 2003 Wiley‐Liss, Inc.