Aspirin, Warfarin and a Thienopyridine for Acute Coronary Syndromes

Background: Although clopidogrel and aspirin (dual therapy, DT) are used for acute coronary syndrome (ACS), sometimes treatment with warfarin (triple therapy, TT) is required. Aim: To determine the incidence, complications, and outcomes of TT. Methods: We analyzed Israeli surveys of ACS from 2000 to...

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Bibliographic Details
Published inCardiology Vol. 105; no. 2; pp. 80 - 85
Main Authors Konstantino, Yuval, Iakobishvili, Zaza, Porter, Avital, Sandach, Amir, Zahger, Doron, Hod, Hanoch, Hammerman, Haim, Gottlieb, Shmuel, Behar, Solomon, Hasdai, David
Format Journal Article
LanguageEnglish
Published Basel, Switzerland S. Karger AG 01.01.2006
Subjects
Aspirin
Aspirin - adverse effects
Aspirin - therapeutic use
Cardiovascular disease
Coronary Disease - complications
Coronary Disease - drug therapy
Coronary Disease - mortality
Coronary vessels
Drug therapy
Drug Therapy, Combination
Female
Hematologic Agents - adverse effects
Hematologic Agents - therapeutic use
Humans
Male
Original Research
Pyridines - adverse effects
Pyridines - therapeutic use
Risk Factors
Syndrome
Ticlopidine - adverse effects
Ticlopidine - analogs & derivatives
Ticlopidine - therapeutic use
Ventricular Function
Warfarin - adverse effects
Warfarin - therapeutic use
Israel
Clopidogrel
Aspirin
Warfarin
Acute coronary syndromes
Mortality
Bleeding
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Summary:Background: Although clopidogrel and aspirin (dual therapy, DT) are used for acute coronary syndrome (ACS), sometimes treatment with warfarin (triple therapy, TT) is required. Aim: To determine the incidence, complications, and outcomes of TT. Methods: We analyzed Israeli surveys of ACS from 2000 to 2004. Results: In these surveys, 5,706 (96%) were discharged alive from hospital. Post-ACS TT and DT were 76 patients (1.3%) and 2,661 patients (46.7%), respectively. The TT group was older with more prior cardiac disease. During hospitalization, the TT patients received more intravenous anticoagulant and antithrombotic agents, and had more heart failure, arrhythmias, ischemia, and major bleeding (2.6 vs. 0.6%, p = 0.03). There were no differences in adjusted 30-day and 6-month mortality between the 2 groups. Conclusion: TT is feasible among ACS patients who require concomitant warfarin treatment.
ISSN:0008-6312
1421-9751
DOI:10.1159/000089548