A Randomized Comparison of Antiplatelet and Anticoagulant Therapy after the Placement of Coronary-Artery Stents

• Published in: The New England journal of medicine Vol. 334; no. 17; pp. 1084 - 1089
• Main Authors: Schömig, Albert, Neumann, Franz-Josef, Kastrati, Adnan, Schühlen, Helmut, Blasini, Rudolf, Hadamitzky, Martin, Walter, Hanna, Zitzmann-Roth, Eva-Maria, Richardt, Gert, Alt, Eckhard, Schmitt, Claus, Ulm, Kurt
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 25.04.1996
• Subjects: Aged; Angioplasty; Angioplasty, Balloon, Coronary; Anticoagulants; Anticoagulants - therapeutic use; Aspirin; Aspirin - therapeutic use; Biological and medical sciences; Blood. Blood coagulation. Reticuloendothelial system; Coronary Disease - prevention & control; Coronary Disease - therapy; Drug therapy; Drug Therapy, Combination; Female; Heparin - therapeutic use; Humans; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Phenprocoumon - therapeutic use; Platelet Aggregation Inhibitors - therapeutic use; Postoperative Complications - epidemiology; Postoperative Complications - mortality; Postoperative Complications - prevention & control; Prospective Studies; Stents; Ticlopidine - therapeutic use; Ultrasonic imaging; Germany; Postoperative; Human; Toxicity; Treatment efficiency; Coronary artery; Instrumentation therapy; Cardiovascular disease; Anticoagulant; Coronary heart disease; Stent; Antiplatelet agent; Chemotherapy; Treatment; Comparative study
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJM199604253341702

Intracoronary stenting is an accepted treatment for vessel closure after percutaneous transluminal coronary angioplasty (PTCA). 1 – 3 Moreover, as compared with balloon angioplasty, elective stent placement reduces the rate of restenosis. 4 , 5 However, thrombotic occlusion of the stent, as well as hemorrhagic and peripheral vascular complications due to the intensive anticoagulation recommended for the first few weeks after the procedure, seriously limits the benefits of intracoronary stenting. 6 , 7 Recent studies with intravascular ultrasonography or coated stents suggest that anticoagulant therapy may be dispensable. 8 , 9 We recently identified a high level of surface expression of the inducible fibrinogen receptor on platelets as . . .