A PILOT-STUDY OF THE EFFICACY OF TICLOPID INE IN THE EARLY PATENCY OFCORONARY EVENTS

Subacute thrombosis of coronary stents is the main complication of thi s technique. The authors studied the outcome of 387 patients and 400 c oronary arteries who underwent implantation of 427 stents between Dece mber 1989 and February 1994 and followed up one month after the proced ure : all patients receive 500 mg of ticlopidine daily from three days before angioplasty throughout the hospital period and continued for a t least one month. Anticoagulation with heparin was undertaken by the intravenous route after implantation and relayed with subcutaneous hep arin for one week until control coronary angiography performed in the first 300 patients. At one month, 96.9 % of patients were free of clin ical coronary events. The following major complications were observed : 5 deaths (1.3 %), 5 Q wave myocardial infarctions (1.3 %);no emergen cy bypass surgery. The peripheral vascular complication rate was 3.6 % . Univariate analysis three risk factors of subacute thrombosis : age (p = 0.0058), arterial diameter of less than 3 mm (p < 0.01) and impla ntation for occlusive dissection (p = 0.03). Multivariate analysis sho wed two independent risk factors : age (p = 0.001) and arterial diamet er of less than 3 mm (p = 0.01). This pilot study shows a particularly low subacute thrombosis rate in unselected indications with an accept able level of vascular complications