RESULTS OF A CONSECUTIVE SERIES OF PATIENTS RECEIVING ONLY ANTIPLATELET THERAPY AFTER OPTIMIZED STENT IMPLANTATION - COMPARISON OF ASPIRIN ALONE VERSUS COMBINED TICLOPIDINE AND ASPIRIN THERAPY

Background Previous studies have shown that stents can be inserted in coronary arteries of patients who are subsequently treated safely with antiplatelet therapy only (ticlopidine and/or aspirin) with a low inc idence of stent thrombosis, provided that stent expansion is adequate and there are no other flow-limiting lesions present. However, it is u nknown whether ticlopidine combined with aspirin is superior to aspiri n alone in preventing stent thrombosis. Methods and Results From March 1993 through July 1995, 801 consecutive patients assigned to receive either aspirin therapy alone (ASA, 264 patients, 348 lesions) or a com bination of ticlopidine and aspirin (TIC-ASA, 537 patients, 737 lesion s) after a successful stent insertion, in most accomplished with intra vascular ultrasound guidance, were evaluated retrospectively. At 1 mon th, there was no difference in the ASA group compared with the TIC-ASA group in the rate of any stent thrombosis (1.9% versus 1.9%; P=1), su bacute stent thrombosis (1.9% versus 1.3%; P=.5), cumulative major adv erse clinical events (1.9% versus 2.0%; P=1), and peripheral vascular complications (0.5% versus 0.2%; P=.3). Medication side effects that r equired termination of antiplatelet therapy occurred only in 1.9% of p atients in the TIC-ASA group (P=.04). Conclusions At 1-month clinical follow-up, stent thrombosis and other adverse clinical outcomes were n ot significantly different between the ASA and TIC-ASA groups. Medicat ion side effects occurred only in patients treated with ticlopidine. T hese results provide further evidence of the safety of treatment with antiplatelet therapy only after optimal stent implantation and support the efficacy of aspirin alone in preventing stent thrombosis.