Timing of Coronary stent thrombosis in patients treated with ticlopidine and aspirin

In patients receiving coronary stents treated with aspirin and coumadin, th e peak incidence of stent thrombosis occurs on the fifth and sixth days fol lowing the implantation procedure. little is known about the timing of sten t thrombosis in patients treated with aspirin and ticlopidine. We compared the timing of coronary stent thrombosis in patients treated with ticlopidin e and aspirin with the timing in those receiving coumadin and aspirin. A re trospective databank analysis was performed and 39 patients were identified who experienced stent thrombosis after successful coronary stent implantat ion. OF these, 21 held been treated with ticlopidine and aspirin and 18 wit h coumadin and aspirin therapy. The median time from stent implantation to stent thrombosis in the ticlopidine and aspirin group was 12 hours (interqu artile range 6 to 72 hours) compared with 4 days in the coumadin and aspiri n group (interquartile range 21 to 68 hours) (p <0.0001). There was no sign ificant difference between the timing of stent thrombosis in patients treat ed with abciximab in addition to ticlopidine and aspirin (median 17 hours, interquartile range 6 to 29) versus ticlopidine and aspirin patients who di d not receive abciximab (median 11 hours, interquartile range 9 to 12, p = 0.57). Thus, in patients who receive coronary stents, stent thrombosis occu rs much earlier after the procedure in patients treated with ticlopidine an d aspirin than in patients treated with anticoagulation therapy. (C) 1999 b y Excerpta Medico, Inc.