Clopidogrel coronary stenting

Bertrand ME, Rupprecht HJ, Urban R Gershlick AH, Investigators FT, Double-blind study ofthe safety of clopidogrel with and without a loading dose in combination with aspirin compared with ticlopidine in combination with aspirin after coronary stenting the clopidogrel aspirin stent international cooperative study (CLASSICS). Circulation 2000 102 624-629,... 

Ahn JC, Song WH, Kwon JA, et al. Effects of cilostazol on platelet activation in coronary stenting patients who already treated with aspirin and clopidogrel. Korean J Int Med 2004 19 230-236. 

Gurbel PA, Bliden KR Hiatt BL, O Connor CM. Clopidogrel for coronary stenting response variability, drug resistance, and the effect of pretreatment platelet reactivity. Circulation 2003 107 2908-2913. 

Lee SW, Park SW, Hong MK, et al, Comparison of cilostazol and clopidogrel after successful coronary stenting. Am J Cardiol 2005 95(7) 859-862. 

Claeys MJ, Van der Planken MG, Bosmans JM, et al. Does pretreatment with aspirin and loading dose clopidogrel obviate the need for glycoprotein llb/llla antagonists during elective coronary stenting A focus on peri-procedural myonecrosis. Eur Heart J 2005 26(6) 567-575. 

The AHA/ASA guidelines recommend that antiplatelet therapy as the cornerstone of antithrombotic therapy for the secondary prevention of ischemic stroke and should be used in noncardioembolic strokes. Aspirin, clopidogrel, and extended-release dipyridamole plus aspirin are aU considered first-line antiplatelet agents (see Table 13-1). The combination of aspirin and clopidogrel can only be recommended in patients with ischemic stroke and a recent history of myocardial infarction or coronary stent placement and then only with ultra-low-dose aspirin to minimize bleeding risk. 

Orford JL, Fasseas P, Melby S, Burger K, Steinhubl SR, Holmes DR, Berger PB. Safety and efficacy of aspirin, clopidogrel, and warfarin after coronary stent placement in patients with an indication for anticoagulation. Am Heart J (2004) 147, 463-7. 

Serebruany VL, Mahnin AI, Calldian KP, Gurbel PA Steinhubl SR Statins do not affect platelet inhibition with clopidogrel during coronary stenting. A roscUrosis (2001) 159, 239-41. 

Liver A 63-year-old man developed fatal hepatocellular liver damage 19 days after starting to take clopidogrel after coronary stenting Although liver damage due... 

P A. Gurbel, C. M. O Connor, C. C. Cummings, V. L. Serebruany, Pharmacol. Res. 1999,40,107-111. Clopidogrel the future choice for preventing platelet activation during coronary stenting . 

Acute coronary syndrome For patients with acute coronary syndrome (unstable angina/non-Q-wave Ml) including patients who are to be managed medically and those who are to be managed with percutaneous coronary intervention (with or without stent) or coronary artery bypass graft (CABG), clopidogrel has been shown to decrease the rate of a combined endpoint of cardiovascular death. Ml, or stroke, as well as the rate of a combined endpoint of cardiovascular death. Ml, stroke, or refractory ischemia. 

I 5 Kastrati A, Mehilli J, Schuhlen H, et al. Intracoronary stenting and antithrombotic regimen-rapid eariy action for coronary treatment study investigators. A clinical trial of abciximab in elective percutaneous coronary intervention after pretreatment with clopidogrel. N Engl J Med 2004 350 232-238. 

Gorchakova O, von Beckerath N, Gawaz M, et al. Antiplatelet effects of a 600 mg loading dose of clopidogrel are not attenuated in patients receiving atorvastatin or simvastatin for at least 4 weeks prior to coronary artery stenting. Eur Heart J 2004 25 1898-1902. 

Muller C, Buttner HJ, Petersen J, Roskamm H. A randomized comparison of clopidogrel and aspirin versus ticlopidine and aspirin after the placement of coronary-artery stents. Circulation 2000 101 (6) 590—603. 

Ticlopidine is a thienopyridine derivative with potent antiplatelet activity associated with inhibition of ADP-induced platelet aggregation. It was first used in Europe in 1978 in the secondary prevention of stroke and coronary events, the treatment of peripheral vascular disease, and after vascular stent placement. However, the use of ticlopidine has been progressively restricted in some countries because of its serious adverse effects. It has largely been superseded by clopidogrel. 

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