Ticlopidine coronary stenting

Barragan P Sainsous J, Silvestri M, et al. Ticlopidine and subcutaneous heparin as an alternative regimen following coronary stenting. Catheter Cardiovasc Diagn 1994 32 133-138. 

Bertrand ME, Legrand V Boland J, et al. Randomized multicenter comparison of conventional anticoagulation versus antiplatelet therapy in unplanned and elective coronary stenting, The full anti coagulation versus aspirin and ticlopidine (fantastic) study. Circulation I 998 98 1 597-1603. 

Urban P Macaya C, Rupprecht HJ, et al. Randomized evaluation of anticoagulation versus antiplatelet therapy after coronary stent implantation in high-risk patients the multicenter aspirin and ticlopidine trial after intracoronary stenting (MATTIS). Circulation 1998 98 2126-2132. 

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,... 

Brockmann MA, Gutensohn K, Bau J, et al. Influence of heparin coating of coronary stents and ex vivo efficacy of different doses of acetyl sal i cy I i c acid and ticlopidine in a pulsed floating model of recirculating human plasma. Platelets 2002 l3(8) 443-449. 

Kamishirado H, Inoue T Mizoguchi K, et al, Randomized comparison of cilostazol versus ticlopidine hydrochloride for antiplatelet therapy after coronary stent implantation for prevention of late restenosis. Am Heart J 2002 144(2) 303—308. 

Sekiguchi M, Hoshizaki H, Adachi H, Ohshima S, Taniguchi K, Kurabayashi M, Effects of antiplatelet agents on subacute thrombosis and restenosis after successful coronary stenting A randomized comparison of ticlopidine and cilostazol. Circ J 2004 68(7) 6I0-6I4,... 

Takeyasu N, Watanabe S, Noguchi Y Ishikawa K, Fumikura Y Yamaguchi I, Randomized comparison of cilostazol vs ticlopidine for antiplatelet therapy after coronary stenting, Circ J 2005 69(7) 780—785. 

In 43 322 patients treated with coronary stents and ticlopidine for 1 year there were 9 cases of thrombotic thrombocytopenic purpura (0.02%) (18). The risk of thrombotic thrombocjdopenic purpura during the use of ticlopidine after coronary stenting was 50-fold higher than in the general population. Ten other cases of thrombotic thrombocytopenic purpura related to ticlopidine were identified from the participating centers. Four of the 19 patients died, and all four deaths occurred in patients who were not treated with plasmapheresis. The authors stressed that early recognition and treatment is crucial for minimizing mortality. 

In a 1-year prospective study of 136 patients taking ticlopidine to prevent thrombosis after coronary stenting, 16 had adverse skin reactions (28). The most common were urticaria, pruritus, and maculopapular eruptions. Three patients had previously unreported reactions a fixed drug eruption, an eiythromelalgia-like eruption, and an erythema multiforme-hke eruption. 

Steinhubl SR, Tan WA, Foody JM, Topol EJ. Incidence and clinical course of thrombotic thrombocytopenic purpura due to ticlopidine following coronary stenting. EPISTENT Investigators. Evaluation of Platelet Ilb/IIIa Inhibitor for Stenting. JAMA 1999 281(9) 806-10. 

Yosipovitch G, Rechavia E, Feinmesser M, David M. Adverse cutaneous reactions to ticlopidine in patients with coronary stents. J Am Acad Dermatol 1999 41(3 Pt l) 473-6. 

Steinhubl SR, ElUs SG, Wolski K, et al. Ticlopidine pretreatment before coronary stenting is associated with sustained decrease in adverse cardiac events Data from the Evaluation of Platelet llb/llla Inhibitor for Stenting Trial (EPISTENT). Circulation 2001 103 1403-1409. 

Brown RIG, Cooper TG. Ticlopidine-carbamazepine interaction in a coronary stent patient... 

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. 

Tanabe Y Ito E, Nakagawa I, Suzuki K. Effect of cilostazol on restenosis after coronary angioplasty and stenting in comparison to conventional coronary artery stenting with ticlopidine, IntJ Cardiol 2001 78(3)285-291. 

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. 

Bennett CL, Davidson CJ, Raisch DW, et al. Thrombotic thrombocytopenic purpura associated wifii ticlopidine in the setting of coronary artery stents and stroke prevention. Arch Intern Med 1999 159 2524-2528. 

Yoon Y, Shim WH, Lee DH, et al Usefulness of cilostazol versus ticlopidine in coronary artery stenting. 

Clopidogrel and ticlopidine are effective in preventing transient ischemic attacks and ischemic strokes, especially in patients who cannot tolerate aspirin. These drugs prevent thrombosis in patients who have recently received a coronary artery stent. 

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