Dual antiplatelet therapy with clopidogrel and aspirin after carotid artery stenting

Deepak L. Bhatt, Samir R. Kapadia, Christopher T. Bajzer, Derek P. Chew, Khaled M. Ziada, Debabrata Mukherjee, Marco Roffi, Eric J. Topol, Jay S. Yadav

Research output: Contribution to journalArticle

109 Citations (Scopus)

Abstract

Background. Carotid artery stenting is being used as an alternative to carotid endarterectomy, both within the context of clinical trials and in non-surgical candidates. Though stcnting is known to activate platelets, the role of antithrombotic therapy in carotid stenting has not been fully characterized. Methods and Results. Consecutive patients (n = 162) were followed in a single-center carotid stent registry. The cumulative rate of 30-day death, stroke, transient ischemic attack and myocardial infarction in those patients receiving a thienopyridine was determined, as were rates of stent thrombosis and intracranial hemorrhage. The mean age of the patients was 70.3 years and there was an extremely high prevalence of cardiovascular comorbidities, including 40% with unstable angina. The carotid lesion was symptomatic in 59% of patients. The average pre-treatment stenosis was 83%. The cumulative 30-day rate of death, stroke, transient ischemic attack and myocardial infarction was 5.6%. Specifically, in the patients who received ticlopidine (n = 23), the rate was 13%, versus 43% in the patients who received clopidogrel (n = 139) (p = 0.01). In this series, there were no cases of stent thrombosis and 1 intracranial hemorrhage. Conclusion. Dual antiplatelet therapy with clopidogrel plus aspirin in patients receiving carotid artery stents is associated with a low rate of ischemic events. Furthermore, clopidogrel appears superior to ticlopidine. Thus, our findings lend support to the dual antiplatelet strategy of clopidogrel plus aspirin for patients undergoing carotid artery stenting.

Original languageEnglish
Pages (from-to)767-771
Number of pages5
JournalJournal of Invasive Cardiology
Volume13
Issue number12
Publication statusPublished - 1 Dec 2001
Externally publishedYes

Keywords

  • Aspirin
  • Carotid
  • Platelets
  • Stent

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Bhatt, D. L., Kapadia, S. R., Bajzer, C. T., Chew, D. P., Ziada, K. M., Mukherjee, D., ... Yadav, J. S. (2001). Dual antiplatelet therapy with clopidogrel and aspirin after carotid artery stenting. Journal of Invasive Cardiology, 13(12), 767-771.