Restenosis after coronary stent placement and randomization to a 4-week combined antiplatelet or anticoagulant therapy: Six-month angiographic follow-up of the Intracoronary Stenting and Antithrombotic Regimen (ISAR) trial

Adnan Kastrati, Helmut Schühlen, Jörg Hausleiter, Hanna Walter, Eva Zitzmann-Roth, Martin Hadamitzky, Shpend Elezi, Kurt Ulm, Josef Dirschinger, Franz Josef Neumann, Albert Schömig

Research output: Contribution to journalArticlepeer-review

105 Scopus citations

Abstract

Background: Platelets and mural thrombus at the lesion site may play a key role in initiating the restenosis process after coronary interventions. The ISAR Trial provides a comparison of the outcomes of patients randomized to two different antithrombotic regimens administered for 4 weeks after successful coronary stent placement; combined antiplatelet therapy (aspirin plus ticlopidine) or a conventional anticoagulant regiment (phenprocoumon with initial overlapping heparin plus aspirin). Within the first 4 weeks after stent placement, combined antiplatelet therapy has been associated with a significant reduction of ischemic complications. In the present study, we examined whether combined antiplatelet therapy administered for 4 weeks after stent placement is able to reduce the process of restenosis at 6 months. Methods and Results: of 517 patients initially randomized, 496 were eligible for 6-month angiographic follow-up. Scheduled angiography was performed in 432 of the eligible patients (87.1%), 216 in each group. In a comparison of the two groups, there were no significant differences in clinical and procedural variables or in qualitative and quantitative lesion characteristics before and after stenting. At 6 months, minimal luminal diameter was 1.95 ± 0.86 mm in the group with initial combined antiplatelet therapy and 1.90 ± 0.87 mm in the group with initial anticoagulant therapy (P=.55). Late lumen loss was 1.10 ± 0.81 and 1.15±0.75 mm (P=.54), and the restenosis rate was 26.8% and 28.9%, respectively (P=.70). Target lesion revascularization rate was 14.6% in the antiplatelet therapy group and 15.6% in the anticoagulant therapy group (P=.85). Conclusions: This study shows that combined antiplatelet therapy (aspirin plus ticlopidine) administered for 4 weeks after coronary Palmaz-Schatz stent placement does not result in a detectable benefit for the prevention of restenosis compared with conventional anticoagulant therapy (phenprocoumon with initial overlapping heparin plus aspirin).

Original languageEnglish
Pages (from-to)462-467
Number of pages6
JournalCirculation
Volume96
Issue number2
StatePublished - 15 Jul 1997

Keywords

  • Anticoagulants
  • Follow-up studies
  • Platelet aggregation inhibitors
  • Stents

Fingerprint

Dive into the research topics of 'Restenosis after coronary stent placement and randomization to a 4-week combined antiplatelet or anticoagulant therapy: Six-month angiographic follow-up of the Intracoronary Stenting and Antithrombotic Regimen (ISAR) trial'. Together they form a unique fingerprint.

Cite this