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Antithrombotic therapy for elective percutaneous coronary intervention: Clinical studies

Thomas Levin, MD
Section Editor
Donald Cutlip, MD
Deputy Editor
Gordon M Saperia, MD, FACC


Intracoronary thrombosis and the attendant risk of myocardial ischemia or infarction may occur soon after percutaneous coronary intervention with stent implantation. Trauma to the coronary endothelium (with the exposure of tissue factors to blood) and placement of metal (which is procoagulant) stents are causative. Stent thrombosis can be a life-threatening event. (See "Coronary artery stent thrombosis: Clinical presentation and management" and "Coronary artery stent thrombosis: Incidence and risk factors".)

Antithrombotic therapy, with both antiplatelet and anticoagulant medications, is used to reduce the risk. Early studies of antithrombotic therapy demonstrated a reduction in early stent thrombosis. (See "Periprocedural complications of percutaneous coronary intervention" and "Coronary artery stent thrombosis: Incidence and risk factors".)

The clinical trials evaluating antithrombotic therapy at the time of stent implantation will be reviewed here. Recommendations for the use of such therapy in stable patients and the use of antiplatelet and anticoagulant strategies in patients with acute coronary syndromes are discussed separately. (See "Antithrombotic therapy for elective percutaneous coronary intervention: General use" and "Antiplatelet agents in acute ST elevation myocardial infarction" and "Antiplatelet agents in acute non-ST elevation acute coronary syndromes" and "Anticoagulant therapy in non-ST elevation acute coronary syndromes" and "Anticoagulant therapy in acute ST elevation myocardial infarction".)

The discussion of and the recommendations for long-term dual antiplatelet therapy is found elsewhere. (See "Coronary artery stent thrombosis: Incidence and risk factors".)


All patients receive periprocedural aspirin and a P2Y12 receptor blocker. A glycoprotein (GP) IIb/IIIa inhibitor is given to some patients.


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Literature review current through: Sep 2016. | This topic last updated: Sep 7, 2016.
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