Safety and efficacy of aspirin, clopidogrel, and warfarin after coronary stent placement in patients with an indication for anticoagulation

James L. Orford, Panayotis Fasseas, Steven Melby, Kelli Burger, Steven R. Steinhubl, David R. Holmes, Peter B. Berger

Research output: Contribution to journalArticle

187 Scopus citations

Abstract

Background Dual antiplatelet therapy with aspirin and clopidogrel has replaced aspirin and systemic anticoagulation with warfarin as the preferred antithrombotic therapy after percutaneous coronary intervention (PCI) with stent placement. However, a number of patients have indications for all 3 drugs. We sought to determine the frequency and type of hemorrhagic complications in patients who undergo systemic anticoagulation with warfarin while receiving aspirin and clopidogrel after a PCI with stent placement. Methods We performed a retrospective analysis of the Mayo Clinic PCI database and identified 66 consecutive patients who were discharged from hospital after PCI between January 2000 and August 2002 (inclusive) receiving a combination of dual antiplatelet therapy (aspirin and clopidogrel) and systemic anticoagulation (warfarin) to determine the incidence of bleeding and other clinical events during the treatment period. Results Six patients (9.2%; 95% CI, 3.5-19.0) reported a bleeding event; 2 patients required a blood transfusion. No patient died or sustained a myocardial infarction or stent thrombosis. Conclusions The risk of bleeding may be increased in patients treated with aspirin, a thienopyridine, and warfarin early after PCI with stent placement.

Original languageEnglish (US)
Pages (from-to)463-467
Number of pages5
JournalAmerican heart journal
Volume147
Issue number3
DOIs
StatePublished - Mar 1 2004

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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