Scope of Bare Metal Stent in the Era of a Potent Newer Antiplatelet Drug ‘Ticagrelor’-Single Centre Observational Study (Sobeat Study)
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2018, Vol 6, Issue 12
Abstract
Abstract: Despite overwhelming data supporting the use of ticagrelor as an alternate potent antiplatelet agent in percutaneous intervention (PCI) with drug eluting stent (DES), to the best of our knowledge there is no study which assessed safety and efficacy of ticagrelor in PCI with bare metal stent (BMS). We aimed to study ticagrelor in cases of PCI with BMS in terms of primary (major adverse cardiac events composite of myocardial infarction, unplanned revascularization and stroke) and secondary (in-stent restenosis, re-hospitalisation, minor bleed and drug switch) end points. This is a prospective, single center, open label observational study conducted between Feb 2016 to July 2016 at post graduate department of cardiology JLN medical college, Ajmer in patients undergoing primary or elective PCI .Total 276 patients were included in the study. Ticagrelor was given in recommended doses with aspirin 75 mg once daily. Procedure was done by upper arm access. Major adverse cardiovascular events occurred at 6 month in 11 patients (0.05%). Quantitative angiography revealed the different values of BMS stented lesion as minimal luminal diameter (mm), before procedure, after procedure, and at 6 month were 0.94±0.31, 2.43±0.41, and 2.12±0.49 respectively, in our study. The trial of the BMS with dual anti-platelets ticagrelor with aspirin reported an average late loss well below the expected historical range, where mean instent late loss is -0.31-/+0.33 mm which corresponded to a Binary angiographic restenosis rate of 8.8%. Total 78 (28.0%) patients switched out of 276 study persons. Switch was more common in people of low socio-economic status particularly in non-educated patients. This study results offer more freedom to clinicians to select the either BMS or DES if patient’s economic status allow using newer potent antiplatelet ticagrelor to be added on top of aspirin for patients with PCI.
Authors and Affiliations
Ram Sagar Roy, Anita Kumari, R. K Gokhroo
Keywords
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