Ticlopidine has a relatively high rate of side-effects (9.3%) after sirolimus-eluting stent implantation, highlighting the need for safer alternatives like clopidogrel.
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Ticlopidine side-effects may occur late, warranting prolonged vigilance; leaves open whether alternatives improve safety after stenting.
BACKGROUND: Because of its side-effects, long-term administration of ticlopidine limits the use of the sirolimus-eluting stent (SES) in Japan. METHODS AND RESULTS: Side-effects of ticlopidine occurred in 41 (9.3%) of 440 patients who underwent SES implantation. The majority were liver dysfunction (4.5%) and rash (3.6%). One patient died from severe liver dysfunction. Neutropenia occurred in 3 patients (0.7%). It is remarkable that 28% of side-effects occurred >8 weeks after the initiation of ticlopidine. CONCLUSIONS: Ticlopidine has a relative high rate of side-effects. Clopidogrel should be approved for prevention of stent thrombosis as soon as possible.
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Fukushima et al. (2007) studied this question.
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