Complications after placement of an intracoronary stent: nursing implications

BACKGROUND: Care of patients after stent placement has evolved with the goal of reducing thrombosis and bleeding. Initially, all patients received full antithrombotic therapy; now most receive antiplatelet therapy only. Despite this evolution, no description of the differences in complications and nursing care with these two treatments has been published. OBJECTIVES: To determine the differences in complications and nursing care for patients receiving different pharmacological therapies after placement of an intracoronary stent. METHODS: A nonrandomized, noncontrolled, retrospective, comparative design was used with 176 sequential patients assigned to treatment groups on the basis of the adjunctive pharmacological therapy the patient received after placement of a stent. The equivalency of baseline characteristics and risk of complications, as well as the differences in length of stay, intensity of nursing care, and frequencies of bleeding and ischemic or thrombotic events were determined for the two groups: 65 patients who received anticoagulant therapy and 111 patients who received antiplatelet therapy. RESULTS: The two groups were equivalent with respect to baseline characteristics of sex, concomitant illness, and cardiac condition before stent placement. The two groups differed with respect to predisposing risks for bleeding and ischemic or thrombotic events. Patients receiving antiplatelet therapy alone had significantly shorter lengths of stay, less use of intensive care, fewer requirements for nursing care, and fewer bleeding complications, with no increase in ischemic or thrombotic events. CONCLUSIONS: Patients receiving anticoagulant therapy had more complications and required a higher intensity of nursing care than did patients who received antiplatelet therapy alone.