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Interventional Cardiology Clinics

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https://www.readbyqxmd.com/read/27886826/antiplatelet-and-anticoagulation-therapy-in-percutaneous-coronary-intervention
#1
EDITORIAL
Dominick J Angiolillo, Matthew J Price
No abstract text is available yet for this article.
January 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/27886825/antiplatelet-and-antithrombotic-therapy-in-patients-with-atrial-fibrillation-undergoing-coronary-stenting
#2
REVIEW
Mikhail S Dzeshka, Richard A Brown, Davide Capodanno, Gregory Y H Lip
Stroke prevention is the main priority in the management cascade of atrial fibrillation. Most patients require long-term oral anticoagulation (OAC) and may require percutaneous coronary intervention. Prevention of recurrent cardiac ischemia and stent thrombosis necessitate dual antiplatelet therapy (DAPT) for up to 12 months. Triple antithrombotic therapy with OAC plus DAPT of shortest feasible duration is warranted, followed by dual antithrombotic therapy of OAC and antiplatelet agent, and OAC alone after 12 months...
January 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/27886824/switching-p2y12-receptor-inhibiting-therapies
#3
REVIEW
Fabiana Rollini, Francesco Franchi, Dominick J Angiolillo
Antiplatelet therapy with aspirin and a P2Y12 receptor inhibitor is the cornerstone of treatment of patients with atherothrombotic disease manifestations. Switching between P2Y12 inhibitors occurs commonly in clinical practice for a variety of reasons, including safety, efficacy, adherence, and economic considerations. There are concerns about the optimal approach for switching because of potential drug interactions, which may lead to ineffective platelet inhibition and thrombotic complications, or potential overdosing due to overlap in drug therapy, which might cause excessive platelet inhibition and increased bleeding...
January 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/27886823/protease-activated-receptor-1-antagonists-post-percutaneous-coronary-intervention
#4
REVIEW
Pierluigi Tricoci
Thrombin is a potent platelet agonist, and protease-activated receptor-1 (PAR-1) is the main thrombin receptor in human platelets and thrombin. PAR-1 antagonism has attracted interest as a potential therapeutic target to reduce atherothrombotic events in patients with atherosclerotic disease, especially coronary artery disease. In this review, the author describes the rationale of PAR-1 antagonism for the reduction of atherothrombotic events and reviews the key phase 3 trial results, with special attention to analyses in percutaneous coronary intervention patients...
January 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/27886822/ticagrelor-effects-beyond-the-p2y12-receptor
#5
REVIEW
Wael Sumaya, Robert F Storey
Platelet P2Y12 receptor inhibitors are crucial in the treatment of patients with acute coronary syndrome or undergoing percutaneous coronary intervention. Ticagrelor is a reversibly binding, potent oral P2Y12 inhibitor that also is a weak inhibitor of the equilibrative nucleoside transporter-1 pathway for cellular adenosine uptake. It is hypothesized that ticagrelor has clinically relevant "off-target" effects, independent of its effect on platelet aggregation and thrombosis. This review considers the pleiotropic effects of ticagrelor and some of the possible mechanisms related to these effects...
January 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/27886821/cangrelor-pharmacology-clinical-data-and-role-in-percutaneous-coronary-intervention
#6
REVIEW
Matthew J Price
In clinical trials that assessed the safety and efficacy of cangrelor during percutaneous coronary intervention (PCI), cangrelor was administered as a 30-μg/kg bolus followed by a 4-μg/kg/min infusion for at least 2 hours or the duration of the PCI, whichever was longer. Cangrelor is currently indicated as an adjunct to PCI to reduce the risk of myocardial infarction, repeat coronary revascularization, and stent thrombosis in patients who have not been treated with a P2Y12 platelet inhibitor and are not being given a glycoprotein IIb/IIIa inhibitor...
January 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/27886820/optimal-duration-of-dual-antiplatelet-therapy-after-percutaneous-coronary-intervention
#7
REVIEW
Arjun Majithia, Deepak L Bhatt
Dual antiplatelet therapy (DAPT) is an essential component of treatment in patients with coronary artery disease treated with percutaneous coronary intervention (PCI). Recommendations for duration of DAPT after PCI should consider patient-specific risk, clinical presentation, stent characteristics, and procedural factors. Prolonged DAPT results in a reduction of stent thrombosis (ST) and myocardial infarction (MI) at the cost of increased bleeding. Studies of shorter-duration DAPT demonstrate similar mortality, MI, ST, and less bleeding when compared with longer DAPT duration...
January 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/27886819/current-role-of-platelet-function-testing-in-percutaneous-coronary-intervention-and-coronary-artery-bypass-grafting
#8
REVIEW
Lisa Gross, Dirk Sibbing
There is interindividual variability in the pharmacodynamic response to antiplatelet medications. High on-treatment platelet reactivity, reflecting a failure to achieve adequate platelet inhibition, is associated with a higher risk for thrombotic events. Low on-treatment platelet reactivity, or an enhanced response to antiplatelet medications, has been linked to a higher risk for bleeding. There is evidence for the prognostic value of platelet function testing for risk prediction. This review presents the current evidence regarding platelet function testing in patients undergoing percutaneous cardiac intervention and coronary artery bypass grafting...
January 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/27886818/genetic-determinants-of-p2y12-inhibitors-and-clinical-implications
#9
REVIEW
Larisa H Cavallari, Aniwaa Owusu Obeng
There is significant interpatient variability in clopidogrel effectiveness, which is due in part to cytochrome P450 (CYP) 2C19 genotype. Approximately 30% of individuals carry CYP2C19 loss-of-function alleles, which have been consistently shown to reduce clopidogrel effectiveness after an acute coronary syndrome and percutaneous coronary intervention. Guidelines recommend consideration of prasugrel or ticagrelor in these patients. A clinical trial examining outcomes with CYP2C19 genotype-guided antiplatelet therapy is ongoing...
January 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/27886817/antithrombotic-therapy-to-reduce-ischemic-events-in-acute-coronary-syndromes-patients-undergoing-percutaneous-coronary-intervention
#10
REVIEW
Freek W A Verheugt
Antithrombotic therapy is essential in the prevention of periprocedural death and myocardial infarction during and after percutaneous coronary intervention. In the pathogenesis of acute coronary syndromes (ACS), both platelets and the coagulation cascade play an important role. Therefore, periprocedural antithrombotic therapy is even more important in ACS than in elective PCI. The most used agents are aspirin, platelet P2Y12 blockers, platelet glycoprotein IIb/IIIa blockers, and parenteral anticoagulants. The P2Y12 blockers must be continued at least 12 months...
January 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/27886816/pretreatment-with-antiplatelet-agents-in-the-setting-of-percutaneous-coronary-intervention-when-and-which-drugs
#11
REVIEW
Davide Capodanno, Dominick J Angiolillo
Administering antiplatelet agents before coronary angiography to patients referred to elective or urgent percutaneous coronary intervention (PCI) requires a careful evaluation of advantages and disadvantages associated with platelet inhibition to avoid overtreatment on one side and undertreatment on the other. The delicate balance between ischemic protection and bleeding demands the ability to undertake risk stratification and individualized decisions, which is particularly challenging in the setting of ad hoc PCI and urgent procedures...
January 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/27886815/antiplatelet-therapy-for-secondary-prevention-after-acute-myocardial-infarction
#12
REVIEW
Ilaria Cavallari, Marc P Bonaca
Patients with prior myocardial infarction (MI) are at long-term heightened risk for recurrent ischemic events. Several large randomized controlled trials have demonstrated the benefit of more intensive antiplatelet strategies for long-term secondary prevention of cardiovascular death, recurrent MI, and stroke in patients with a history of MI at a cost of increased bleeding. The bleeding risk associated with long-term intensive antiplatelet strategies requires careful patient selection and involvement of patients in shared decision making regarding risks and benefits of therapy...
January 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/27886814/regulation-of-platelet-activation-and-coagulation-and-its-role-in-vascular-injury-and-arterial-thrombosis
#13
REVIEW
Maurizio Tomaiuolo, Lawrence F Brass, Timothy J Stalker
Hemostasis requires tightly regulated interaction of the coagulation system, platelets, blood cells, and vessel wall components at a site of vascular injury. Dysregulation of this response may result in excessive bleeding if the response is impaired, and pathologic thrombosis with vessel occlusion and tissue ischemia if the response is robust. Studies have elucidated the major molecular signaling pathways responsible for platelet activation and aggregation. Antithrombotic agents targeting these pathways are in clinical use...
January 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/27852491/transcatheter-mitral-valve-intervention
#14
(no author information available yet)
No abstract text is available yet for this article.
January 2016: Interventional cardiology clinics
https://www.readbyqxmd.com/read/27852490/contents
#15
(no author information available yet)
No abstract text is available yet for this article.
January 2016: Interventional cardiology clinics
https://www.readbyqxmd.com/read/27852489/a-revolution-in-transcatheter-mitral-valve-intervention
#16
EDITORIAL
Jason H Rogers
No abstract text is available yet for this article.
January 2016: Interventional cardiology clinics
https://www.readbyqxmd.com/read/27852488/contributors
#17
(no author information available yet)
No abstract text is available yet for this article.
January 2016: Interventional cardiology clinics
https://www.readbyqxmd.com/read/27852487/copyright
#18
(no author information available yet)
No abstract text is available yet for this article.
January 2016: Interventional cardiology clinics
https://www.readbyqxmd.com/read/27852486/interventional-cardiology-clinics
#19
Matthew J Price
No abstract text is available yet for this article.
January 2016: Interventional cardiology clinics
https://www.readbyqxmd.com/read/27852485/coronary-sinus-based-approach-to-mitral-regurgitation
#20
REVIEW
Steven L Goldberg, Christoph Hammerstingl
Functional, or secondary, mitral regurgitation (FMR) is clinically important because patient with congestive heart failure with FMR have worse clinical outcomes and associated higher risks than patients without FMR. There is interest in finding repair techniques which may modify the mitral valve dysfunction and reduce the clinical impact. Although several devices have taken advantage of the close anatomical relationship between the coronary sinus and the posterior annulus of the mitral valve, in order to provide a cinching force on the mitral annulus, only the Carillon device is currently in use in humans...
January 2016: Interventional cardiology clinics
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