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https://www.readbyqxmd.com/read/28528320/predicting-long-term-bleeding-risk-after-acute-coronary-syndrome-a-step-closer-to-optimising-dual-antiplatelet-therapy-duration
#1
EDITORIAL
Simon Wilson, David E Newby
No abstract text is available yet for this article.
May 20, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28489475/antithrombotic-strategies-for-preventing-long-term-major-adverse-cardiovascular-events-in-patients-with-non-valvular-atrial-fibrillation-who-undergo-percutaneous-coronary-intervention
#2
Manan Pareek, Deepak L Bhatt, Jürrien M Ten Berg, Steen D Kristensen, Erik L Grove
Balancing the risk of recurrent ischemia and bleeding among patients with non-valvular atrial fibrillation who undergo percutaneous coronary intervention (PCI) is challenging. Postprocedural antithrombotic therapy aims to reduce the risk related to coronary artery disease, stent placement, and atrial fibrillation, with acceptable risks of bleeding. Areas Covered: This brief review summarizes evidence and recommendations related to long-term antithrombotic strategies in such patients. An overview of the findings from recent meta-analyses and select observational studies is provided, and important completed and ongoing randomized trials are described in detail...
May 10, 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28475584/duration-of-dual-antiplatelet-therapy-in-patients-treated-with-percutaneous-coronary-intervention-for-coronary-chronic-total-occlusion
#3
Seung Hwa Lee, Jeong Hoon Yang, Seung-Hyuk Choi, Taek Kyu Park, Woo Jin Jang, Young Bin Song, Joo-Yong Hahn, Jin-Ho Choi, Hyeon-Cheol Gwon
BACKGROUND: The duration of dual antiplatelet therapy (DAPT) after drug-eluting stent implantation in coronary chronic total occlusion (CTO) remains unclear. METHODS: We retrospectively analyzed a total of 512 patients treated with percutaneous coronary intervention (PCI) in the Samsung Medical Center CTO registry. Patients were separated into ≤ 12-month (199, 38.9%) vs. > 12 month (313, 61.1%) based on DAPT duration with aspirin and clopidogrel. The primary outcome was major adverse cardiac and cerebrovascular event (MACCE) during follow-up...
2017: PloS One
https://www.readbyqxmd.com/read/28473118/extended-duration-dual-antiplatelet-therapy-after-coronary-stenting-among-patients-with-peripheral-arterial-disease-a-subanalysis-of-the-dual-antiplatelet-therapy-study
#4
Eric A Secemsky, Robert W Yeh, Dean J Kereiakes, Donald E Cutlip, P Gabriel Steg, Joseph M Massaro, Patricia K Apruzzese, Laura Mauri
OBJECTIVES: This study sought to determine whether patients with peripheral arterial disease (PAD) experience different reductions in ischemic event and increases in bleeding events with extended duration dual antiplatelet therapy versus those without PAD. BACKGROUND: Patients with PAD have increased ischemic and bleeding risks after coronary stenting. METHODS: The DAPT (Dual Antiplatelet Therapy) study randomized 11,648 patients free from ischemic and bleeding events 12 months after coronary stenting to continued thienopyridine plus aspirin therapy for an additional 18 months versus aspirin therapy alone...
May 8, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28454794/reduced-duration-of-dual-antiplatelet-therapy-using-an-improved-drug-eluting-stent-for-percutaneous-coronary-intervention-of-the-left-main-artery-in-a-real-world-all-comer-population-rationale-and-study-design-of-the-prospective-randomized-multicenter-ideal
#5
Miguel E Lemmert, Keith Oldroyd, Paul Barragan, Maciej Lesiak, Robert A Byrne, Evgeny Merkulov, Joost Daemen, Yoshinobu Onuma, Karen Witberg, Robert-Jan van Geuns
BACKGROUND: Continuous improvements in stent technology make percutaneous coronary intervention (PCI) a potential alternative to surgery in selected patients with unprotected left main coronary artery (uLMCA) disease. The optimal duration of dual antiplatelet therapy (DAPT) in these patients remains undetermined, and in addition, new stent designs using a bioabsorbable polymer might allow shorter duration of DAPT. STUDY DESIGN: IDEAL-LM is a prospective, randomized, multicenter study that will enroll 818 patients undergoing uLMCA PCI...
May 2017: American Heart Journal
https://www.readbyqxmd.com/read/28449432/should-we-reconsider-dual-antiplatelet-therapy-duration-following-bioresorbable-scaffold-angioplasty
#6
EDITORIAL
Dario Buccheri, Giuseppe Caramanno, Salvatore Geraci, Bernardo Cortese
No abstract text is available yet for this article.
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28431474/previous-hypertensive-hemorrhage-increases-the-risk-for-bleeding-and-ischemia-for-pci-patients-on-dual-antiplatelet-therapy
#7
Manli Qiao, Qi Bi, Paul Fu, Yixin Wang, Zhe Song, Fang Guo
OBJECTIVES: The use of antiplatelet therapy after intracerebral hemorrhage remains controversial, while the use of dual antiplatelet therapy (DAPT) is required after cardiac stenting. In this study, we examine the risk of bleeding and ischemic events for PCI patients with a history of hypertensive hemorrhage on DAPT. METHODS: A total of 128 cases and 153 controls were selected from Chinese patients with cardiac stenting on dual anti-platelet therapy for a single-center retrospective case-control study...
June 2017: Neurological Research
https://www.readbyqxmd.com/read/28427576/bleeding-related-deaths-in-relation-to-the-duration-of-dual-antiplatelet-therapy-after-coronary-stenting
#8
Tullio Palmerini, Letizia Bacchi Reggiani, Diego Della Riva, Mattia Romanello, Fausto Feres, Alexandre Abizaid, Martine Gilard, Marie-Claude Morice, Marco Valgimigli, Myeong-Ki Hong, Byeong-Keuk Kim, Yangsoo Jang, Hyo-Soo Kim, Kyung Woo Park, Antonio Colombo, Alaide Chieffo, Jung-Min Ahn, Seung-Jung Park, Stefanie Schüpke, Adnan Kastrati, Gilles Montalescot, Philippe Gabriel Steg, Abdourahmane Diallo, Eric Vicaut, Gerard Helft, Giuseppe Biondi-Zoccai, Bo Xu, Yaling Han, Philippe Genereux, Deepak L Bhatt, Gregg W Stone
BACKGROUND: Although some randomized controlled trials (RCTs) and meta-analyses have suggested that prolonged dual-antiplatelet therapy (DAPT) may be associated with increased mortality, the mechanistic underpinnings of this association remain unclear. OBJECTIVES: The aim of this study was to analyze the associations among bleeding, mortality, and DAPT duration after drug-eluting stent implantation in a meta-analysis of RCTs. METHODS: RCTs comparing different DAPT durations after drug-eluting stent placement were sought through the MEDLINE, Embase, and Cochrane databases and the proceedings of international meetings...
April 25, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28400917/coronary-stenting-a-matter-of-revascularization
#9
EDITORIAL
Aldo Bonaventura, Fabrizio Montecucco, Luca Liberale
In the last few decades, the recommended treatment for coronary artery disease has been dramatically improved by percutaneous coronary intervention (PCI) and the use of balloon catheters, bare metal stents (BMSs), and drug-eluting stents (DESs). Catheter balloons were burdened by acute vessel occlusion or target-lesion re-stenosis. BMSs greatly reduced those problems holding up the vessel structure, but showed high rates of in-stent re-stenosis, which is characterized by neo-intimal hyperplasia and vessel remodeling leading to a re-narrowing of the vessel diameter...
March 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28399979/efficacy-of-short-term-dual-antiplatelet-therapy-after-implantation-of-second-generation-drug-eluting-stents-a-meta-analysis-and-systematic-review
#10
Huang Peisen, Yu Yuan, Han Xikun, Yang Yuejin
Objective The benefit of short-term dual antiplatelet therapy (DAPT) following second-generation drug-eluting stents implantation has not been systematically evaluated. To bridge the knowledge gap, we did a meta-analysis to assess the efficacy of ≤6 months versus ≥12 months DAPT among patients with second-generation drug-eluting stents.Methods We searched online databases and identified randomized controlled trials that assess the clinical impact of short-term DAPT (≤6 months) published before March 3, 2016...
April 10, 2017: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
https://www.readbyqxmd.com/read/28394997/optimizing-dual-antiplatelet-therapy-duration-after-myocardial-infarction-evidence-based-precision-or-personalized-medicine
#11
Fernando Alfonso, Luis Jesús Jiménez-Borreguero
No abstract text is available yet for this article.
April 7, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28381584/predicting-the-risk-of-bleeding-during-dual-antiplatelet-therapy-after-acute-coronary-syndromes
#12
Joakim Alfredsson, Benjamin Neely, Megan L Neely, Deepak L Bhatt, Shaun G Goodman, Pierluigi Tricoci, Kenneth W Mahaffey, Jan H Cornel, Harvey D White, Keith Aa Fox, Dorairaj Prabhakaran, Kenneth J Winters, Paul W Armstrong, E Magnus Ohman, Matthew T Roe
OBJECTIVES: Dual antiplatelet therapy (DAPT) with aspirin + a P2Y12 inhibitor is recommended for at least 12 months for patients with acute coronary syndrome (ACS), with shorter durations considered for patients with increased bleeding risk. However, there are no decision support tools available to predict an individual patient's bleeding risk during DAPT treatment in the post-ACS setting. METHODS: To develop a longitudinal bleeding risk prediction model, we analysed 9240 patients with unstable angina/non-ST segment elevation myocardial infarction (NSTEMI) from the Targeted Platelet Inhibition to Clarify the Optimal Strategy to Medically Manage Acute Coronary Syndromes (TRILOGY ACS) trial, who were managed without revascularisation and treated with DAPT for a median of 14...
April 5, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28377396/optimal-duration-of-dual-antiplatelet-therapy-following-percutaneous-coronary-intervention-protocol-for-an-umbrella-review
#13
Jesse Elliott, Shannon E Kelly, Zemin Bai, Wenfei Liu, Becky Skidmore, Michel Boucher, Derek Y F So, George A Wells
INTRODUCTION: Although dual antiplatelet therapy (DAPT) is routinely given to patients after percutaneous coronary intervention (PCI) with stenting, the optimal duration is unknown. Recent evidence indicates there may be benefits in extending the duration beyond 12 months but such decisions may increase the risk of bleeding. Our objective is to provide a comprehensive overview of the literature for clinicians and policymakers via an umbrella review assessing the optimal duration of DAPT...
April 4, 2017: BMJ Open
https://www.readbyqxmd.com/read/28344205/decreased-serum-albumin-predicts-bleeding-events-in-patients-on-antiplatelet-therapy-after-percutaneous-coronary-intervention
#14
Yosuke Tatami, Hideki Ishii, Toshijiro Aoki, Kazuhiro Harada, Kenshi Hirayama, Yohei Shibata, Takuya Sumi, Yosuke Negishi, Kazuhiro Kawashima, Ayako Kunimura, Toshiki Kawamiya, Dai Yamamoto, Susumu Suzuki, Toyoaki Murohara
BACKGROUND: Antiplatelet therapy (APT) after percutaneous coronary intervention (PCI) prevents ischemic events with increased risk of bleeding. Little is known about the relationship between hypoalbuminemia and bleeding risk in patients receiving APT after PCI. This study investigated the association between serum albumin level and bleeding events in this population.Methods and Results:We enrolled 438 consecutive patients who were prescribed dual APT (DAPT; aspirin and thienopyridine) beyond 1 month after successful PCI without adverse events...
March 25, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28325638/clinically-significant-bleeding-with-low-dose-rivaroxaban-versus-aspirin-in-addition-to-p2y12-inhibition-in-acute-coronary-syndromes-gemini-acs-1-a-double-blind-multicentre-randomised-trial
#15
E Magnus Ohman, Matthew T Roe, P Gabriel Steg, Stefan K James, Thomas J Povsic, Jennifer White, Frank Rockhold, Alexei Plotnikov, Hardi Mundl, John Strony, Xiang Sun, Steen Husted, Michal Tendera, Gilles Montalescot, M Cecilia Bahit, Diego Ardissino, Héctor Bueno, Marc J Claeys, Jose C Nicolau, Jan H Cornel, Shinya Goto, Róbert Gábor Kiss, Ümit Güray, Duk-Woo Park, Christoph Bode, Robert C Welsh, C Michael Gibson
BACKGROUND: Dual antiplatelet therapy (DAPT), aspirin plus a P2Y12 inhibitor, is the standard antithrombotic treatment following acute coronary syndromes. The factor Xa inhibitor rivaroxaban reduced mortality and ischaemic events when added to DAPT, but caused increased bleeding. The safety of a dual pathway antithrombotic therapy approach combining low-dose rivaroxaban (in place of aspirin) with a P2Y12 inhibitor has not been assesssed in acute coronary syndromes. We aimed to assess rivaroxaban 2·5 mg twice daily versus aspirin 100 mg daily, in addition to clopidogrel or ticagrelor (chosen at investigator discretion before randomisation), for patients with acute coronary syndromes started within 10 days after presentation and continued for 6-12 months...
May 6, 2017: Lancet
https://www.readbyqxmd.com/read/28318138/safety-and-efficacy-of-6-month-versus-12-month-dual-antiplatelet-therapy-in-patients-after-implantation-of-multiple-biodegradable-polymer-coated-sirolimus-eluting-coronary-stents-insight-from-the-i-love-it-2-trial
#16
RANDOMIZED CONTROLLED TRIAL
Jing Qi, Yi Li, Jing Li, Quanmin Jing, Kai Xu, Chuanyu Gao, Likun Ma, Zhi Zhang, Bo Xu, Yaling Han
OBJECTIVE: This study sought to compare the clinical outcomes of 6-month versus 12-month dual antiplatelet therapy (DAPT) in patients receiving multiple biodegradable polymer-coated sirolimus-eluting stents (BP-SES) implants. BACKGROUND: The clinical outcomes for patients who undergo multiple BP-SES implantation with different DAPT durations are uncertain. METHODS: In the I-LOVE-IT 2 trial, 907 patients treated with multiple BP-SES (total stent number ≥2) were assigned to receive 6-month (n = 440) or 12-month (n = 467) DAPT...
March 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28317790/clinical-events-beyond-one-year-after-an-acute-coronary-syndrome-insights-from-the-reclose-2-acs-study
#17
Guido Parodi, Benedetta Bellandi, Giuseppe Tarantini, Fernando Scudiero, Renato Valenti, Rossella Marcucci, Angela Migliorini, Niccolò Marchionni, Anna Maria Gori, Chiara Zocchi, David Antoniucci
AIMS: The optimal duration of dual antiplatelet therapy after an acute coronary syndrome (ACS) is still unknown and debated. We sought to assess the incidence of adverse clinical events beyond 12 months after an ACS in patients treated by percutaneous coronary intervention (PCI) and clopidogrel. METHODS AND RESULTS: Among 1,592 consecutive ACS patients treated by PCI enrolled in the RECLOSE 2-ACS study and without event within one year, 1,310 (82%) patients presented at least one risk factor such as age ≥65 years, diabetes, prior myocardial infarction (MI), chronic kidney disease and multivessel coronary disease...
March 20, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28297004/deciding-on-the-duration-of-dual-antiplatelet-therapy-when-the-choice-between-2-evils-is-still-evil
#18
Marco Valgimigli, Giuseppe Gargiulo
No abstract text is available yet for this article.
May 1, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28290994/derivation-and-validation-of-the-predicting-bleeding-complications-in-patients-undergoing-stent-implantation-and-subsequent-dual-antiplatelet-therapy-precise-dapt-score-a-pooled-analysis-of-individual-patient-datasets-from-clinical-trials
#19
Francesco Costa, David van Klaveren, Stefan James, Dik Heg, Lorenz Räber, Fausto Feres, Thomas Pilgrim, Myeong-Ki Hong, Hyo-Soo Kim, Antonio Colombo, Philippe Gabriel Steg, Thomas Zanchin, Tullio Palmerini, Lars Wallentin, Deepak L Bhatt, Gregg W Stone, Stephan Windecker, Ewout W Steyerberg, Marco Valgimigli
BACKGROUND: Dual antiplatelet therapy (DAPT) with aspirin plus a P2Y12 inhibitor prevents ischaemic events after coronary stenting, but increases bleeding. Guidelines support weighting bleeding risk before the selection of treatment duration, but no standardised tool exists for this purpose. METHODS: A total of 14 963 patients treated with DAPT after coronary stenting-largely consisting of aspirin and clopidogrel and without indication to oral anticoagulation-were pooled at a single-patient level from eight multicentre randomised clinical trials with independent adjudication of events...
March 11, 2017: Lancet
https://www.readbyqxmd.com/read/28284365/initiation-and-duration-of-dual-antiplatelet-therapy-after-inpatient-percutaneous-coronary-intervention-with-stent-implantation-in-germany-an-electronic-healthcare-database-cohort-study
#20
Andres Luque Ramos, Christoph Ohlmeier, Dirk Enders, Roland Linder, Dirk Horenkamp-Sonntag, Jürgen H Prochaska, Rafael Mikolajczyk, Edeltraut Garbe
BACKGROUND: Studies assessing the routine outpatient dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) in Germany are scarce. The aim of this study was (i) to investigate the initiation and duration of DAPT after inpatient PCI with stent implantation in Germany, and (ii) to identify factors associated with DAPT discontinuation during the recommended treatment period. METHODS: This retrospective cohort study was based on data from a large German electronic healthcare database of the years 2004 to 2009...
February 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
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