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duration dual antiplatelet therapy

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https://www.readbyqxmd.com/read/29306228/emergency-coronary-bypass-surgery-in-patients-under-the-influence-of-dualantiplatelet-therapy-effects-of-tranexamic-acid-and-desmopressin-acetate
#1
Gökalp Altun, Doğuş Hemşinli, Zerrin Pulathan, Ali Civelek
Background/aim: Bleeding in patients undergoing coronary artery bypass grafting (CABG) while using dual antiplatelet therapy (DAPT) is a cause of significant morbidity and mortality. The aim of this study is to examine the perioperative hemostatic effects of tranexamic acid (TnX-A) and desmopressin acetate (Des) in these patients. Materials and methods: This clinical study was planned in a prospective and randomized manner. Fifty-four patients were enrolled and classified into 4 different groups. They were compared in terms of various bleeding and transfusion parameters...
December 19, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29291426/evolution-of-coronary-stent-technology-and-implications-for-duration-of-dual-antiplatelet-therapy
#2
REVIEW
Jae Youn Moon, Francesco Franchi, Fabiana Rollini, Dominick J Angiolillo
Dual antiplatelet therapy (DAPT) has represented for decades the cornerstone of treatment for the prevention of ischemic complications, including stent thrombosis, in patients undergoing percutaneous coronary intervention (PCI). Despite the evolution in stent technologies, which has allowed the reduction in the minimum required duration of DAPT, the optimal duration of DAPT to ensure the best safety and efficacy still remains largely debated. Indeed, the results from investigations regarding the optimal DAPT duration based on stent type is limited...
December 29, 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/29277295/duration-of-dual-antiplatelet-therapy-following-drug-eluting-stent-implantation-in-diabetic-and-non-diabetic-patients-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#3
REVIEW
Abhishek Sharma, Aakash Garg, Sammy Elmariah, Douglas Drachman, Chukwudi Obiagwu, Ajay Vallakati, Samin K Sharma, Carl J Lavie, Debabrata Mukherjee, Ron Waksman, Giulio G Stefanini, Fausto Feres, Jonathan D Marmur, Gérard Helft
BACKGROUND: Diabetic patients account for an increasing number of patients undergoing percutaneous coronary intervention (PCI). However, diabetes mellitus (DM) is associated with increased residual platelet activity during dual antiplatelet treatment (DAPT) and DM patients have worse clinical outcomes after PCI as compared to non-DM. OBJECTIVE: To evaluate efficacy and safety of short duration DAPT (S-DAPT) and long duration DAPT (L-DAPT) after drug eluting stent (DES) implantation in DM and non-DM patients...
December 22, 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/29277288/early-discontinuation-of-dual-antiplatelet-therapy-in-patients-treated-with-the-bio-engineered-pro-healing-sirolimus-eluting-combo-stent
#4
REVIEW
Deborah N Kalkman, Pier Woudstra, Ian B A Menown, Jan G Tijssen, Marcel A M Beijk, Robbert J de Winter
BACKGROUND: When the pro-healing COMBO stent is used, a short duration of dual-antiplatelet therapy (DAPT) might be safe. However, no cases have been described of patients with short duration of DAPT after COMBO stent placement. METHODS AND RESULTS: We investigate clinical outcomes at 1year after early discontinuation of DAPT in patients participating in the REMEDEE Registry. This is a prospective, multicentre, European, all-comers registry with a 1000 patients treated with COMBO stent...
October 17, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29276176/coronary-aneurysms-in-the-acute-patient-incidence-characterization-and-long-term-management-results
#5
Iván J Núñez-Gil, Belén Terol, Gisela Feltes, Luis Nombela-Franco, Pablo Salinas, Javier Escaned, Pilar Jiménez-Quevedo, Nieves Gonzalo, David Vivas, Daniel Bautista, Carlos Macaya, Antonio Fernández-Ortiz
BACKGROUND: Coronary aneurysms (1.5 times dilation the reference-vessel) are uncommon and have been diagnosed with increasing frequency with coronary angiography. The incidence varies from 1.5% to 5%. Reported complications are multiple: thrombosis, distal embolization, rupture and vasospasm, causing ischemia, heart failure or arrhythmias. However, the natural history and prognosis remains obscure. We aimed to describe the characteristics of acute patients with coronary aneurysms. METHODS: Prospective coronariography registry of patients with the diagnosis of coronary aneurysm between 2002 and 2013...
December 6, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29275879/cost-effectiveness-of-different-durations-of-dual-antiplatelet-use-after-percutaneous-coronary-intervention
#6
Yaron Arbel, Maria C Bennell, Shaun G Goodman, Harindra C Wijeysundera
BACKGROUND: There is uncertainty regarding the optimal duration of dual-antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI). Our goal was to evaluate the cost-effectiveness of different durations of DAPT. METHODS: We created a probabilistic patient-level Markov microsimulation model to assess the discounted lifetime costs and quality-adjusted life years (QALYs) of short duration (3-6 months: short-duration group) vs standard therapy (12 months: standard-duration group) vs prolonged therapy (30-36 months: long-duration group) in patients undergoing PCI...
January 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29275371/stent-and-dual-antiplatelet-therapy-duration-comparisons-in-the-setting-of-a-multicenter-randomized-controlled-trial-can-the-operator-experience-affect-the-study-results
#7
Giuseppe Gargiulo, Dik Heg, Fabrizio Ferrari, Gianfranco Percoco, Gianluca Campo, Carlo Tumscitz, Federico Colombo, Andrea Zuffi, Fausto Castriota, Alberto Cremonesi, Stephan Windecker, Marco Valgimigli
BACKGROUND: Operator experience influences outcomes after percutaneous coronary intervention, but this association in the controlled setting of a randomized, clinical trial is unclear. METHODS AND RESULTS: We investigated operator-related outcomes (30-day and 2-year efficacy and safety end points) among patients undergoing percutaneous coronary intervention and randomized to different dual antiplatelet therapy durations and stent types. A total of 2003 patients were analyzed, and 7 operator groups were compared...
December 23, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29261190/optimal-duration-of-antiplatelet-therapy-following-acute-coronary-syndrome
#8
REVIEW
Tomas Villanueva
This newsletter provides an overview of the available data pertaining to the optimal duration of dual antiplatelet therapy following an acute coronary syndrome, with a focus on individualized treatment plans to optimize patient outcomes.
December 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/29251650/duration-of-dual-antiplatelet-therapy-in-the-post-acute-coronary-syndrome-patient
#9
Rodel V Bobadilla
BACKGROUND: After acute coronary syndrome, guidelines recommend dual antiplatelet therapy with aspirin and a P2Y12 inhibitor for a period of 12 months for the prevention of secondary cardiovascular events. However, the risk of recurrent ischemic events can persist beyond 12 months, and there has been much debate regarding the benefits of prolonging dual antiplatelet therapy in certain patient populations. PURPOSE: The purpose of this review was to investigate the optimal duration of dual antiplatelet therapy in the post-acute coronary syndrome patient...
December 14, 2017: Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/29236148/dual-antiplatelet-therapy-after-percutaneous-coronary-intervention-for-stable-cad-or-acs-redefining-the-optimal-duration-of%C3%A2-treatment
#10
B E Stähli, U Landmesser
The duration and combination of dual antiplatelet therapy after coronary stent implantation, consisting of aspirin and a P2Y12 inhibitor, is among the most intensely investigated therapeutic strategies in cardiovascular medicine. While initial studies have mainly focused on the efficacy and safety of individual antithrombotic agents, the increased need for a personalized, risk-based approach to define the optimal duration of antithrombotic treatment according to the estimated ischemic and bleeding risk was then recognized...
December 13, 2017: Herz
https://www.readbyqxmd.com/read/29236147/-platelet-inhibition-in-elderly-patients
#11
A Schäfer, J Bauersachs
Single antiplatelet therapy (SAPT) using predominantly acetylsalicylic acid (ASA) is the baseline anti-thrombotic therapy in primary as well as secondary prevention of atherosclerotic disease. Dual antiplatelet therapy (DAPT) is the cornerstone of maintenance medication following elective percutaneous coronary interventions or acute coronary syndromes (ST elevation myocardial infarction, non-ST elevation myocardial infarction and unstable angina pectoris). In the past the duration of DAPT in particular has been frequently discussed...
December 13, 2017: Herz
https://www.readbyqxmd.com/read/29167613/clinical-outcomes-of-polytetrafluoroethylene-covered-stents-for-coronary-artery-perforation-in-elderly-patients-undergoing-percutaneous-coronary-interventions
#12
Huang-Joe Wang, Jen-Jyh Lin, Wan-Yu Lo, Chih-Ping Chang, Chung-Ho Hsu, Li-Chuan Hsieh, Yeh-Peng Chen, Yen-Nien Lin, Kuan-Cheng Chang, Ping-Han Lo
Background: Coronary artery perforation (CAP) during percutaneous coronary intervention (PCI) is associated with increased mortality. Polytetrafluoroethylene covered stents (CS) are an effective approach to treat CAP, but data regarding elderly patients requiring CS implantation for CAP are limited. The aim of this study is to report clinical data for elderly CAP patients undergoing CS implantation during PCI. Methods: Nineteen consecutive elderly patients (≥ 65 years) undergoing CS implantation due to PCI-induced CAP in a tertiary referral center from July 2003 to April 2016 were retrospectively examined...
November 2017: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/29119223/-acute-myocardial-infarction-in-patients-with-st-segment-elevation-myocardial-infarction-esc-guidelines-2017
#13
REVIEW
H Thiele, S Desch, S de Waha
This article gives an update on the management of acute ST-segment elevation myocardial infarction (STEMI) according to the recently released European Society of Cardiology guidelines 2017 and the modifications are compared to the previous STEMI guidelines from 2012. Primary percutaneous coronary intervention (PCI) remains the preferred reperfusion strategy. New guideline recommendations relate to the access site with a clear preference for the radial artery, use of drug-eluting stents over bare metal stents, complete revascularization during the index hospitalization, and avoidance of routine thrombus aspiration...
November 8, 2017: Herz
https://www.readbyqxmd.com/read/29110813/duration-of-dual-antiplatelet-therapy-following-drug-eluting-stent-implantation-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#14
Abhishek Sharma, Ofek Hai, Akash Garg, Ajay Vallakati, Carl J Lavie, Jonathan D Marmur
To evaluate the efficacy and safety of long-duration dual antiplatelet therapy (L-DAPT) compared to short-duration dual antiplatelet therapy (S-DAPT) after drug-eluting stent implantation. We searched Medline, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) to identify randomized controlled trials assessing the clinical effect of L-DAPT vs S-DAPT after drug-eluting stent. Efficacy end points were all-cause mortality, cardiac mortality, myocardial infarction (MI), stent thrombosis (ST), and target vessel revascularization (TVR)...
December 2017: Current Problems in Cardiology
https://www.readbyqxmd.com/read/29104179/safety-of-6-month-dual-antiplatelet-therapy-after-second-generation-drug-eluting-stent-implantation-optima-c-randomized-clinical-trial-and-oct-substudy
#15
Byoung-Kwon Lee, Jung-Sun Kim, Oh-Huyn Lee, Pil-Ki Min, Young-Won Yoon, Bum-Kee Hong, Dong-Ho Shin, Tae-Soo Kang, Byung Ok Kim, Duk-Kyu Cho, Dong Woon Jeon, Sung-Ill Woo, Seonghoon Choi, Byung-Ryul Cho, Woong-Chol Kang, Seunghwan Kim, Byeong-Keuk Kim, Myeong-Ki Hong, Yangsoo Jang, Hyuck Moon Kwon
AIMS: There are few randomized studies of the optimal duration of dual antiplatelet therapy (DAPT) for patients who receive a second-generation drug-eluting stent (DES). METHODS AND RESULTS: A prospective, randomized, multicenter trial was performed at 10 medical centers. The 1,368 patients included in the study received a biolimus-eluting stent (BES) or zotarolimus-eluting stent (ZES). The primary outcome measured was the composite of major adverse cardiac events (MACEs), including cardiac death, myocardial infarction (MI), or ischemia-driven target lesion revascularization at the 12-month follow-up...
November 7, 2017: EuroIntervention
https://www.readbyqxmd.com/read/29091481/the-quest-for-safer-antithrombotic-treatment-regimens-in-patients-with-coronary-artery-disease-new-strategies-and-paradigm-shifts
#16
Jae Youn Moon, Francesco Franchi, Fabiana Rollini, Dominick J Angiolillo
Despite the undeniable benefits on reducing ischemic adverse events, antiplatelet regimens including dual antiplatelet therapy (DAPT) with aspirin and P2Y12 receptor inhibitors are associated with an increased risk of bleeding. The awareness of the unfavorable prognostic implications associated with bleeding complications have somewhat hampered the enthusiasm towards the use of more potent antiplatelet treatment regimens or prolonged use of DAPT. This awareness also has prompted a series of investigations geared towards the identification of antithrombotic treatment regimens which are efficacious at reducing ischemic recurrences while also safe in terms of bleeding risk profile...
November 14, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/29081979/dual-antiplatelet-therapy-for-secondary-prevention-of-coronary-artery-disease
#17
REVIEW
Sophie Degrauwe, Thomas Pilgrim, Adel Aminian, Stephane Noble, Pascal Meier, Juan F Iglesias
Dual antiplatelet therapy (DAPT) combining aspirin and a P2Y12 receptor inhibitor has been consistently shown to reduce recurrent major adverse cardiovascular events (MACE) in patients with acute coronary syndrome (ACS) or undergoing percutaneous coronary intervention (PCI) for stable coronary artery disease (CAD) compared with aspirin monotherapy, but at the expense of an increased risk of major bleeding. Nevertheless, the optimal duration of DAPT for secondary prevention of CAD remains uncertain, owing to the conflicting results of several large randomised trials...
2017: Open Heart
https://www.readbyqxmd.com/read/29076813/optimal-duration-of-dual-antiplatelet-therapy-after-drug-eluting-stent-implantation-a-network-meta-analysis
#18
Rama Dilip Gajulapalli, Sofia Dias, Deepak J Pattanshetty, Ganesh Athappan
OBJECTIVE: There has been much debate regarding the optimal duration of dual antiplatelet therapy (DAPT) cover after drug eluting stent (DES) implantation. We aimed to assess the relative benefits of shorter and longer durations of DAPT coverage. METHODS: We performed a network meta-analysis (NMA) of all the randomized clinical trials (RCT) comparing different time durations of DAPT cover. RESULTS: We included 11 unique trials with a total of 33,458 patients; the longest duration of follow-up was 48 months and the shortest was 3 months...
October 2017: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/29073948/long-term-duration-of-dual%C3%A2-antiplatelet%C3%A2-therapy-patient-complexity-is-more-important-than-lesion-complexity
#19
EDITORIAL
Antonio Colombo, Francesco Giannini
No abstract text is available yet for this article.
October 31, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29045310/risk-of-stroke-after-transcatheter-prosthetic-aortic-valve-implant-with-aortic-bioprosthesis-subclinical-thrombosis-and-possible-therapeutic-implications
#20
Giuseppe Di Pasquale, Gloria V Coutsoumbas, Silvia Zagnoni
: Many factors could increase the risk of stroke after transcatheter prosthetic aortic valve implant, mainly related to the procedure itself, or to the type of valvular prosthesis, or to the presence of atrial fibrillation. There is a wide variability in the antithrombotic treatment utilized in clinical practice, as far as the choice of drugs (anticoagulant, single or dual antiplatelet treatment), and its optimal duration. The most popular therapeutic strategy, also recommended by the Scientific Societies, is dual antiplatelet (aspirin and clopidogrel) for the first 3-6 months then switching to single antiplatelet (usually aspirin), limiting oral anticoagulant therapy only to those patients with other primary indication to the treatment...
October 16, 2017: Journal of Cardiovascular Medicine
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