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duration dual antiplatelet therapy

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https://www.readbyqxmd.com/read/29119223/-acute-myocardial-infarction-in-patients-with-st-segment-elevation-myocardial-infarction-esc-guidelines-2017
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
https://www.readbyqxmd.com/read/29045308/thirty-days-only-double-antiplatelet-therapy-after-drug-eluting-stenting-could-a-short-term-treatment-be-advantageous
#9
Gianni Casella, Elvira Resciniti, Pamela Gallo
: The duration of dual antiplatelet therapy (DAPT) after coronary stenting has been evaluated in randomized studies with apparently conflicting results. Prolonged DAPT reduces late stent thrombosis and myocardial infarction, but at the expenses of more hemorrhages. On the contrary, bleedings are associated with higher morbidity and mortality. Thus, in patients at high risk of bleeding, the less effective bare-metal stents could be preferred to drug-eluting stents (DES) due to the shortened DAPT needed. However, new DES technology carries a lower risk of stent thrombosis and casts doubts on the recommended prolonged DAPT regimen after DES...
October 16, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/29044393/duration-of-dual-antiplatelet-therapy-and-associated-outcomes-following-percutaneous-coronary-intervention-for-acute-myocardial-infarction-contemporary-practice-insights-from-the-canadian-observational-antiplatelet-study
#10
Juan J Russo, Shaun G Goodman, Akshay Bagai, Jean-Pierre Déry, Mary K Tan, Harold N Fisher, Xiang Zhang, Yajun Emily Zhu, Robert C Welsh, Anthony Della Siega, Andre Kokis, Brian Y L Wong, Mark Henderson, Sohrab Lutchmedial, Shahar Lavi, Shamir R Mehta, Andrew T Yan
Aims: There is a paucity of real-world, contemporary data of practice patterns and clinical outcomes following dual-antiplatelet therapy (DAPT) in acute myocardial infarction (AMI) patients treated with percutaneous coronary intervention (PCI). Methods and results: The Canadian Observational Antiplatelet Study was a prospective, multicentre, cohort study examining adenosine diphosphate receptor antagonist use following PCI for AMI. We compared practice patterns, patient characteristics, and clinical outcomes in relation to DAPT duration (<6 weeks, 6 weeks to <6 months, 6 to <12, and ≥12 months)...
October 1, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/29025834/study-protocol-for-a-randomised-controlled-trial-harmonising-optimal-strategy-for-treatment-of-coronary-artery-stenosis-coronary-intervention-with-next-generation-drug-eluting-stent-platforms-and-abbreviated-dual-antiplatelet-therapy-host-idea-trial
#11
Chi-Hoon Kim, Jung-Kyu Han, Han-Mo Yang, Kyung Woo Park, Hae-Young Lee, Hyun-Jae Kang, Bon-Kwon Koo, Namho Lee, Tae-Joon Cha, Tae-Hyun Yang, Myung-Ho Jeong, Myeong-Ho Yoon, Seung Uk Lee, Seung Jin Lee, Jin Won Kim, Jin-Man Cho, Kyu-Rock Han, Wook Bum Pyun, Hyo-Soo Kim
INTRODUCTION: We have recently seen the introduction of newer generation drug-eluting stents with ultrathin struts that use advanced polymer technologies. However, the efficacy and safety of these newest stents have not yet been fully explored. In addition, there are still controversies over the optimal duration of dual antiplatelet therapy (DAPT) after stent implantation, particularly for ultrathin stents with the newest polymer technologies. METHODS AND ANALYSIS: The HOST-IDEA trial is a randomised, open-label, multicentre, non-inferiority trial and the first study to directly compare two of these ultrathin sirolimus-eluting stents: Orsiro stent with biodegradable polymer, and polymer-free Coroflex ISAR (CX-ISAR) stent...
October 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/29020300/impact-of-design-of-coronary-stents-and-length-of-dual-antiplatelet-therapies-on-ischaemic-and-bleeding-events-a-network-meta-analysis-of-64-randomized-controlled-trials-and-102%C3%A2-735-patients
#12
Fabrizio D'Ascenzo, Mario Iannaccone, Gaelle Saint-Hilary, Maurizio Bertaina, Stefanie Schulz-Schüpke, Cheol Wahn Lee, Alaide Chieffo, Gerard Helft, Sebastiano Gili, Umberto Barbero, Giuseppe Biondi Zoccai, Claudio Moretti, Fabrizio Ugo, Maurizio D'Amico, Roberto Garbo, Gregg Stone, Sara Rettegno, Pierluigi Omedè, Federico Conrotto, Christian Templin, Antonio Colombo, Seung-Jung Park, Adnan Kastrati, David Hildick-Smith, Mauro Gasparini, Fiorenzo Gaita
Aims: The differential impact on ischaemic and bleeding events of the type of drug-eluting stent [durable polymer stents [DES] vs. biodegradable polymer stents vs. bioresorbable scaffolds (BRS)] and length of dual antiplatelet therapy (DAPT) remains to be defined. Methods and results: Randomized controlled trials comparing different types of DES and/or DAPT durations were selected. The primary endpoint was Major Adverse Cardiovascular Events (MACE) [a composite of death, myocardial infarction (MI), and target vessel revascularization]...
November 7, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28968483/antiplatelet-and-anticoagulant-agents-for-secondary-prevention-of-stroke-and-other-thromboembolic-events-in-people-with-antiphospholipid-syndrome
#13
REVIEW
Malgorzata M Bala, Magdalena Celinska-Lowenhoff, Wojciech Szot, Agnieszka Padjas, Mateusz Kaczmarczyk, Mateusz J Swierz, Anetta Undas
BACKGROUND: Antiphospholipid syndrome (APS) is a systemic autoimmune disease characterized by arterial or venous thrombosis (or both) and/or pregnancy morbidity in association with the presence of antiphospholipid antibodies. The prevalence is estimated at 40 to 50 cases per 100,000 people. The most common sites of thrombosis are cerebral arteries and deep veins of the lower limbs. People with a definite APS diagnosis have an increased lifetime risk of recurrent thrombotic events. OBJECTIVES: To assess the effects of antiplatelet or anticoagulant agents, or both, for the secondary prevention of recurrent thrombosis, particularly ischemic stroke, in people with antiphospholipid syndrome...
October 2, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28938240/atrial-fibrillation-bleeding-and-coronary-intervention-current-recommendations
#14
Serdar Farhan, Roxana Mehran
The patient population with the need for oral anticoagulation to reduce stroke risk associated with atrial fibrillation (AF) and dual antiplatelet therapy to prevent stent thrombosis and myocardial infarction after percutaneous coronary intervention is increasing. However, patients treated with a triple therapy consisting of oral anticoagulation, aspirin, and a P2Y12 inhibitor have been demonstrated to be at high bleeding risk. The best combination of these agents and the duration of the different therapies are still uncertain...
September 21, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28931024/formal-comment-to-toyota-et-al-short-versus-prolonged-dual-antiplatelet-therapy-dapt-duration-after-coronary-stent-implantation-a-comparison-between-the-dapt-study-and-9-other-trials-evaluating-dapt-duration
#15
COMMENT
https://www.readbyqxmd.com/read/28931015/short-versus-prolonged-dual-antiplatelet-therapy-dapt-duration-after-coronary-stent-implantation-a-comparison-between-the-dapt-study-and-9-other-trials-evaluating-dapt-duration
#16
REVIEW
Toshiaki Toyota, Hiroki Shiomi, Takeshi Morimoto, Masahiro Natsuaki, Takeshi Kimura
AIMS: The Dual Antiplatelet Therapy (DAPT) study demonstrated that DAPT beyond 1-year after drug-eluting stent (DES) implantation, as compared with aspirin therapy alone, significantly reduced the risk of major cardiovascular and cerebrovascular events, which was mainly driven by the large risk reduction for myocardial infarction (MI). We sought to compare the largest DAPT study with other trials evaluating DAPT durations after DES implantation. METHODS AND RESULTS: By a systematic literature search, we identified 9 trials comparing prolonged- versus short-DAPT in addition to the DAPT study...
2017: PloS One
https://www.readbyqxmd.com/read/28923692/polymer-free-biolimus-a9-coated-stents-in-the-treatment-of-de-novo-coronary-lesions-with-short-dapt-9-month-angiographic-and-clinical-follow-up-of-the-prospective-multicenter-biofreedom-usa-clinical-trial
#17
Ron Waksman, Guy N Piegari, Ameer Kabour, Louis Cannon, John Wang, George Adams, Naresh Solankhi, Anthony Smeglin, Dean J Kereiakes, Roy Leiboff, Mia-Ashley Spad, Rebecca Torguson, Nina Chandra, Roshni Bastian, Jolanda DeGroot, Margaret W Kayo, Hans-Peter Stoll, Hector M Garcia-Garcia
BACKGROUND: BioFreedom is a polymer- and carrier-free drug-coated stent that delivers Biolimus A9 to the vessel wall. Our purpose was to evaluate the efficacy and safety of this DCS in patients with short-duration dual antiplatelet therapy. METHODS: The BioFreedom US IDE feasibility trial was a single-arm, open-label, prospective study of patients requiring stenting of de novo lesions. Patients received 3 months of DAPT, repeat angiography at 9 months, and clinical follow-up at multiple intervals...
July 31, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28895303/coronary-angiography-with-or-without-percutaneous-coronary-intervention-in-patients-with-hemophilia-systematic-review
#18
Christian Boehnel, Hans Rickli, Lukas Graf, Micha T Maeder
OBJECTIVES: We aimed to summarize the evidence for periprocedural and long-term strategies to both minimize the bleeding risk and ensure sufficient anticoagulation and antiaggregation in hemophilia patients undergoing coronary angiography with or without percutaneous coronary interventions (PCI). BACKGROUND: Hemophilia patients undergoing coronary angiography and PCI are at risk of bleeding due to deficiency of the essential clotting factors VIII or IX combined with the need of peri-interventional anticoagulation and antiaggregation and dual antiplatelet therapy (DAPT) after PCI...
September 12, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28855078/guided-de-escalation-of-antiplatelet-treatment-in-patients-with-acute-coronary-syndrome-undergoing-percutaneous-coronary-intervention-tropical-acs-a-randomised-open-label-multicentre-trial
#19
Dirk Sibbing, Dániel Aradi, Claudius Jacobshagen, Lisa Gross, Dietmar Trenk, Tobias Geisler, Martin Orban, Martin Hadamitzky, Béla Merkely, Róbert Gábor Kiss, András Komócsi, Csaba A Dézsi, Lesca Holdt, Stephan B Felix, Radoslaw Parma, Mariusz Klopotowski, Robert H G Schwinger, Johannes Rieber, Kurt Huber, Franz-Josef Neumann, Lukasz Koltowski, Julinda Mehilli, Zenon Huczek, Steffen Massberg
BACKGROUND: Current guidelines recommend potent platelet inhibition with prasugrel or ticagrelor for 12 months after an acute coronary syndrome managed with percutaneous coronary intervention (PCI). However, the greatest anti-ischaemic benefit of potent antiplatelet drugs over the less potent clopidogrel occurs early, while most excess bleeding events arise during chronic treatment. Hence, a stage-adapted treatment with potent platelet inhibition in the acute phase and de-escalation to clopidogrel in the maintenance phase could be an alternative approach...
October 14, 2017: Lancet
https://www.readbyqxmd.com/read/28853033/dual-antiplatelet-therapy-duration-reconciling-the-inconsistencies
#20
REVIEW
Francesco Costa, Stephan Windecker, Marco Valgimigli
Dual antiplatelet therapy (DAPT) prevents recurrent ischemic events after an acute coronary syndrome (ACS) as well as stent thrombosis (ST) in patients with prior stent implantation. Nevertheless, these benefits are counterbalanced by a significant bleeding hazard, which is directly related to the treatment duration. Although DAPT has been extensively studied in numerous clinical trials, optimal treatment duration is still debated, mostly because of apparent inconsistencies among studies. Shortened treatment duration of 6 or 3 months was shown to mitigate bleeding risk compared with consensus-grounded 12-month standard duration, without any apparent excess of ischemic events...
October 2017: Drugs
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