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duration dual antiplatelet therapy

Glenn N Levine, Eric R Bates, John A Bittl, Ralph G Brindis, Stephan D Fihn, Lee A Fleisher, Christopher B Granger, Richard A Lange, Michael J Mack, Laura Mauri, Roxana Mehran, Debabrata Mukherjee, L Kristin Newby, Patrick T O'Gara, Marc S Sabatine, Peter K Smith, Sidney C Smith, Jonathan L Halperin, Glenn N Levine, Sana M Al-Khatib, Kim K Birtcher, Biykem Bozkurt, Ralph G Brindis, Joaquin E Cigarroa, Lesley H Curtis, Lee A Fleisher, Federico Gentile, Samuel Gidding, Mark A Hlatky, John S Ikonomidis, José A Joglar, Susan J Pressler, Duminda N Wijeysundera
No abstract text is available yet for this article.
November 2016: Journal of Thoracic and Cardiovascular Surgery
W Amara, S Naccache, C Akret, S Cheggour, S M'Zoughi, G Galuscan, A Dompnier
INTRODUCTION: Management of antiplatelet therapy at the time of device implantation remains controversial. This study aimed to assess the risk of bleeding complications in patients receiving ticagrelor at the time of cardiac device surgery. METHODS: We performed a multicentre (n=4), retrospective study from January 2015 to January 2016. The survey included all patients (pts) treated with ticagrelor before undergoing pacemaker, implantable cardioverter-defibrillator (ICD) implantation or generator replacement...
September 29, 2016: Annales de Cardiologie et D'angéiologie
Anthony P Carnicelli, Patrick T O'Gara, Robert P Giugliano
Valvular heart disease is prevalent and represents a significant contributor to cardiac morbidity and mortality. Several options for valve replacement exist, including surgical replacement and transcatheter valve implantation. Prosthetic valves lead to increased risk of thromboembolic disease; therefore, antithrombotic therapy after valve replacement is indicated. For patients with mechanical prostheses, indefinite vitamin K antagonist and antiplatelet therapy are the mainstays of treatment. There is no consensus regarding optimal antithrombotic therapy after bioprosthetic valve replacement, although vitamin K antagonist therapy of varying duration in addition to antiplatelet therapy is recommended by guidelines...
August 13, 2016: American Journal of Cardiology
Masahiro Natsuaki, Takeshi Morimoto, Yutaka Furukawa, Yoshihisa Nakagawa, Kazushige Kadota, Kenji Ando, Hiroki Shiomi, Toshiaki Toyota, Hirotoshi Watanabe, Koh Ono, Satoshi Shizuta, Takashi Tamura, Moriaki Inoko, Tsukasa Inada, Manabu Shirotani, Mitsuo Matsuda, Takeshi Aoyama, Tomoya Onodera, Satoru Suwa, Teruki Takeda, Katsumi Inoue, Takeshi Kimura
One-month duration of dual antiplatelet therapy (DAPT) has widely been adopted after bare-metal stent (BMS) implantation in the real clinical practice. However, it has not been adequately addressed yet whether DAPT for only 1-month could provide sufficient protection from ischemic events beyond 1-month after BMS implantation. We assessed the effects of short DAPT relative to prolonged DAPT on clinical outcomes with the landmark analysis at 2 month after BMS implantation. Among 13,058 consecutive patients enrolled in the CREDO-Kyoto registry cohort-2, this study population consisted of 4905 patients treated with BMS only in whom the information on the status of antiplatelet therapy was available at 2 month after stent implantation [single-antiplatelet therapy (SAPT) group: N = 2575 (acute myocardial infarction (AMI): N = 1257, and non-AMI: N = 1318), and DAPT group: N = 2330 (AMI: N = 1304, and non-AMI: N = 1026)]...
September 19, 2016: Cardiovascular Intervention and Therapeutics
Na-Rae Yang, Pyoung Jeon, Byungjun Kim, Keon Ha Kim, Kyungil Jo
BACKGROUND: While carotid angioplasty and stenting (CAS) has become an established procedure, outcomes of early CAS for symptomatic extracranial carotid stenosis (SECS) remain poorly understood. The present study aimed at determining the effectiveness of early CAS in SECS. METHODS: Herein, 224 SECS patients underwent elective CAS between January 2008 and June 2015. The study population was stratified based on the time from symptom onset to the procedure (early CAS group: within 14 days; delayed CAS group: later than 14 days)...
September 15, 2016: World Neurosurgery
Seung-Yul Lee, Myeong-Ki Hong, Dong-Ho Shin, Jung-Sun Kim, Byeong-Keuk Kim, Young-Guk Ko, Donghoon Choi, Yangsoo Jang, Hyo-Soo Kim, Marco Valgimigli, Tullio Palmerini, Gregg W Stone
BACKGROUND: The optimal duration of dual antiplatelet therapy (DAPT) after drug-eluting stent (DES) implantation has not been established yet. The objectives of this study were to evaluate the optimal duration of DAPT after the DES implantation. METHODS: From three randomized controlled trials investigating DAPT duration after coronary stent implantation, we evaluated the clinical outcomes of short-term (6 months or less) DAPT compared with prolonged DAPT (12 months or more) in 1661 DES-treated pairs matched by propensity scores...
September 8, 2016: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Anthony W A Wassef, Hadi Khafaji, Ishba Syed, Andrew T Yan, Jacob A Udell, Shaun G Goodman, Asim N Cheema, Akshay Bagai
BACKGROUND: Current guidelines recommend 12 months of dual-antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) with drug-eluting stent (DES) implantation. Whether the duration of DAPT can be safely shortened with use of second-generation DESs is unclear. METHODS: We conducted a meta-analysis of randomized controlled trials comparing short duration (SD) (3-6 months) with standard longer duration (LD) (≥12 months) DAPT in patients treated with primarily second-generation DES implantation...
September 15, 2016: Journal of Invasive Cardiology
Raphaela Lohaus, Jonathan Michel, Katharina Mayer, Anna Lena Lahmann, Robert A Byrne, Annabelle Wolk, Jurrien M Ten Berg, Franz-Josef Neumann, Yaling Han, Tom Adriaenssens, Ralph Tölg, Melchior Seyfarth, Michael Maeng, Bernhard Zrenner, Claudius Jacobshagen, Jochen Wöhrle, Sebastian Kufner, Tanja Morath, Tareq Ibrahim, Isabell Bernlochner, Marcus Fischer, Heribert Schunkert, Karl-Ludwig Laugwitz, Julinda Mehilli, Adnan Kastrati, Stefanie Schulz-Schüpke
In patients presenting with acute coronary syndrome (ACS) the optimal duration of dual-antiplatelet therapy after drug-eluting stent (DES) implantation remains unclear. At 6 months after intervention, patients receiving clopidogrel were randomly assigned to either a further 6-month period of placebo or clopidogrel. The primary composite endpoint was death, myocardial infarction, stent thrombosis, stroke, or major bleeding 9 months after randomization. The ISAR-SAFE trial was terminated early due to low event rates and slow recruitment...
2016: Scientific Reports
Erin A Woods, Margaret L Ackman, Michelle M Graham, Sheri L Koshman, Rosaleen M Boswell, Arden R Barry
BACKGROUND: Current guidelines recommend triple antithrombotic therapy (TAT), defined as acetylsalicylic acid (ASA), clopidogrel, and warfarin, for patients with nonvalvular atrial fibrillation who have undergone percutaneous coronary intervention with stent implantation. The choice of anticoagulant/antiplatelet therapy in this population is ambiguous and complex, and prescribing patterns are not well documented. OBJECTIVE: To characterize local prescribing patterns for anticoagulant/antiplatelet therapy after percutaneous coronary intervention in patients with nonvalvular atrial fibrillation...
July 2016: Canadian Journal of Hospital Pharmacy
Gérard Helft
No abstract text is available yet for this article.
August 2016: Journal of Thoracic Disease
Gennaro Giustino, Alaide Chieffo, Tullio Palmerini, Marco Valgimigli, Fausto Feres, Alexandre Abizaid, Ricardo A Costa, Myeong-Ki Hong, Byeong-Keuk Kim, Yangsoo Jang, Hyo-Soo Kim, Kyung Woo Park, Martine Gilard, Marie-Claude Morice, Fadi Sawaya, Gennaro Sardella, Philippe Genereux, Bjorn Redfors, Martin B Leon, Deepak L Bhatt, Gregg W Stone, Antonio Colombo
BACKGROUND: Optimal upfront dual antiplatelet therapy (DAPT) duration after complex percutaneous coronary intervention (PCI) with drug-eluting stents (DES) remains unclear. OBJECTIVES: This study investigated the efficacy and safety of long- (≥12 months) versus short-term (3 or 6 months) DAPT with aspirin and clopidogrel according to PCI complexity. METHODS: We pooled patient-level data from 6 randomized controlled trials investigating DAPT durations after PCI...
August 25, 2016: Journal of the American College of Cardiology
Jade E Basaraba, Arden R Barry
BACKGROUND: Twelve months of dual antiplatelet therapy (DAPT) is recommended after percutaneous coronary intervention (PCI) with drug-eluting stent (DES) implantation. However, certain clinical scenarios may require premature discontinuation of therapy (e.g. urgent surgical procedure, major bleeding). The objective of this systematic review and meta-analysis was to investigate clinically relevant outcomes associated with a shorter duration of DAPT after PCI with DES implantation. METHODS: A systematic search of Medline and Embase (inception to December 2015) was conducted...
August 30, 2016: Journal of Cardiology
Dasdo Antonius Sinaga, Hee Hwa Ho, Timothy James Watson, Alyssa Sim, Thuzar Tint Nyein, Fahim H Jafary, Jason K K Loh, Yau Wei Ooi, Julian K B Tan, Paul J L Ong
BACKGROUND: Drug-coated balloons (DCB) have been used to treat de novo small vessel coronary disease (SVD), with promising results and shorter dual antiplatelet therapy (DAPT) duration compared to drug-eluting stents (DES). We compared safety and effectiveness of the two treatments at 1 year. METHODS: We reviewed 3,613 angioplasty cases retrospectively from 2011 to 2013 and identified 335 patients with SVD treated with device diameter of ≤2.5 mm. DCB-only angioplasty was performed in 172 patients, whereas 163 patients were treated with second-generation DES...
October 2016: Journal of Interventional Cardiology
Anna Franzone, Raffaele Piccolo, Giuseppe Gargiulo, Sara Ariotti, Marcello Marino, Andrea Santucci, Andrea Baldo, Giulia Magnani, Aris Moschovitis, Stephan Windecker, Marco Valgimigli
Importance: Patients with concomitant peripheral arterial disease (PAD) experience worse cardiovascular outcomes after percutaneous coronary intervention (PCI). Objective: To assess the efficacy and safety of prolonged (24 months) vs short (≤6 months) dual antiplatelet therapy (DAPT) in patients with PAD undergoing PCI. Design, Setting, and Participants: This subanalysis of the randomized Prolonging Dual Antiplatelet Treatment After Grading Stent-Induced Intimal Hyperplasia Study (PRODIGY) trial assessed unselected patients from tertiary care hospitals with stable coronary artery disease or acute coronary syndromes with or without concomitant PAD from December 2006 to December 2008...
August 30, 2016: JAMA Cardiology
Laura Mauri, Sidney C Smith
No abstract text is available yet for this article.
September 1, 2016: JAMA Cardiology
Giuseppe Gargiulo, Sara Ariotti, Andrea Santucci, Raffaele Piccolo, Andrea Baldo, Anna Franzone, Giulia Magnani, Marcello Marino, Giovanni Esposito, Stephan Windecker, Marco Valgimigli
OBJECTIVES: The aim of this study was to assess the impact of sex on 2-year outcomes after percutaneous coronary intervention (PCI) in patients randomly allocated to 24-month versus 6-month dual-antiplatelet therapy (DAPT). BACKGROUND: The optimal duration of DAPT after PCI is highly debated. Whether sex per se should drive decision making on DAPT duration remains unclear. METHODS: The primary efficacy endpoint of PRODIGY (Prolonging Dual Antiplatelet Treatment After Grading Stent-Induced Intimal Hyperplasia Study) was the composite of death, myocardial infarction, or cerebrovascular accident at 24-month follow-up...
September 12, 2016: JACC. Cardiovascular Interventions
Pierre Sabouret, Sophie K Rushton-Smith, Mathieu Kerneis, Johanne Silvain, Jean-Philippe Collet, Gilles Montalescot
Platelet activation and aggregability play a key role in the genesis of arterial thrombus secondary to plaque rupture. For coronary patients, inhibition of platelet function is crucial to decrease the rate of major adverse cardiac events but may expose them to excess bleeding risk. Switching P2Y12 inhibitors is common, yet the clinical consequences are unknown. The aim of this review is to provide an overview of the evidence from randomized, clinical trials and epidemiological studies, with a focus on the optimal duration of dual antiplatelet therapy (DAPT) and appropriate agent and dose selection...
July 2015: European Heart Journal. Cardiovascular Pharmacotherapy
Gianluigi Savarese, Stefano Savonitto, Lars H Lund, Stefania Paolillo, Caterina Marciano, Santo Dellegrottaglie, Antonio Parente, Bruno Trimarco, Thomas F Luscher, Pasquale Perrone-Filardi
AIMS: The optimal duration of dual antiplatelet therapy (DAPT) in patients with ischaemic cardiovascular (CV) disease is still debated. Previous meta-analyses reported conflicting results about prolonged DAPT on mortality and major CV events. Aim of this study was to assess the effects of prolonged vs. no/short-term DAPT on myocardial infarction (MI), stroke, bleeding, and mortality. METHODS AND RESULTS: Trial inclusion criteria were: randomization to prolonged duration vs...
October 2016: European Heart Journal. Cardiovascular Pharmacotherapy
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