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duration dual antiplatelet therapy

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https://www.readbyqxmd.com/read/29776573/duration-of-dual-antiplatelet-therapy-and-outcome-in-patients-with-acute-coronary-syndrome-undergoing-percutaneous-revascularization-a-meta-analysis-of-11-randomized-trials
#1
Monica Verdoia, Elvin Khedi, Claudia Ceccon, Harry Suryapranata, Giuseppe De Luca
BACKGROUND: Acute coronary syndromes (ACS) represent a context of higher thrombotic risk, where larger advantages have been achieved by the administration of dual antiplatelet therapy (DAPT). However, the indication of 1 year DAPT after coronary angioplasty for ACS has been supported by an outdated randomized trial (PCI-CURE). In addition, the initial fear of late thrombotic events emerged with first generation drug-eluting stents (DES), that suggested the need of a prolonged DAPT prescription, has been completely overcome by the recent technological evolution of DES, that have shown faster re-endothelization and lower rates of late thrombotic complications...
August 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29760293/-safety-of-dual-antiplatelet-therapy-with-argatroban-in-patients-with-acute-ischemic-stroke
#2
Yoshinari Nagakane, Eijirou Tanaka, Shinji Ashida, Yuta Kojima, Shiori Ogura, Keiko Maezono, Yasumasa Yamamoto
To prevent early neurological worsening or recurrence in stroke patients with intracranial arterial stenosis or branch atheromatous disease, aggressive antithrombotic therapy, such as dual antiplatelet therapy (DAPT) with or without anticoagulant therapy, is warranted. Such an aggressive antithrombotic therapy, however, may increase the bleeding risk. We studied the risks of DAPT with the anticoagulant argatroban in patients with acute ischemic stroke or transient ischemic attack (TIA). Between October 2011 and September 2015, 341 patients with stroke or TIA, who received DAPT with argatroban within 48 hours after onset, were retrospectively studied...
May 2018: Brain and Nerve, Shinkei Kenkyū No Shinpo
https://www.readbyqxmd.com/read/29753563/critical-appraisal-of-the-2018-acc-scientific-sessions-late-breaking-trials-from-a-statistician-s-perspective
#3
REVIEW
Stuart J Pocock, Tim J Collier
The late-breaking clinical trials presentations at the American College of Cardiology Scientific Sessions in March 2018 are an important contribution to the field of cardiology. This paper presents a constructive critical appraisal of 7 key studies: ODYSSEY OUTCOMES (Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab), VEST (Vest Prevention of Early Sudden Death Trial), SECURE-PCI (Statins Evaluation in Coronary Procedures and Revascularization), TREAT (Ticagrelor in Patients with ST-Elevation Myocardial Infarction treated with Pharmacological Thrombolysis), POISE (PeriOperative ISchemic Evaluation), SMART-DATE (Safety of 6-Month Duration of Dual Antiplatelet Therapy After Percutaneous Coronary Intervention in Patients With Acute Coronary Syndrome), and CVD-REAL 2 (Comparative Effectiveness of Cardiovascular Outcomes in New Users of SGLT-2 Inhibitors)...
May 7, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29734199/are-shorter-durations-of-dual-antiplatelet-therapy-acceptable-following-percutaneous-coronary-intervention
#4
Jessica M Lewis, James J Nawarskas
Much debate has centered on whether or not the standard 12 month duration of dual antiplatelet therapy (DAPT) is still necessary post-percutaneous coronary intervention (PCI) given recent improvements in stent technology. The benefits of shorter (3-6 months) durations of DAPT include a potential lower risk for bleeding and less patient drug cost and pill burden. While randomized clinical trials have shown non-inferiority for shorter versus longer DAPT regimens in many regards, some endpoints (e.g. myocardial infarction) may still occur less frequently with longer DAPT regimens, particularly in higher risk populations (e...
May 4, 2018: Cardiology in Review
https://www.readbyqxmd.com/read/29713989/optimal-duration-of-dual-antiplatelet-therapy-for-coronary-artery-disease
#5
REVIEW
W J Kikkert, P Damman
The optimal duration of dual antiplatelet therapy (DAPT) for stable coronary artery disease and acute coronary syndrome is a complex decision. We review current literature on standard duration DAPT versus short duration DAPT (6 months or shorter) or extended duration DAPT (>12 months) after percutaneous coronary intervention with drug-eluting stent placement, and prolonged treatment after 12 months in acute coronary syndrome. Current guideline recommendations are summarised, including the use of risk scores for ischaemic and bleeding risk assessment...
April 30, 2018: Netherlands Heart Journal
https://www.readbyqxmd.com/read/29685692/antiplatelet-and-anticoagulation-regimen-in-patients-with-mechanical-valve-undergoing-pci-state-of-the-art-review
#6
Deepakraj Gajanana, Toby Rogers, Micaela Iantorno, Kyle D Buchanan, Itsik Ben-Dor, Augusto D Pichard, Lowell F Satler, Rebecca Torguson, Petros G Okubagzi, Ron Waksman
A common clinical dilemma regarding treatment of patients with a mechanical valve is the need for concomitant antiplatelet therapy for a variety of reasons, referred to as triple therapy. Triple therapy is when a patient is prescribed aspirin, a P2Y12 antagonist, and an oral anticoagulant. Based on the totality of the available evidence, best practice in 2017 for patients with mechanical valves undergoing percutaneous coronary intervention (PCI) is unclear. Furthermore, the optimal duration of dual antiplatelet therapy after PCI is evolving...
April 2, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29642547/antiplatelet-therapy-in-coronary-artery-disease-a-daunting-dilemma
#7
REVIEW
Surya Chaturvedula, Daniel Diver, Aseem Vashist
Percutaneous coronary intervention (PCI) with stenting for the treatment of acute coronary syndrome (ACS) is the contemporary standard of care. Such treatment is followed by dual antiplatelet therapy (DAPT) comprising of aspirin and a P2Y12 inhibitor. The efficacy of this therapy has been well established but the optimal duration of DAPT remains elusive, and has thus far attracted a prodigious deal of scientific attention. The decision regarding DAPT duration can be clinically challenging in the modern era with the evolution of newer stents, more potent antiplatelet agents, and novel anticoagulant drugs in addition to an older patient population with multiple comorbidities...
April 9, 2018: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/29627909/technological-advances-in-stent-therapies-a-year-in-review
#8
REVIEW
Jad Raffoul, Ammar Nasir, Andrew J P Klein
Stent technology has rapidly evolved since the first stainless steel bare metal stents with substantial developments in scaffolding, polymer, drug choice, drug delivery, and elution mechanisms. Most recently, there has been the evolution of bioabsorbable vascular scaffolds, potentially eliminating the need for long-term foreign object retention. These rapid developments have led to an ever-expanding selection of new stents, making the choice of which to use in which patient challenging. Operators must balance potential short- and long-term clinical ramifications, namely stent thrombosis, in-stent restenosis, target lesion revascularization, and target lesion failure...
April 7, 2018: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29607737/dual-antiplatelet-therapy-after-percutaneous-left-atrial-appendage-occlusion-single-center-experience-with-the-amplatzer-cardiac-plug
#9
Philippe B Bertrand, Melanie Habran, Karlijn Kenis, Julie Lecomte, Linde Moonen, Didier Stroobants, Edouard Benit
BACKGROUND: Percutaneous left atrial appendage occlusion (LAAO) is an alternative to anticoagulation in atrial fibrillation patients at high bleeding risk. Dual antiplatelet therapy (DAPT) is generally recommended in the months following the procedure to prevent thrombotic complications. The aim of this study was to evaluate the safety and efficacy of DAPT after LAAO in a single-centre population of high bleeding risk patients. METHODS: All patients who received DAPT after LAAO using the Amplatzer Cardiac Plug at Jessa Hospital (Hasselt, BE) between February 2011 and October 2016 were included...
April 1, 2018: Acta Cardiologica
https://www.readbyqxmd.com/read/29602648/dual-antiplatelet-therapy-after-coronary-stent-implantation-individualizing-the-optimal-duration
#10
REVIEW
Leslie Marisol Lugo, José Luis Ferreiro
Dual antiplatelet therapy (DAPT) with a P2Y12 receptor antagonist in addition to aspirin is the antiplatelet treatment of choice in patients undergoing percutaneous coronary intervention. Despite DAPT being one of the most widely investigated treatment strategies in the cardiology field, its optimal duration after coronary stenting remains controversial. The balance between the possible benefit of preventing a thrombotic event and the risk of suffering a bleeding complication due to maintenance of therapy is of critical relevance to determine the duration of DAPT in a given patient...
March 27, 2018: Journal of Cardiology
https://www.readbyqxmd.com/read/29601308/real-world-application-of-currently-available-decision-models-for-dual-antiplatelet-therapy-duration-in-acute-coronary-syndrome
#11
Nuccia Morici, Enrico Piccinelli, Dario Brunelli, Alice Sacco, Giovanna Viola, Jacopo A Oreglia, Fabrizio Oliva, Marco Valgimigli
No abstract text is available yet for this article.
March 29, 2018: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/29599096/antithrombotic-therapy-trends-in-non-valvular-atrial-fibrillation-patients-undergoing-percutaneous-coronary-stent-implantation-results-from-a-survey-among-fellows-at-the-japanese-college-of-cardiology
#12
Daisuke Fukamachi, Atsushi Hirayama, Katsumi Miyauchi, Satoshi Yasuda, Hisao Ogawa, Hiroshi Ito, Hiroyuki Daida
BACKGROUND: Antithrombotic therapy with oral anticoagulants (OAC) in patients with atrial fibrillation (AF) after stent implantation, where dual antiplatelet therapy (DAPT) is also recommended, is not established. Antithrombotic therapies prescribed vary widely among cardiologists and may change year by year, according to the accumulation of new evidence. METHODS: A questionnaire-based survey concerning the antithrombotic therapy prescribed for OAC-treated AF patients who underwent stent implantation was conducted from 2014 to 2016...
March 26, 2018: Journal of Cardiology
https://www.readbyqxmd.com/read/29589672/the-synergy-stent-in-high-bleeding-risk-patients-why-design-matters
#13
Mauro Chiarito, Davide Cao, Francesco Cannata, Cristina Panico, Bernhard Reimers, Giulio G Stefanini
Antithrombotic management after percutaneous coronary intervention is based on dual antiplatelet therapy (DAPT), that has unequivocally shown to reduce the risk of recurrent ischemic events at cost of an important risk of bleeding. In order to balance ischemic and bleeding risks, DAPT duration should be based on patients and lesions features as well as stent type. Based on these considerations, patients at high bleeding risk (HBR) undergoing PCI represent a challenging subgroup. The Synergy stent (Boston Scientific, Marlborough, MA, USA) is a new-generation everolimus-eluting stent with a biodegradable polymer coating, presenting several features that have the potential to reduce acute and long-term thrombogenicity and the subsequent need for DAPT...
March 28, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29582698/a-new-category-stent-with-novel-polyphosphazene-surface-modification
#14
Hiroyoshi Mori, Hiroyuki Jinnouchi, Chahal Diljon, Sho Torii, Atsushi Sakamoto, Frank D Kolodgie, Renu Virmani, Aloke V Finn
The COBRA-PzF™ (CeloNova BioSciences, Inc., TX, USA) is a new type of coronary stent composed of a cobalt chromium metallic backbone surrounded by a nanothin layer of Polyzene-F (PzF) without any added drug. Evidence from basic studies supports antithrombotic and anti-inflammatory properties for the PzF surface coating. Preclinical studies support the thromboresistance of PzF coated surfaces and clinical studies have shown good outcomes for patients receiving this device with very low rates of stent thrombosis...
March 27, 2018: Future Cardiology
https://www.readbyqxmd.com/read/29544699/6-month-versus-12-month-or-longer-dual-antiplatelet-therapy-after-percutaneous-coronary-intervention-in-patients-with-acute-coronary-syndrome-smart-date-a-randomised-open-label-non-inferiority-trial
#15
Joo-Yong Hahn, Young Bin Song, Ju-Hyeon Oh, Deok-Kyu Cho, Jin Bae Lee, Joon-Hyung Doh, Sang-Hyun Kim, Jin-Ok Jeong, Jang-Ho Bae, Byung-Ok Kim, Jang Hyun Cho, Il-Woo Suh, Doo-Il Kim, Hoon-Ki Park, Jong-Seon Park, Woong Gil Choi, Wang Soo Lee, Jihoon Kim, Ki Hong Choi, Taek Kyu Park, Joo Myung Lee, Jeong Hoon Yang, Jin-Ho Choi, Seung-Hyuk Choi, Hyeon-Cheol Gwon
BACKGROUND: Current guidelines recommend dual antiplatelet therapy (DAPT) of aspirin plus a P2Y12 inhibitor for at least 12 months after implantation of drug-eluting stents (DES) in patients with acute coronary syndrome. However, available data about the optimal duration of DAPT in patients with acute coronary syndrome undergoing percutaneous coronary intervention are scant. We aimed to investigate whether a 6-month duration of DAPT would be non-inferior to the conventional 12-month or longer duration of DAPT in this population...
March 31, 2018: Lancet
https://www.readbyqxmd.com/read/29541996/short-versus-long-duration-of-dual-antiplatelet-therapy-following-drug-eluting-stents-a-meta-analysis-of-randomised-trials
#16
R Rozemeijer, M Voskuil, J P Greving, M L Bots, P A Doevendans, P R Stella
BACKGROUND: Dual antiplatelet therapy (DAPT) remains the cornerstone therapy in the prevention of ischaemic events following drug-eluting stent (DES) implantation. Mandatory duration of DAPT after DES however, is a matter of debate. We aimed to evaluate safety and efficacy of short-term (up to 6 months) versus long-term (12 months) DAPT after DES implantation. METHODS: We searched PubMed, EMBASE, Cochrane databases, and international meetings for randomised clinical trials (RCTs) comparing short with long DAPT...
March 14, 2018: Netherlands Heart Journal
https://www.readbyqxmd.com/read/29475527/2018-canadian-cardiovascular-society-canadian-association-of-interventional-cardiology-focused-update-of-the-guidelines-for-the-use-of-antiplatelet-therapy
#17
Shamir R Mehta, Kevin R Bainey, Warren J Cantor, Marie Lordkipanidzé, Guillaume Marquis-Gravel, Simon D Robinson, Matthew Sibbald, Derek Y So, Graham C Wong, Joseph G Abunassar, Margaret L Ackman, Alan D Bell, Raymond Cartier, James D Douketis, Patrick R Lawler, Michael S McMurtry, Jacob A Udell, Sean van Diepen, Subodh Verma, G B John Mancini, John A Cairns, Jean-François Tanguay
Antiplatelet therapy (APT) has become an important tool in the treatment and prevention of atherosclerotic events, particularly those associated with coronary artery disease. A large evidence base has evolved regarding the relationship between APT prescription in various clinical contexts and risk/benefit relationships. The Guidelines Committee of the Canadian Cardiovascular Society and Canadian Association of Interventional Cardiology publishes regular updates of its recommendations, taking into consideration the most recent clinical evidence...
March 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29468725/a-clinical-risk-score-to-identify-patients-at-high-risk-of-very-late-stent-thrombosis
#18
Thea C Godschalk, Marieke E Gimbel, Wouter W Nolet, Dionne J van Kessel, Giovanni Amoroso, Willem J Dewilde, Joanna J Wykrzykowska, Paul W Janssen, Thomas O Bergmeijer, Johannes C Kelder, Ton Heestermans, Jurriën M Ten Berg
OBJECTIVES: The aim of this study was to determine predictors of very late stent thrombosis (VLST; >1 year after stenting), and to evaluate whether addition of these predictors to the dual antiplatelet therapy (DAPT) score would improve the ability to identify patients at high risk of VLST who might benefit from DAPT. BACKGROUND: VLST is a severe complication of percutaneous coronary intervention (PCI). Extended knowledge about the predictors of VLST is needed to prevent this life-threatening complication...
April 2018: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29466171/-duration-of-dual-antiplatelet-therapy-in-patients-with-ischemic-heart-disease-after-implantation-of-endovascular-stents
#19
A B Sumarokov, L I Buryachkovskaya, N V Lomakin, Y V Dotsenko, I A Uchitel, L A Timofeeva
Optimal duration of dual antiplatelet therapy (DAPT) after stent implantation is uncertain. Some patients have an extended risk of thrombotic complications including that of very late stent thrombosis after cessation of recommended course of DAPT (6-12 months). On the other hand, there is a real risk of bleeding on DAPT. In this review, we present and discuss results of clinical trials of long-term DAPT and data of their meta-analyses. The review also contains consideration of some aspects of new AHA/ACC recommendations (2016) on duration of DAPT...
January 2018: Kardiologiia
https://www.readbyqxmd.com/read/29464342/vascular-response-to-biolimus-a-9-eluting-stent-in-patients-with-shorter-and-prolonged-dual-antiplatelet-therapy-optical-coherence-tomography-sub-study-of-the-nippon-trial
#20
Koji Kuroda, Toshiro Shinke, Hiromasa Otake, Hiroto Kinutani, Raisuke Iijima, Junya Ako, Hisayuki Okada, Yoshiaki Ito, Kenji Ando, Hitoshi Anzai, Hiroyuki Tanaka, Yasunori Ueda, Shin Takiuchi, Yasunori Nishida, Hiroshi Ohira, Katsuhiro Kawaguchi, Makoto Kadotani, Hiroyuki Niinuma, Kazuto Omiya, Takashi Morita, Kan Zen, Yoshinori Yasaka, Kenji Inoue, Sugao Ishiwata, Masahiko Ochiai, Toshimitsu Hamasaki, Kazushi Urasawa, Toru Kataoka, Minoru Yoshiyama, Kenshi Fujii, Takumi Inoue, Masahito Kawata, Hiroyoshi Yokoi, Masato Nakamura
Dual antiplatelet therapy (DAPT) with thienopyridine and aspirin is the standard care for the prevention of stent thrombosis. However, the optimal duration and effect of the duration of DAPT on intra-stent thrombus (IS-Th) formation are unknown. The NIPPON study (Nobori Dual Antiplatelet Therapy as Appropriate Duration) was an open label, randomized multicenter, assessor-blinded, trial designed to demonstrate the non-inferiority of shorter (6-month) DAPT to prolonged (18-month) DAPT, after biolimus A9 eluting stent implantation in 3773 patients at 130 sites in Japan...
February 20, 2018: Heart and Vessels
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