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clopidogrel and drug-eluting stents

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https://www.readbyqxmd.com/read/28228427/myocardial-infarction-risk-after-discontinuation-of-thienopyridine-therapy-in-the-randomized-dapt-study
#1
Ada C Stefanescu Schmidt, Dean J Kereiakes, Donald E Cutlip, Robert W Yeh, Ralph B D'Agostino, Joseph M Massaro, Wen-Hua Hsieh, Laura Mauri
Background -Thienopyridine plus aspirin beyond one year after coronary stenting (PCI) reduces myocardial infarction (MI) risk and increases bleeding risk compared with aspirin alone. The hazard associated with late thienopyridine discontinuation and risk factors for MI after discontinuation are poorly defined. Methods -In the Dual Antiplatelet Therapy (DAPT) Study, after PCI and 12 months of thienopyridine (clopidogrel or prasugrel) plus aspirin, eligible patients remained on aspirin and were randomized to continued thienopyridine vs...
February 22, 2017: Circulation
https://www.readbyqxmd.com/read/28193677/sex-differences-in-the-clinical-impact-of-high-platelet-reactivity-after-percutaneous-coronary-intervention-with-drug-eluting-stents-results-from-the-adapt-des-study-assessment-of-dual-antiplatelet-therapy-with-drug-eluting-stents
#2
Jennifer Yu, Roxana Mehran, Usman Baber, Sze-Yuan Ooi, Bernhard Witzenbichler, Giora Weisz, Michael J Rinaldi, Franz-Josef Neumann, D Christopher Metzger, Timothy D Henry, David A Cox, Peter L Duffy, Ernest L Mazzaferri, Bruce R Brodie, Thomas D Stuckey, Akiko Maehara, Ke Xu, Ori Ben-Yehuda, Ajay J Kirtane, Gregg W Stone
BACKGROUND: Sex differences in the outcomes after percutaneous coronary intervention with drug-eluting stents and in the response to clopidogrel therapy have been reported; however, the differential risk of high platelet reactivity (HPR) on clopidogrel in women versus men is unknown. METHODS AND RESULTS: We compared 8448 patients enrolled in the ADAPT-DES study (Assessment of Dual Antiplatelet Therapy With Drug-Eluting Stents) according to sex and the presence/absence of HPR on clopidogrel (defined as P2Y12 reactivity units >208)...
February 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28184261/dual-antiplatelet-therapy-and-non-cardiac-surgery-evolving-issues-and-anesthetic-implications
#3
REVIEW
Jong Wook Song, Sarah Soh, Jae-Kwang Shim
Dual antiplatelet therapy (DAPT) consisting of aspirin plus a P2Y12 inhibitor (clopidogrel, prasugrel, or ticagrelor) is imperative for the treatment of acute coronary syndrome, particularly during the re-endothelialization period after percutaneous coronary intervention (PCI). When patients undergo surgery during this period, the consequences of stent thrombosis are far more serious than those of bleeding complications, except in cases of intracranial surgery. The recommendations for perioperative DAPT have changed with emerging evidence regarding the improved efficacy of non-first-generation drug (everolimus, zotarolimus)-eluting stents (DES)...
February 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28181585/single-or-dual-antiplatelet-therapy-after-pci
#4
REVIEW
Yosuke Miyazaki, Pannipa Suwannasom, Yohei Sotomi, Mohammad Abdelghani, Karthik Tummala, Yuki Katagiri, Taku Asano, Erhan Tenekecioglu, Yaping Zeng, Rafael Cavalcante, Carlos Collet, Yoshinobu Onuma, Patrick W Serruys
The optimal duration and type of antiplatelet therapy after implantation of a drug-eluting stent (DES) remains uncertain. At the time of the first-in-man implantation of the sirolimus DES in 1999, the protocol-defined dual antiplatelet therapy (DAPT) duration was only 2 months. Subsequently, DAPT duration was extended to 1 year on the basis of anecdotal historical data, and this practice was then incorporated into clinical guidelines. For >1 decade, trialists have sought to compare the safety and efficacy of abbreviated (<6 months) and prolonged (>12 months) DAPT regimens...
February 9, 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/28161565/dual-antiplatelet-therapy-does-not-increase-the-risk-of-bleeding-after-carotid-endarterectomy-results-of-a-prospective-study
#5
Giulio Illuminati, Fabrice Schneider, Giulia Pizzardi, Federica Masci, Francesco G Calio', Jean-Baptiste Ricco
BACKGROUND: The purpose of this study was to evaluate the risk of bleeding and other postoperative complications of carotid endarterectomy (CEA) in patients receiving dual antiplatelet therapy (DAPT). METHODS: From January 2005 to December 2015, 188 consecutive patients undergoing CEA and receiving DAPT (aspirin 100 mg + clopidogrel 75 mg) were enrolled in a prospective study. All of them underwent coronary artery stenting with drug-eluting stents during the 6 months preceding CEA...
February 2, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28159194/optimal-same-day-platelet-inhibition-in-patients-receiving-drug-eluting-stents-with-or-without-previous-maintenance-thienopyridine-therapy-from-the-evaluation-of-platelet-inhibition-in-patients-having-a-verifynow-assay-epiphany-trial
#6
Michael S Lee, Evan Shlofmitz, Elizabeth Haag, Lyn Santiago, Simcha Pollack, Nathaniel Reichek, Richard A Shlofmitz
We determined if high on-treatment platelet reactivity (HTPR) can be overcome on the day of percutaneous coronary intervention (PCI) in patients with or without previous maintenance thienopyridine therapy. Patients with HTPR, as defined as P2Y12 reaction units (PRU) >230, were switched to an alternate thienopyridine. Patients with HTPR undergoing PCI are at increased risk for ischemic complications. A total of 429 patients undergoing PCI with drug-eluting stents were enrolled. Patients on maintenance thienopyridine (n = 249) with PRU >230 were loaded with the alternative thienopyridine...
January 5, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28110296/three-six-or-twelve-months-of-dual-antiplatelet-therapy-after-des-implantation-in-patients-with-or-without-acute-coronary-syndromes-an-individual-patient-data-pairwise-and-network-meta-analysis-of-six-randomized-trials-and-11%C3%A2-473-patients
#7
Tullio Palmerini, Diego Della Riva, Umberto Benedetto, Letizia Bacchi Reggiani, 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, Diego Sangiorgi, Giuseppe Biondi-Zoccai, Philippe Généreux, Gianni D Angelini, Maria Pufulete, Jonathon White, Deepak L Bhatt, Gregg W Stone
AIM: We sought to determine whether the optimal dual antiplatelet therapy (DAPT) duration after drug-eluting stent (DES) placement varies according to clinical presentation. METHODS AND RESULTS: We performed an individual patient data pairwise and network meta-analysis comparing short-term (≤6-months) versus long-term (1-year) DAPT as well as 3-month vs. 6-month vs 1-year DAPT. The primary study outcome was the 1-year composite risk of myocardial infarction (MI) or definite/probable stent thrombosis (ST)...
January 21, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28058211/organ-transplantation-and-drug-eluting-stents-perioperative-challenges
#8
REVIEW
Aparna Dalal
Patients listed for organ transplant frequently have severe coronary artery disease (CAD), which may be treated with drug eluting stents (DES). Everolimus and zotarolimus eluting stents are commonly used. Newer generation biolimus and novolimus eluting biodegradable stents are becoming increasingly popular. Patients undergoing transplant surgery soon after the placement of DES are at increased risk of stent thrombosis (ST) in the perioperative period. Dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 inhibitor such as clopidogrel, prasugrel and ticagrelor is instated post stenting to decrease the incident of ST...
December 24, 2016: World Journal of Transplantation
https://www.readbyqxmd.com/read/28042404/in-hospital-and-one-year-clinical-outcome-of-percutaneous-coronary-intervention-in-a-tertiary-hospital-in-oman-oman-pci-registry
#9
Prashanth Panduranga, Majdah Al-Rashidi, Fatma Al-Hajri
OBJECTIVES: The aim of the study was to investigate the in-hospital and one-year clinical outcome of patients treated with percutaneous coronary intervention (PCI) in a tertiary hospital in Oman. METHODS: We conducted a retrospective, single-center, observational study looking at patients > 18 years old who underwent a PCI from 1 January to 31 December 2013. The primary end point was the occurrence of a major adverse cardiovascular event (MACE), defined as death, any myocardial infarction (MI), cerebrovascular accident (CVA), and target vessel revascularization (TVR) with either repeat PCI or coronary artery bypass surgery (CABG)...
January 2017: Oman Medical Journal
https://www.readbyqxmd.com/read/27980542/antithrombotic-management-in-patients-with-percutaneous-coronary-intervention-requiring-oral-anticoagulation
#10
REVIEW
Jarosław Zalewski, Anetta Undas
The dynamic evolution of therapeutic options including the use of vitamin K antagonists (VKA), non-vitamin K oral anticoagulants (NOAC), more potent antiplatelet drugs as well as new generation drug-eluting stents could lead to the view that the current recommendations on the management of patients with percutaneous coronary intervention (PCI) requiring oral anticoagulation do not keep up with the results of several clinical studies published within the last 5 years. In the present overview, we summarize the recent advances in antithrombotic management used in atrial fibrillation patients undergoing PCI for stable coronary artery disease or acute coronary syndrome (ACS)...
2016: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
https://www.readbyqxmd.com/read/27970172/tct-785-association-between-the-platelet-reactivity-under-clopidogrel-treatment-and-the-severity-of-angioscopic-intra-stent-thrombus-following-drug-eluting-stent-implantation-in-the-femoropopliteal-artery
#11
Takayuki Ishihara, Osamu Iida, Amane Kozuki, Toshiro Shinke, Masashi Fukunaga, Tetsuo Horimatsu, Kenichi Fujii, Junya Shite, Daisuke Terashita, Yoshiro Tsukiyama, Kan Zen, Mitsuyoshi Takahara, Masaaki Uematsu, Shinsuke Nanto
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27914991/antiplatelet-therapy-in-patients-with-glucose-6-phosphate-dehydrogenases-deficiency-after-percutaneous-coronary-intervention-a-reappraisal-for-clinical-and-interventional-cardiologists
#12
REVIEW
Marco Zuin, Gianluca Rigatelli, Mauro Carraro, Maria Paola Galasso, Fabio Dell'Avvocata, Rossella Paolini, Giovanni Zuliani, Loris Roncon
Glucose-6-phosphate dehydrogenase (G6PD) deficiency represents one of the most common erythrocyte enzymopathy. In the era of drug-eluting stents (DESs), the use of prolonged dual antiplatelet therapy (DAPT) with aspirin (ASA) and thienopyridine (clopidogrel or ticlopidine) has become mandatory in the treatment of patients with acute coronary syndromes (ACS) and/or after percutaneous coronary intervention (PCI). However, the use of ASA, and more in general of antiplatelet drugs in patients with G6PD deficiency remains controversial, also for the absence of specific guidelines and scientific evidences...
November 28, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/27894260/high-platelet-reactivity-affects-the-clinical-outcomes-of-patients-undergoing-percutaneous-coronary-intervention
#13
Jun-Jie Zhang, Xiao-Fei Gao, Zhen Ge, Nai-Liang Tian, Zhi-Zhong Liu, Song Lin, Fei Ye, Shao-Liang Chen
BACKGROUND: The association of platelet reactivity and clinical outcomes, especially stent thrombosis, was not so clear. We sought to investigate whether high platelet reactivity affects clinical outcomes of patients with drug eluting stents (DESs) implantation. METHODS: All enrolled individuals treated with DESs implantation were evaluated by PL-11, using sequentially platelet counting method. The primary end point was the occurrence of definite and probable stent thrombosis at 2 years...
November 29, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27846735/perioperative-management-of-dual-anti-platelet-therapy
#14
Tyler D Webster, Prashant Vaishnava, Kim A Eagle
Dual anti-platelet therapy denotes a regimen of aspirin plus a P2Y12 receptor inhibitor, clopidogrel, prasugrel, or ticagrelor. Such therapy is a cornerstone of medical management following acute coronary syndromes and is imperative following percutaneous coronary interventions. While there is uncertainty about the optimal duration of dual antiplatelet therapy following percutaneous coronary intervention, the new 2016 American College of Cardiology/American Heart Association Guidelines suggest that for patients with stable ischemic heart disease at least six months of such therapy following a drug eluting stent and one month following a bare metal stent should be implemented...
December 2016: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/27789517/early-cessation-of-adenosine-diphosphate-receptor-inhibitors-among-acute-myocardial-infarction-patients-treated-with-percutaneous-coronary-intervention-insights-from-the-translate-acs-study-treatment-with-adenosine-diphosphate-receptor-inhibitors-longitudinal
#15
Emil L Fosbøl, Christine Ju, Kevin J Anstrom, Marjorie E Zettler, John C Messenger, Ron Waksman, Mark B Effron, Brian A Baker, David J Cohen, Eric D Peterson, Tracy Y Wang
BACKGROUND: Guidelines recommend the use of adenosine diphosphate receptor inhibitor (ADPri) therapy for 1 year postacute myocardial infarction; yet, early cessation of therapy occurs frequently in clinical practice. METHODS AND RESULTS: We examined 11 858 acute myocardial infarction patients treated with percutaneous coronary intervention discharged alive on ADPri therapy from 233 United States TRANSLATE-ACS study (Treatment With Adenosine Diphosphate Receptor Inhibitors: Longitudinal Assessment of Treatment Patterns and Events After Acute Coronary Syndrome) participating hospitals to determine the prevalence of early ADPri cessation (within 1 year), patient-reported reasons for cessation, and associated risk of major adverse cardiovascular events at 1 year...
November 2016: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27663414/factors-associated-with-initial-prasugrel-versus-clopidogrel-selection-for-patients-with-acute-myocardial-infarction-undergoing-percutaneous-coronary-intervention-insights-from-the-treatment-with-adp-receptor-inhibitors-longitudinal-assessment-of-treatment
#16
Amit N Vora, Eric D Peterson, Lisa A McCoy, Mark B Effron, Kevin J Anstrom, Douglas E Faries, Marjorie E Zettler, Gregg C Fonarow, Brian A Baker, Gregg W Stone, Tracy Y Wang
BACKGROUND: Few studies have examined how antiplatelet therapies are selected during the routine care of acute myocardial infarction patients, particularly relative to the patient's estimated mortality and bleeding risks. METHODS AND RESULTS: We examined patients presenting with acute myocardial infarction treated with percutaneous coronary intervention at 233 US hospitals in the TRANSLATE-ACS observational study from April 2010 to October 2012. We developed a multivariable logistic regression model to identify factors associated with prasugrel selection...
September 23, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27650615/the-diagnostic-utility-of-the-point-of-care-cyp2c19-genotyping-assay-in-patients-with-acute-coronary-syndrome-dosing-clopidogrel-comparison-with-platelet-function-test-and-snp-genotyping
#17
COMPARATIVE STUDY
Jae-Lim Choi, Bo-Ram Kim, Kwang-Sook Woo, Kyeong-Hee Kim, Jeong-Man Kim, Moo-Hyun Kim, Jin-Yeong Han
BACKGROUND: Clopidogrel is a widely used antiplatelet agent for dual antiplatelet therapy and metabolized by CYP2C19. The polymorphism of CYP2C19 is associated with the therapeutic effect of clopidogrel. METHODS: A total of 119 patients diagnosed with acute coronary syndrome (ACS) and underwent percutaneous coronary intervention (PCI) with drug-eluting stents was enrolled. Polymorphisms of CYP2C19 *2,*3,*17 were determined by the Spartan RX CYP2C19 and confirmed by SNP genotyping assay...
September 2016: Annals of Clinical and Laboratory Science
https://www.readbyqxmd.com/read/27641219/short-and-long-term-efficacy-and-safety-of-triple-vs-dual-antithrombotic-therapy-in-patients-with-drug-eluting-stent-implantation-and-an-indication-for-oral-anticoagulation-a-meta-analysis
#18
Yong Cao, Xiao-Yan Tian, Ran Zhang, Jia-Qi Zhao, Meng Zhang, Yun-Tao Cheng, Chuan-Fang Li, Gen-Li Liu, Yi An
BACKGROUND: The optimal antithrombotic regimen after coronary stenting in patients taking oral anticoagulants (OACs) is still unclear. Therefore, this meta-analysis focused on the short- and long-term efficacy and safety of triple therapy (TT: OAC, aspirin, and thienopyridine) and dual therapy (DT: OAC plus single antiplatelet drug or aspirin plus thienopyridine). METHODS: We searched PubMed, Embase, the Cochrane Library, Wangfang database, and Google Scholar up to December 1, 2015 (January 1, 2000 - December 2015), from randomized and nonrandomized studies comparing TT and DT in patients with OACs undergoing drug-eluting stent (DES) implantation...
December 2016: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/27624287/six-versus-twelve-months-clopidogrel-therapy-after-drug-eluting-stenting-in-patients-with-acute-coronary-syndrome-an-isar-safe-study-subgroup-analysis
#19
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...
September 14, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27621487/anticoagulant-and-antiplatelet-prescribing-patterns-for-patients-with-atrial-fibrillation-after-percutaneous-coronary-intervention
#20
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
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