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https://www.readbyqxmd.com/read/29782255/-high-on-treatment-platelet-reactivity-determinants-on-dual-antiplatelet-therapy-in-patients-with-ischemic-heart-disease-before-elective-percutaneous-coronary-intervention
#1
E Z Golukhova, M V Grigoryan, M N Ryabinina, N I Bulaeva
OBJECTIVE: to determine impact of different laboratory and genetic factors on high on-treatment platelet reactivity (HOPR) during dual antiplatelet therapy (DAPT). METHODS: We included in this study 94 patients with stable ischemic heart disease (mean age 59±9.67 years). All patients underwent elective PCI with implantation of drug eluting stents at the background of dual antiplatelet therapy (DAPT) with aspirin and clopidogrel. Platelet reactivity was assessed using light transmission aggregometry with 5 μmol/L ADP (LTA 5ADP) and VerifyNow assay before PCI...
April 2018: Kardiologiia
https://www.readbyqxmd.com/read/29764713/utility-of-grace-and-acuity-horizons-risk-scores-to-guide-dual-antiplatelet-therapy-in-korean-patients-with-acute-myocardial-infarction-undergoing-drug-eluting-stenting
#2
Doo Sun Sim, Myung Ho Jeong, Hyo Soo Kim, Hyeon Cheol Gwon, Ki Bae Seung, Seung Woon Rha, Shung Chull Chae, Chong Jin Kim, Kwang Soo Cha, Jong Sun Park, Jung Han Yoon, Jei Keon Chae, Seung Jae Joo, Dong Ju Choi, Seung Ho Hur, In Whan Seong, Myeong Chan Cho, Doo Il Kim, Seok Kyu Oh, Tae Hoon Ahn, Jin Yong Hwang
BACKGROUND: Dual antiplatelet therapy (DAPT) is recommended in patients receiving drug-eluting stents (DES). However, bleeding risk should be weighed against ischemic risk. Utility of GRACE risk score and ACUITY-HORIZONS bleeding risk score was assessed in patients with acute myocardial infarction (MI) according to use of P2Y12 blocker. METHODS: From the Korea Acute Myocardial Infarction Registry-National Institute of Health database, 7791 patients with acute MI receiving DES were divided into ticagrelor (n=1554) and clopidogrel (n=6237) groups...
May 12, 2018: Journal of Cardiology
https://www.readbyqxmd.com/read/29692936/safety-and-efficacy-of-triple-therapeutic-targets-with-rivaroxaban-after-acute-myocardial-infarction-complicated-by-left-ventricular-thrombi-in-a-case-of-nonvalvular-atrial-fibrillation
#3
Francesco Summaria, Gregory A Sgueglia, Fabrizio D'Errico, Antonella De Santis, Fabiana Piccioni, Gaetano Gioffrè, Achille Gaspardone
We present the complex case of a high-risk patient with nonvalvular atrial fibrillation, who experienced a non-ST elevation myocardial infarction complicated by left ventricular (LV) thrombi and underwent percutaneous coronary intervention with drug-eluting stent implantation. The patient was initially treated with short-term triple therapy including aspirin, clopidogrel, and rivaroxaban 15 mg/die. Following aspirin dropping one month after discharge, the patient continued on dual therapy with clopidogrel and rivaroxaban, and a clinical and imaging follow-up at 6 and 12 months confirmed the LV thrombi resolution, with no thromboembolic episodes and a good safety profile...
2018: Case Reports in Cardiology
https://www.readbyqxmd.com/read/29670522/dabigatran-added-to-dual-antiplatelet-therapy-to-treat-a-left-ventricular-thrombus-in-an-87-year-old-patient-with-myocardial-infarction-and-very-high-bleeding-risk
#4
Maria Noflatscher, Nicolas Moes, Eva-Maria Gassner, Peter Marschang
Background: A left ventricular (LV) thrombus is detected in approximately 5-10% of patients after myocardial infarction (MI). If left untreated, these LV thrombi carry a significant risk of complications including embolic stroke. According to current guidelines, anticoagulation with vitamin K antagonists (VKA) is recommended to treat a LV thrombus. Case presentation: An 87 year old patient was referred to our department with non ST-elevation MI. Five months before, he had been diagnosed with a subacute ST elevation MI, which had been treated conservatively...
2018: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29618159/early-p2y12-inhibitors-escalation-in-primary-pci-patients-insights-from-the-renovami-registry
#5
Alessandro Lupi, Roberta Della Bona, Emanuele Meliga, Davide Capodanno, Alon Schaffer, Angelo S Bongo, Giovanni Gaudio, Luigina Guasti, Dimitrios Alexopoulos, Marco Valgimigli, Italo Porto
BACKGROUND:  Early escalation from clopidogrel to new generation P2Y12 inhibitors is common practice in patients with ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI). Real-world data about this strategy, however, are limited. METHODS:  From 2012 to 2015, 1,057 consecutive STEMI patients treated with pPCI in an Italian hub-and-spoke network were prospectively included in an observational registry (RENOVAMI, ClinicalTrials...
April 4, 2018: Thrombosis and Haemostasis
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
#6
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/29562422/-predictive-value-of-the-grace-discharge-score-on-the-long-term-out-of-hospital-coronary-thrombotic-events-after-implantation-of-drug-eluting-stents
#7
X Y Zhao, J X Li, X F Tang, Y Xian, J J Xu, Y Song, L Jiang, L J Xu, J Chen, Y Zhang, L Song, L J Gao, Z Gao, J Zhang, Y Wu, S B Qiao, Y J Yang, R L Gao, B Xu, J Q Yuan
Objective: To evaluate the predictive value of GRACE discharge score on the long-term out-of-hospital coronary thrombotic events (CTE) after percutaneous coronary intervention (PCI) with drug-eluting stents. Methods: Present study was a prospective, observational, single center study. 10 724 consecutive patients underwent PCI in Fuwai Hospital between January and December 2013 were included, stents were implanted with conventional method. After PCI, patients were prescribed aspirin 100 mg once daily indefinitely, and either clopidogrel 75 mg once daily or ticagrelor 90 mg twice daily for at least 1 year...
March 24, 2018: Zhonghua Xin Xue Guan Bing za Zhi
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
#8
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/29544348/epidemiology-and-management-of-patients-with-acute-coronary-syndromes-in-contemporary-real-world-practice-evolving-trends-from-the-eyeshot-study-to-the-start-antiplatelet-registry
#9
Paolo Calabrò, Felice Gragnano, Marco di Maio, Giuseppe Patti, Emilia Antonucci, Plinio Cirillo, Paolo Gresele, Gualtiero Palareti, Vittorio Pengo, Pasquale Pignatelli, Mauro Pennacchi, Antonino Granatelli, Stefano De Servi, Leonardo De Luca, Rossella Marcucci
The epidemiology and management of patients with acute coronary syndromes (ACSs) have evolved. We aimed to describe recent demographics and therapeutic changes in the Italian ACS population. We analyzed data from 2 multicenter consecutive Italian registries (the EYESHOT [EmploYEd antithrombotic therapies in patients with acute coronary Syndromes HOspitalised in iTalian cardiac care units] and START-ANTIPLATELET registries) enrolling patients with ACS between December 2013 and June 2016. An overall population of 3756 patients with ACS was enrolled: 2585 in the EYESHOT and 1171 in the START-ANTIPLATELET...
January 1, 2018: Angiology
https://www.readbyqxmd.com/read/29475531/associations-between-complex-pci-and-prasugrel-or-clopidogrel-use-in-patients-with-acute-coronary-syndrome-who-undergo-pci-from-the-prometheus-study
#10
Jaya Chandrasekhar, Usman Baber, Samantha Sartori, Melissa Aquino, Annapoorna S Kini, Sunil Rao, William Weintraub, Timothy D Henry, Serdar Farhan, Birgit Vogel, Sabato Sorrentino, Zhen Ge, Samir Kapadia, Joseph B Muhlestein, Sandra Weiss, Craig Strauss, Catalin Toma, Anthony DeFranco, Mark B Effron, Stuart Keller, Brian A Baker, Stuart Pocock, George Dangas, Roxana Mehran
BACKGROUND: Potent P2Y12 inhibitors might offer enhanced benefit against thrombotic events in complex percutaneous coronary intervention (PCI). We examined prasugrel use and outcomes according to PCI complexity, as well as analyzing treatment effects according to thienopyridine type. METHODS: PROMETHEUS was a multicentre observational study that compared clopidogrel vs prasugrel in acute coronary syndrome patients who underwent PCI (n = 19,914). Complex PCI was defined as PCI of the left main, bifurcation lesion, moderate-severely calcified lesion, or total stent length ≥ 30 mm...
March 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29456058/comparison-of-the-9-month-intra-stent-conditions-and-2-year-clinical-outcomes-after-resolute-zotarolimus-eluting-stent-implantation-between-3-month-and-standard-dual-antiplatelet-therapy
#11
Wataru Fujimoto, Takahiro Sawada, Takayoshi Toba, Yu Takahashi, Taishi Miyata, Shogo Oishi, Tsuyoshi Osue, Tetsuari Onishi, Tomofumi Takaya, Akira Shimane, Yasuyo Taniguchi, Hiroya Kawai, Yoshinori Yasaka
BACKGROUND: The use of short-duration dual antiplatelet therapy (DAPT) remains controversial. To investigate efficacy and safety of short-duration DAPT, we performed a detailed comparison of intra-stent conditions by optical coherence tomography (OCT) after second-generation drug-eluting stent implantation with short-term and standard DAPT. METHODS AND RESULTS: Eighty-two consecutive patients with stable angina pectoris who received Resolute zotarolimus-eluting stents (R-ZESs; Medtronic Cardiovascular, Santa Rosa, CA, USA) were enrolled...
February 16, 2018: Journal of Cardiology
https://www.readbyqxmd.com/read/29447787/rationale-and-design-of-the-comparison-between-a-p2y12-inhibitor-monotherapy-versus-dual-antiplatelet-therapy-in-patients-undergoing-implantation-of-coronary-drug-eluting-stents-smart-choice-a-prospective-multicenter-randomized-trial
#12
Young Bin Song, Seok Kyu Oh, Ju-Hyeon Oh, Eul-Soon Im, Deok-Kyu Cho, Byung Ryul Cho, Jong-Young Lee, Joo Myung Lee, Taek Kyu Park, Jeong Hoon Yang, Jin-Ho Choi, Seung-Hyuck Choi, Sang Hoon Lee, Hyeon-Cheol Gwon, Joo-Yong Hahn
BACKGROUND AND RATIONALE: Dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 inhibitor reduces thrombotic events in patients undergoing percutaneous coronary intervention (PCI), but these benefits come at the expense of increased risk of bleeding when compared with aspirin monotherapy. It is unclear whether P2Y12 inhibitor monotherapy might maintain anti-ischemic efficacy while reducing the bleeding risk compared with DAPT after implantation of the current generation of drug-eluting stents (DES)...
March 2018: American Heart Journal
https://www.readbyqxmd.com/read/29447774/percutaneous-coronary-intervention-of-lesions-with-in-stent-restenosis-a-report-from-the-adapt-des-study
#13
Björn Redfors, Philippe Généreux, Bernhard Witzenbichler, Akiko Maehara, Giora Weisz, Thomas McAndrew, Roxana Mehran, Ajay J Kirtane, Gregg W Stone
BACKGROUND: There is a paucity of data from large contemporary cohorts of patients with in-stent restenosis (ISR) treated with drug-eluting stents (DESs), and no studies have examined the impact of high platelet reactivity (HPR) on the occurrence of ischemic events after ISR percutaneous coronary intervention (PCI) with DESs. We sought to report outcomes after PCI of ISR lesions and its association with HPR. METHODS: Patients in the prospective, multicenter ADAPT-DES study were stratified according to whether they had ISR versus non-ISR PCI...
March 2018: American Heart Journal
https://www.readbyqxmd.com/read/29397568/cyp2c19-and-abcb1-genetic-polymorphisms-correlate-with-the-recurrence-of-ischemic-cardiovascular-adverse-events-after-clopidogrel-treatment
#14
Xumin Hou, Wenzheng Han, Qian Gan, Yuan Liu, Weiyi Fang
BACKGROUND: This study was aimed to investigate the correlation between CYP2C19 and ABCB1 polymorphisms and the recurrence of ischemic cardiovascular adverse events in patients with coronary artery disease treated with clopidogrel. METHODS: A total of 168 patients with coronary heart disease who underwent PCI operation and received clopidogrel treatment were enrolled. Dual antiplatelet therapy was applied to the treatment of patients for 2 years. Thromboelastography was used to test the efficiency of blood coagulation...
February 4, 2018: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/29352151/effects-of-genetic-variants-on-platelet-reactivity-and-one-year-clinical-outcomes-after-percutaneous-coronary-intervention-a-prospective-multicentre-registry-study
#15
Hyung Joon Joo, Sung Gyun Ahn, Jae Hyoung Park, Ji Young Park, Soon Jun Hong, Seok-Yeon Kim, WoongGil Choi, HyeonCheol Gwon, Young-Hyo Lim, Weon Kim, Woong Chol Kang, Yun-Hyeong Cho, Yong Hoon Kim, JungHan Yoon, WonYong Shin, Myeong-Ki Hong, Scot Garg, Yangsoo Jang, Do-Sun Lim
Clopidogrel is the mainstay for antiplatelet treatment after percutaneous coronary intervention (PCI). The relationship of platelet reactivity and genetic polymorphism with clinical outcomes with newer-generation drug-eluting stents is unclear. We analysed 4,587 patients for the most powerful single-nucleotide polymorphisms (CYP2C19, CYP2C9, ABCB1, PON1, and P2Y12) related to on-treatment platelet reactivity (OPR). The optimal cut-off value of high OPR for major adverse thrombotic events was 266. CYP2C19 was significantly associated with high OPR and the number of CYP2C19*R (*2 or *3) alleles was proportional to the increased risk of high OPR...
January 19, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29349545/risk-of-discontinuation-of-clopidogrel-after-1-month-following-bare-metal-stents-a-propensity-score-adjusted-comparison-with-continued-administration-of-clopidogrel-after-drug-eluting-stents
#16
Christian M Valina, Sebastian Merz, Nikolaus Löffelhardt, Michael Amann, Miroslaw Ferenc, Christian Stratz, Franz-Josef Neumann, Willibald Hochholzer
In patients at high risk for bleeding undergoing percutaneous coronary intervention (PCI) the use of bare-metal-stent (BMS) is considered an option that allows discontinuation of clopidogrel after 4 weeks. We sought to investigate the risk of early discontinuation of clopidogrel in patients with BMS as compared with a 6-month course of clopidogrel after DES in patients with or without high on-treatment platelet reactivity (HTPR). In 765 consecutive patients undergoing PCI after loading with clopidogrel 600 mg, HTPR was tested by optical aggregometry and defined as residual platelet reactivity > 14%...
April 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29343478/treatment-of-gastrointestinal-bleeding-with-idarucizumab-in-a-patient-receiving-dabigatran
#17
Jennifer Mourafetis, Norman Doctor, Simon Leung
PURPOSE: A case report describing use of idarucizumab for dabigatran reversal without the use of hemostatic agents in a patient who developed acute upper gastrointestinal (GI) bleeding while receiving triple antithrombotic therapy is presented. SUMMARY: A 77-year-old man with a complex cardiac history presented to the emergency room with chief complaints of black tarry stools and low blood pressures for 4 days. His past medical history included recent percutaneous coronary intervention (PCI) and drug-eluting stent (DES) placement, atrial fibrillation, hypertension, hyperlipidemia, coronary artery disease, coronary artery bypass graft surgery, stage 3 chronic kidney disease, and cholecystectomy...
February 15, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29334682/body-mass-index-and-plasma-p-selectin-before-coronary-stenting-predict-high-residual-platelet-reactivity-at-6-months-on-dual-antiplatelet-therapy
#18
Elena Z Golukhova, Marina V Grigoryan, Mariya N Ryabinina, Naida I Bulaeva, Victor L Serebruany
BACKGROUND: High residual platelet reactivity (HRPR) during dual antiplatelet therapy (DAPT) may impact clinical outcomes following percutaneous coronary interventions (PCI). However, whether any biomarkers assessed before PCI at DAPT loading may predict delayed maintenance HRPR is not clear. OBJECTIVE: The aim of this study was to determine whether conventional clinical or laboratory indices at loading before stenting may predict HRPR at 6 months of maintenance DAPT...
2018: Cardiology
https://www.readbyqxmd.com/read/29312662/is-there-a-safe-time-to-stop-clopidogrel-in-patients-on-dual-antiplatelet-therapy-after-a-percutaneous-coronary-intervention-and-placement-of-drug-eluting-stents
#19
EDITORIAL
Nureddin Almaddah, Rami N Khouzam
No abstract text is available yet for this article.
December 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29279531/dual-antiplatelet-therapy-guided-by-cyp2c19-polymorphisms-after-implantation-of-second-generation-drug-eluting-stents-for-management-of-acute-coronary-syndrome
#20
Takuya Ozawa, Masayoshi Suda, Ryutaro Ikegami, Toshiki Takano, Takayuki Wakasugi, Takao Yanagawa, Komei Tanaka, Kazuyuki Ozaki, Satoru Hirono, Tohru Minamino
Prasugrel, a novel P2Y12 receptor inhibitor, is administered to patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI), but it can increase the risk of bleeding. The Japanese exhibit weaker responses to clopidogrel than other races because of CYP2C19 polymorphisms; thus, it is unclear whether these patients should continue dual antiplatelet therapy (DAPT) using prasugrel or switch to clopidogrel in the chronic phase. Here we evaluated the clinical outcomes of DAPT guided by CYP2C19 polymorphisms after implantation of second-generation drug-eluting stents (DESs) for ACS management...
January 27, 2018: International Heart Journal
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