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clopidogrel and drug-eluting stents

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https://www.readbyqxmd.com/read/28810251/a-prospective-randomized-open-label-blinded-endpoint-study-exploring-platelet-response-to-half-dose-prasugrel-and-ticagrelor-in-patients-with-the-acute-coronary-syndrome-hope-tailor-study
#1
Cai De Jin, Moo Hyun Kim, Junghee Bang, Victor Serebruany
BACKGROUND: The optimal dosing of novel oral P2Y12 receptor platelet inhibitors such as prasugrel or ticagrelor is unclear and especially challenging in East Asians. We hypothesize that half-dose prasugrel and ticagrelor may be sufficient for long-term maintenance management in Korean patients with the acute coronary syndrome (ACS) compared with conventional dosages. DESIGN: HOPE-TAILOR (Half Dose of Prasugrel and Ticagrelor in Platelet Response after Acute Coronary Syndromes) is a prospective, randomized, open-label, blinded, endpoint (PROBE) single-center, clinical trial...
August 16, 2017: Cardiology
https://www.readbyqxmd.com/read/28783201/validation-of-the-dapt-score-in-patients-randomized-to-6-or-12-months-clopidogrel-after-predominantly-second-generation-drug-eluting-stents
#2
Yukinori Harada, Jonathan Michel, Raphaela Lohaus, Katharina Mayer, Roberto Emmer, Anna Lena Lahmann, Roisin Colleran, Daniele Giacoppo, 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, Robert A Byrne, Adnan Kastrati, Stefanie Schulz-Schüpke
The DAPT score is a recently-proposed decision tool for guiding optimal duration of dual antiplatelet therapy (DAPT). It showed modest accuracy in prior derivation and validation cohorts of patients with ≥12 months DAPT. This study was aimed to evaluate the validity of the DAPT score in a cohort of patients with 6 or 12 months DAPT after implantation of predominantly second-generation drug-eluting stents. We analyzed data of patients enrolled in the ISAR-SAFE trial. Patients were classified into low (<2) or high (≥2) DAPT score groups...
July 27, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28780034/impact-of-aspirin-and-clopidogrel-hyporesponsiveness-in-patients-treated%C3%A2-with-drug-eluting-stents-2-year-results-of-a-prospective-multicenter-registry-study
#3
Thomas D Stuckey, Ajay J Kirtane, Bruce R Brodie, Bernhard Witzenbichler, Claire Litherland, Giora Weisz, Michael J Rinaldi, Franz-Josef Neumann, D Christopher Metzger, Timothy D Henry, David A Cox, Peter L Duffy, Ernest L Mazzaferri, Paul A Gurbel, Roxana Mehran, Philippe Généreux, Ori Ben-Yehuda, Charles A Simonton, Gregg W Stone
OBJECTIVES: In this analysis of 2-year outcomes in the ADAPT-DES (Assessment of Dual AntiPlatelet Therapy with Drug-Eluting Stents) study, the authors sought to examine the independent associations between platelet reactivity to both aspirin and clopidogrel and subsequent outcomes. BACKGROUND: The relationship between platelet reactivity and long-term adverse events following implantation of drug-eluting stents (DES) has been incompletely characterized. METHODS: The ADAPT-DES study was a multicenter registry of patients undergoing routine platelet function testing following percutaneous coronary intervention with DES...
July 27, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28754568/quantifying-ischemic-risk-after-percutaneous-coronary-intervention-attributable-to-high-platelet-reactivity-on-clopidogrel-from-the-assessment-of-dual-antiplatelet-therapy-with-drug-eluting-stents-study
#4
Björn Redfors, Ori Ben-Yehuda, Sheng-Hsuan Lin, Ariel Furer, Ajay J Kirtane, Bernhard Witzenbichler, Giora Weisz, Thomas D Stuckey, Akiko Maehara, Philippe Généreux, Gennaro Giustino, Michael J Rinaldi, Franz-Josef Neumann, D Christopher Metzger, Timothy D Henry, David A Cox, Peter L Duffy, Ernest L Mazzaferri, Girma Minalu Ayele, Roxana Mehran, Gary S Mintz, Gregg W Stone
Patients at high risk of thrombotic events after percutaneous coronary intervention (PCI) may potentially benefit from intensified antiplatelet therapy. However, more potent antiplatelet therapy would be expected to only overcome risk that is mediated by high platelet reactivity (PR). We used mediation analysis to determine the contribution of residual PR to the 2-year risk of major adverse cardiac events (MACE; the composite of cardiac death, myocardial infarction, or stent thrombosis) associated with clinical risk factors after PCI with drug-eluting stents (DES) in 8,374 patients from the prospective, multicenter Assessment of Dual AntiPlatelet Therapy with Drug-Eluting Stents (ADAPT-DES) registry...
June 28, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28745576/association-of-cyp2c19-2-polymorphism-with-clopidogrel-response-and-1-year-major-adverse-cardiovascular-events-in-a-multiethnic-population-with-drug-eluting-stents
#5
Shirley Siang Ning Tan, Alan Yean Yip Fong, Melissa Mejin, Jerry Gerunsin, Khai Liy Kong, Felicia Yien Yin Chin, Lee Len Tiong, Melissa Siaw Han Lim, Asri Said, Ning Zan Khiew, Chi Yen Voon, Nor Hanim Mohd Amin, Yee Ling Cham, Keng Tat Koh, Yen Yee Oon, Tiong Kiam Ong
BACKGROUND: Patients undergoing elective percutaneous coronary intervention (PCI) with drug-eluting stents (DES) who have impaired clopidogrel response, have a higher risk of subsequent major adverse cardiovascular events (MACE). AIM OF THE STUDY: To establish the relationship between CYP2C19 genotype, clopidogrel responsiveness and 1-year MACE. MATERIALS & METHODS: Aspirin/clopidogrel responses were assessed with Multiplate Analyzer and CYP2C19*2 allele by SpartanRx...
July 26, 2017: Pharmacogenomics
https://www.readbyqxmd.com/read/28697899/hiv-and-coronary-disease-when-secondary-prevention-is-insufficient
#6
Ana Sofia Carvalho, Rui Osório Valente, Luís Almeida Morais, Pedro Modas Daniel, Ramiro Sá Carvalho, Lurdes Ferreira, Rui Cruz Ferreira
Highly active antiretroviral therapy (HAART) has created a new paradigm for human immunodeficiency virus (HIV)-infected patients, but their increased risk for coronary disease is well documented. We present the case of a 57-year-old man, co-infected with HIV-2 and hepatitis B virus, adequately controlled and with insulin-treated type 2 diabetes and dyslipidemia, who was admitted with non-ST elevation acute myocardial infarction. Coronary angiography performed on day four of hospital stay documented two-vessel disease (mid segment of the right coronary artery [RCA, 90% stenosis] and the first marginal)...
July 8, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28683175/cost-effectiveness-analysis-of-30-month-vs-12-month-dual-antiplatelet-therapy-with-clopidogrel-and-aspirin-after-drug-eluting-stents-in-patients-with-acute-coronary-syndrome
#7
Minghuan Jiang, Joyce H S You
Continuation of dual antiplatelet therapy (DAPT) beyond 1 year reduces late stent thrombosis and ischemic events after drug-eluting stents (DES) but increases risk of bleeding. We hypothesized that extending DAPT from 12 months to 30 months in patients with acute coronary syndrome (ACS) after DES is cost-effective. A lifelong decision-analytic model was designed to simulate 2 antiplatelet strategies in event-free ACS patients who had completed 12-month DAPT after DES: aspirin monotherapy (75-162 mg daily) and continuation of DAPT (clopidogrel 75 mg daily plus aspirin 75-162 mg daily) for 18 months...
July 6, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28641840/6-versus-24-month-dual-antiplatelet-therapy-after-implantation-of-drug-eluting%C3%A2-stents-in-patients-nonresistant-to-aspirin-final-results-of-the-italic-trial-is-there-a-life-for-des-after-discontinuation-of-clopidogrel
#8
Romain Didier, Marie Claude Morice, Paul Barragan, Arif A L Noryani, Hussam A Noor, Talib Majwal, Thomas Hovasse, Philippe Castellant, Michel Schneeberger, Luc Maillard, Erwan Bressolette, Jaroslaw Wojcik, Nicolas Delarche, Didier Blanchard, Bernard Jouve, Olivier Ormezzano, Franck Paganelli, Gilles Levy, Joël Sainsous, Didier Carrie, Alain Furber, Jacques Berlan, Olivier Darremont, Hervé Le Breton, Anne Lyuycx-Bore, Antoine Gommeaux, Claude Cassat, Alain Kermarrec, Pierre Cazaux, Philippe Druelles, Raphael Dauphin, Jean Armengaud, Patrick Dupouy, Didier Champagnac, Patrick Ohlmann, Hakim Ben Amer, Robert G Kiss, Irme Ungi, Martine Gilard
OBJECTIVES: The aim of this study was to test the hypothesis that 6-month dual antiplatelet therapy (DAPT) is noninferior to 24-month DAPT in aspirin-sensitive patients. BACKGROUND: The ITALIC (Is There a Life for DES After Discontinuation of Clopidogrel) trial showed that rates of bleeding and thrombotic events at 1 year were much the same with 6 versus 12 months of DAPT after percutaneous coronary intervention with second-generation drug-eluting stents. In this report, 2-year follow-up is presented...
June 26, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28605779/use-of-the-dual-antiplatelet-therapy-score-to-guide-treatment-duration-after-percutaneous-coronary-intervention
#9
RANDOMIZED CONTROLLED TRIAL
Raffaele Piccolo, Giuseppe Gargiulo, Anna Franzone, Andrea Santucci, Sara Ariotti, Andrea Baldo, Carlo Tumscitz, Aris Moschovitis, Stephan Windecker, Marco Valgimigli
Background: The dual-antiplatelet therapy (DAPT) score was developed to identify patients more likely to derive harm (score <2) or benefit (score ≥2) from prolonged DAPT after percutaneous coronary intervention (PCI). Objective: To evaluate the safety and efficacy of DAPT duration according to DAPT score. Design: Retrospective assessment of DAPT score-guided treatment duration in a randomized clinical trial. (ClinicalTrials.gov: NCT00611286)...
July 4, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28589365/variability-of-platelet-response-to-clopidogrel-is-not-related-to-adverse-cardiovascular-events-in-patients-with-stable-coronary-artery-disease-undergoing-percutaneous-coronary-intervention
#10
Szymon Olędzki, Zdzisława Kornacewicz-Jach, Krzysztof Safranow, Radosław Kiedrowicz, Barbara Gawrońska-Szklarz, Maria Jastrzębska, Jarosław Gorący
BACKGROUND: Antiplatelet response to clopidogrel and its influence upon the risk of cardiovascular adverse events among patients with stable coronary artery disease undergoing percutaneous coronary intervention (PCI) has not been investigated fully. METHODS: Two hundred eleven patients treated with aspirin and clopidogrel were included in the study. Immediately before PCI, residual platelet reactivity testing with impedance aggregometry assay and a single-nucleotide polymorphism genotyping analysis targeting variants of CYP2C19, ABCB1, and PON1 genes was performed...
September 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28576266/safety-and-tolerability-of-transitioning-from-cangrelor-to-ticagrelor-in-patients-who-underwent-percutaneous-coronary-intervention
#11
Hisham A Badreldin, Danielle Carter, Bryan M Cook, Arman Qamar, Muthiah Vaduganathan, Deepak L Bhatt
The 3 phase 3 CHAMPION (Cangrelor vs Standard Therapy to Achieve Optimal Management of Platelet Inhibition) trials collectively demonstrated the safety of transitioning from cangrelor, a potent, parenteral rapidly-acting P2Y12 inhibitor, to clopidogrel in patients who underwent percutaneous coronary intervention (PCI). However, variation in timing of therapy, site-specific binding, and drug half-lives may theoretically complicate switching to other oral P2Y12 inhibitors. Since regulatory approval, limited data are available regarding the "real-world" safety and tolerability of transitioning to these more potent oral P2Y12 antagonists...
August 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28527773/prevalence-management-and-long-term-6-year-outcomes-of-atrial%C3%A2-fibrillation-among-patients-receiving-drug-eluting-coronary-stents
#12
Hyo-In Choi, Jung-Min Ahn, Se Hun Kang, Pil Hyung Lee, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, Duk-Woo Park, Seung-Jung Park
OBJECTIVES: This study sought to investigate the incidence, management, and clinical relevance of atrial fibrillation (AF) during and after percutaneous coronary intervention (PCI) with drug-eluting stents (DES) and evaluate outcomes of different antithrombotic strategies. BACKGROUND: Uncertainty exists regarding the optimal antithrombotic strategy in patients with AF who are undergoing PCI with DES. METHODS: Using a consecutive series of 10,027 patients who underwent DES implantation between 2003 and 2011, we evaluated the overall prevalence and clinical impact of AF...
June 12, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28506579/-initial-management-of-st-elevation-myocardial-infarction-in-2014-from-guidelines-to-practices-survey-of-176-french-interventional-cardiologists
#13
E Capilla, R Poyet, A-V Tortat, F-X Brocq, F Pons, S Kerebel, C Jego, G R Cellarier
BACKGROUND: Real life management of myocardial infarction has not recently been evaluated in France. AIMS: To describe ST-elevation myocardial infarction management in France in 2014 and to compare it with current guidelines. METHODS: A multicentre study was performed. An e-mail questionnaire was sent to French interventional cardiologists. Demographic data of interventional cardiologists, procedural aspects of percutaneous coronary intervention, antithrombotic treatments and patient rehabilitation have been investigated...
May 12, 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/28495896/percutaneous-coronary-intervention-of-saphenous-vein-graft
#14
Björn Redfors, Philippe Généreux, Bernhard Witzenbichler, Thomas McAndrew, Jamie Diamond, Xin Huang, Akiko Maehara, Giora Weisz, Roxana Mehran, Ajay J Kirtane, Gregg W Stone
BACKGROUND: Percutaneous coronary intervention (PCI) of saphenous vein grafts (SVGs) has historically been associated with a high risk of adverse ischemic events, but there is a paucity of contemporary data on the second-generation drug-eluting stent use within SVG, and the relative importance of high platelet reactivity (HPR) in SVG PCI versus native lesion PCI is unknown. We studied ischemic and bleeding events after SVG PCI and their association with HPR. METHODS AND RESULTS: Subjects in the prospective, multicenter ADAPT-DES study (Assessment of Dual Antiplatelet Therapy With Drug-Eluting Stents) were stratified according to whether they had PCI of an SVG or a non-SVG lesion...
May 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28487152/effects-of-ticagrelor-on-neointimal-hyperplasia-and-endothelial-function-compared-with-clopidogrel-and-prasugrel-in-a-porcine-coronary-stent-restenosis-model
#15
Hyun Kuk Kim, Myung Ho Jeong, Kyung Seob Lim, Jung Ha Kim, Han Chul Lim, Min Chul Kim, Young Joon Hong, Sung Soo Kim, Keun-Ho Park, Kyoung-Sig Chang
BACKGROUND: Several investigations have been conducted to evaluate the off-target effects of ticagrelor. The aim of the present study was to evaluate the off-target effects of ticagrelor such as neointimal formation and endothelial function after drug-eluting stent implantation in a porcine restenosis model. METHODS: A total of 30 pigs were randomly allocated based on the following P2Y12 inhibitor: (1) clopidogrel 300mg loading plus 75mg maintenance (n=10); (2) prasugrel 60mg loading plus 10mg maintenance (n=10); (3) ticagrelor 180mg loading plus 180mg maintenance (n=10)...
May 3, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28475584/duration-of-dual-antiplatelet-therapy-in-patients-treated-with-percutaneous-coronary-intervention-for-coronary-chronic-total-occlusion
#16
Seung Hwa Lee, Jeong Hoon Yang, Seung-Hyuk Choi, Taek Kyu Park, Woo Jin Jang, Young Bin Song, Joo-Yong Hahn, Jin-Ho Choi, Hyeon-Cheol Gwon
BACKGROUND: The duration of dual antiplatelet therapy (DAPT) after drug-eluting stent implantation in coronary chronic total occlusion (CTO) remains unclear. METHODS: We retrospectively analyzed a total of 512 patients treated with percutaneous coronary intervention (PCI) in the Samsung Medical Center CTO registry. Patients were separated into ≤ 12-month (199, 38.9%) vs. > 12 month (313, 61.1%) based on DAPT duration with aspirin and clopidogrel. The primary outcome was major adverse cardiac and cerebrovascular event (MACCE) during follow-up...
2017: PloS One
https://www.readbyqxmd.com/read/28424434/high-dose-bolus-tirofiban-versus-low-dose-bolus-in-patients-with-acute-coronary-syndrome-undergoing-percutaneous-coronary-intervention
#17
Taner Ulus, Utku Şenol, Senan Tahmazov, Kemal Iskenderov, Fezan Mutlu, Yüksel Çavuşoğlu
OBJECTIVE: Aim of the present study was to determine effects of high-dose versus low-dose intravenous (IV) bolus tirofiban on angiographic measures, ST resolution, enzymatic infarct size, and clinical outcomes in patients with acute coronary syndrome (ACS) who were undergoing percutaneous coronary intervention (PCI) and received current pharmacoinvasive therapy. METHODS: Acute coronary syndrome patients (n=271, 85.6% male; mean age: 57.9±12.6 years) from between 2009 and 2015 who received IV tirofiban therapy following PCI were retrospectively analyzed...
March 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28382368/on-clopidogrel-platelet-reactivity-as-predictor-for-long-term-clinical-outcome-in-patients-after-planned-discontinuation-of-clopidogrel
#18
Timo Bömicke, Christian M Valina, Christian Stratz, Michael Amann, Franz-Josef Neumann, Willibald Hochholzer
It is unknown whether the known association of high on-treatment platelet reactivity (HTPR) with worse clinical outcome in patients on clopidogrel following coronary stent implantation persists after planned discontinuation of clopidogrel. This study investigated the association of HTPR with major ischaemic events after planned discontinuation of clopidogrel. Consecutive patients undergoing elective coronary stent implantation after loading with clopidogrel 600 mg were followed for up to seven years (n=765)...
July 26, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28276728/determinants-of-high-on-treatment-platelet-reactivity-and-agreement-between-verifynow-and-multiplate-assays
#19
Dorota Danielak, Anna Komosa, Aleksandra Tomczak, Agnieszka Graczyk-Szuster, Maciej Lesiak, Franciszek Główka, Marta Karaźniewicz-Łada
Dual antiplatelet therapy with clopidogrel is a regimen used before and after drug-eluting stent (DES) implantation. Point-of-care platelet reactivity assays are easy-to-use methods to determine adequate response to the drug. The aim of this study was a comparison of the two platelet reactivity assays: Multiplate(®) and VerifyNow(®) and an identification of factors potentially influencing the results of these tests, including common genetic polymorphisms. The study included 39 patients receiving 75 mg clopidogrel daily before angioplasty with DES implantation...
May 2017: Scandinavian Journal of Clinical and Laboratory Investigation
https://www.readbyqxmd.com/read/28268087/longer-term-oral-antiplatelet-use-in-stable-post-myocardial-infarction-patients-insights-from-the-long-term-risk-clinical-management-and-healthcare-resource-utilization-of-stable-coronary-artery-disease-tigris-observational-study
#20
Shaun G Goodman, Jose C Nicolau, Gema Requena, Andrew Maguire, Stefan Blankenberg, Ji Yan Chen, Christopher B Granger, Richard Grieve, Stuart J Pocock, Tabassome Simon, Satoshi Yasuda, Ana Maria Vega, David Brieger
OBJECTIVE: To describe contemporary patient characteristics and treatment patterns, including antithrombotic management, of post-myocardial infarction (MI) stable coronary artery disease (CAD) patients at high atherothrombotic risk from different geographical regions. METHODS: Patients ≥50years with prior MI 1-3years ago and ≥1 risk factor (age ≥65years, diabetes, 2nd prior MI >1yr ago, multivessel CAD, creatinine clearance 15-<60ml/min) were enrolled by 369 physicians (96% cardiologists) in 25 countries (2013-14) in the prospective TIGRIS study (NCT01866904)...
June 1, 2017: International Journal of Cardiology
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