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clopidogrel and drug-eluting stents

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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
#1
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
#2
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)...
June 13, 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
#3
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...
June 6, 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
#4
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...
May 10, 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
#5
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...
May 11, 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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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)...
April 6, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28276728/determinants-of-high-on-treatment-platelet-reactivity-and-agreement-between-verifynow-and-multiplate-assays
#12
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
#13
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
https://www.readbyqxmd.com/read/28267471/a-randomized-clinical-trial-comparing-long-term-clopidogrel-vs-aspirin-monotherapy-beyond-dual-antiplatelet-therapy-after-drug-eluting-coronary-stent-implantation-design-and-rationale-of-the-harmonizing-optimal-strategy-for-treatment-of-coronary-artery-stenosis
#14
MULTICENTER STUDY
Heesun Lee, Bon-Kwon Koo, Kyung Woo Park, Eun-Seok Shin, Sang Wook Lim, Seung-Woon Rha, Jang-Whan Bae, Dong Woon Jeon, Seok-Kyu Oh, Seung-Ho Hur, Bum-Su Kim, Jung-Hee Lee, Tae-Ho Park, Nam Ho Lee, Hyo-Soo Kim
Percutaneous coronary intervention (PCI) has been developed by drug-eluting stent (DES), but stent implantation has brought the issue of stent thrombosis and optimal antiplatelet therapy. Guidelines recommend at least 6- to 12 months of dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 receptor inhibitor such as clopidogrel. Beyond DAPT after PCI with DES, however, there has been still a debate for antiplatelet regimen. Therefore, we report on the upcoming HOST-EXAM trial (NCT02044250), which will evaluate the efficacy and safety of aspirin and clopidogrel monotherapies beyond DAPT after DES implantation...
March 2017: American Heart Journal
https://www.readbyqxmd.com/read/28255102/randomized-angiographic-and-intravascular-ultrasound-comparison-of-dual-antiplatelet-therapy-vs-triple-antiplatelet-therapy-to-reduce-neointimal-tissue-proliferation-in-diabetic-patients
#15
Maria Fernanda Zuliani Mauro, J Armando Mangione, J Ribamar Costa, Ricardo Costa, Luiz Alberto Piva E Mattos, Rodolfo Staico, Fausto Feres, Dimytri Siqueira, Amanda Sousa, Alexandre Abizaid
BACKGROUND: Previous studies have suggested a benefit of cilostazol in addition to standard dual-antiplatelet therapy (DAPT), reducing in-stent late luminal loss and restenosis after percutaneous coronary intervention (PCI) with bare-metal and drug-eluting stent (DES) implantation. However, there is a paucity of intravascular ultrasound (IVUS) assessment of neointimal tissue hyperplasia (NIH) after triple-antiplatelet therapy (TAPT), especially in diabetic patients treated with DES. METHODS: This prospective, placebo-controlled trial was conducted in diabetic patients randomized (1:1) to receive either standard DAPT (aspirin and clopidogrel) vs TAPT with cilostazol for a minimum of 12 months after PCI with Endeavor zotarolimus-eluting stent (E-ZES)...
March 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28228427/myocardial-infarction-risk-after-discontinuation-of-thienopyridine-therapy-in-the-randomized-dapt-study-dual-antiplatelet-therapy
#16
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 1 year after coronary stenting reduces myocardial infarction (MI) risk and increases bleeding risk in comparison with aspirin alone. The hazard associated with late thienopyridine discontinuation and risk factors for MI after discontinuation are poorly defined. METHODS: In the DAPT Study (Dual Antiplatelet Therapy), after percutaneous coronary intervention and 12 months of thienopyridine (clopidogrel or prasugrel) plus aspirin, eligible patients remained on aspirin and were randomly assigned to continued thienopyridine versus placebo for 18 months...
May 2, 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
#17
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
#18
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
#19
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...
May 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
#20
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
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