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https://www.readbyqxmd.com/read/28330641/incidence-patterns-and-associations-between-dual-antiplatelet-therapy-cessation-and-risk%C3%A2-for-adverse-events%C3%A2-among-patients-with-and-without%C3%A2-diabetes-mellitus-receiving-drug-eluting-stents-results-from-the-paris-registry
#1
Michela Faggioni, Usman Baber, Samantha Sartori, Gennaro Giustino, David J Cohen, Timothy D Henry, Serdar Farhan, Cono Ariti, George Dangas, Michael Gibson, Daniele Giacoppo, Mitchell W Krucoff, Melissa Aquino, Jaya Chandrasekhar, David J Moliterno, Antonio Colombo, Birgit Vogel, Alaide Chieffo, Annapoorna S Kini, Bernhard Witzenbichler, Giora Weisz, Philippe Gabriel Steg, Stuart Pocock, Roxana Mehran
OBJECTIVES: The aim of this study was to examine the frequency and clinical impact of different cessation patterns of dual-antiplatelet therapy (DAPT) after percutaneous coronary intervention with drug-eluting stents among patients with and those without diabetes mellitus (DM). BACKGROUND: Early DAPT suspension after percutaneous coronary intervention increases the risk for major adverse cardiac events. However, temporal variability in risk and relation to DAPT cessation patterns among patients with DM remain unclear...
March 10, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28329300/personalising-the-decision-for-prolonged-dual-antiplatelet-therapy-development-validation-and-potential-impact-of-prognostic-models-for-cardiovascular-events-and-bleeding-in-myocardial-infarction-survivors
#2
Laura Pasea, Sheng-Chia Chung, Mar Pujades-Rodriguez, Alireza Moayyeri, Spiros Denaxas, Keith A A Fox, Lars Wallentin, Stuart J Pocock, Adam Timmis, Amitava Banerjee, Riyaz Patel, Harry Hemingway
Aims: The aim of this study is to develop models to aid the decision to prolong dual antiplatelet therapy (DAPT) that requires balancing an individual patient's potential benefits and harms. Methods and results: Using population-based electronic health records (EHRs) (CALIBER, England, 2000-10), of patients evaluated 1 year after acute myocardial infarction (MI), we developed (n = 12 694 patients) and validated (n = 5613) prognostic models for cardiovascular (cardiovascular death, MI or stroke) events and three different bleeding endpoints...
February 27, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28325638/clinically-significant-bleeding-with-low-dose-rivaroxaban-versus-aspirin-in-addition-to-p2y12-inhibition-in-acute-coronary-syndromes-gemini-acs-1-a-double-blind-multicentre-randomised-trial
#3
E Magnus Ohman, Matthew T Roe, P Gabriel Steg, Stefan K James, Thomas J Povsic, Jennifer White, Frank Rockhold, Alexei Plotnikov, Hardi Mundl, John Strony, Xiang Sun, Steen Husted, Michal Tendera, Gilles Montalescot, M Cecilia Bahit, Diego Ardissino, Héctor Bueno, Marc J Claeys, Jose C Nicolau, Jan H Cornel, Shinya Goto, Róbert Gábor Kiss, Ümit Güray, Duk-Woo Park, Christoph Bode, Robert C Welsh, C Michael Gibson
BACKGROUND: Dual antiplatelet therapy (DAPT), aspirin plus a P2Y12 inhibitor, is the standard antithrombotic treatment following acute coronary syndromes. The factor Xa inhibitor rivaroxaban reduced mortality and ischaemic events when added to DAPT, but caused increased bleeding. The safety of a dual pathway antithrombotic therapy approach combining low-dose rivaroxaban (in place of aspirin) with a P2Y12 inhibitor has not been assesssed in acute coronary syndromes. We aimed to assess rivaroxaban 2·5 mg twice daily versus aspirin 100 mg daily, in addition to clopidogrel or ticagrelor (chosen at investigator discretion before randomisation), for patients with acute coronary syndromes started within 10 days after presentation and continued for 6-12 months...
March 17, 2017: Lancet
https://www.readbyqxmd.com/read/28321726/-secondary-prevention-after-myocardial-infarction-with-prolonged-dual-anti-platelet-therapy-dapt-a-new-therapeutic-concept
#4
REVIEW
Sigmund Silber
No abstract text is available yet for this article.
March 2017: MMW Fortschritte der Medizin
https://www.readbyqxmd.com/read/28318138/safety-and-efficacy-of-6-month-versus-12-month-dual-antiplatelet-therapy-in-patients-after-implantation-of-multiple-biodegradable-polymer-coated-sirolimus-eluting-coronary-stents-insight-from-the-i-love-it-2-trial
#5
Jing Qi, Yi Li, Jing Li, Quanmin Jing, Kai Xu, Chuanyu Gao, Likun Ma, Zhi Zhang, Bo Xu, Yaling Han
OBJECTIVE: This study sought to compare the clinical outcomes of 6-month versus 12-month dual antiplatelet therapy (DAPT) in patients receiving multiple biodegradable polymer-coated sirolimus-eluting stents (BP-SES) implants. BACKGROUND: The clinical outcomes for patients who undergo multiple BP-SES implantation with different DAPT durations are uncertain. METHODS: In the I-LOVE-IT 2 trial, 907 patients treated with multiple BP-SES (total stent number ≥2) were assigned to receive 6-month (n = 440) or 12-month (n = 467) DAPT...
March 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28300284/predictors-and-variability-of-drug-eluting-vs-bare-metal-stent-selection-in-contemporary-percutaneous-coronary-intervention-insights-from-the-prism-study
#6
Ali Shafiq, Kensey Gosch, Amit P Amin, Henry H Ting, John A Spertus, Adam C Salisbury
Drug-eluting stents (DES) reduce risk of in-stent restenosis after percutaneous coronary intervention (PCI) but require dual antiplatelet therapy (DAPT) for a longer term than bare-metal stents (BMS). Few studies have examined clinical predictors of DES vs BMS, and variability in provider selection between DES and BMS in clinical practice has not been well described. These insights can inform our understanding of current practice and may identify opportunities to improve decision-making stent selection decinsion-making...
March 16, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28297015/mortality-following-cardiovascular-and-bleeding-events-occurring-beyond-1-year-after-coronary-stenting-a-secondary-analysis-of-the-dual-antiplatelet-therapy-dapt-study
#7
Eric A Secemsky, Robert W Yeh, Dean J Kereiakes, Donald E Cutlip, David J Cohen, P Gabriel Steg, Christopher P Cannon, Patricia K Apruzzese, Ralph B D'Agostino, Joseph M Massaro, Laura Mauri
Importance: Early cardiovascular and bleeding events after coronary stenting are associated with high risk of morbidity and mortality. Objective: To assess the prognosis of cardiovascular and bleeding events occurring beyond 1 year after coronary stenting. Design, Setting, and Participants: This secondary analysis is derived from data from the Dual Antiplatelet Therapy (DAPT) Study, a multicenter trial involving 220 US and international clinical sites from 11 countries...
March 15, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28291000/tailoring-duration-of-dapt-with-risk-scores
#8
Davide Capodanno, Dominick J Angiolillo
No abstract text is available yet for this article.
March 11, 2017: Lancet
https://www.readbyqxmd.com/read/28290994/derivation-and-validation-of-the-predicting-bleeding-complications-in-patients-undergoing-stent-implantation-and-subsequent-dual-antiplatelet-therapy-precise-dapt-score-a-pooled-analysis-of-individual-patient-datasets-from-clinical-trials
#9
Francesco Costa, David van Klaveren, Stefan James, Dik Heg, Lorenz Räber, Fausto Feres, Thomas Pilgrim, Myeong-Ki Hong, Hyo-Soo Kim, Antonio Colombo, Philippe Gabriel Steg, Thomas Zanchin, Tullio Palmerini, Lars Wallentin, Deepak L Bhatt, Gregg W Stone, Stephan Windecker, Ewout W Steyerberg, Marco Valgimigli
BACKGROUND: Dual antiplatelet therapy (DAPT) with aspirin plus a P2Y12 inhibitor prevents ischaemic events after coronary stenting, but increases bleeding. Guidelines support weighting bleeding risk before the selection of treatment duration, but no standardised tool exists for this purpose. METHODS: A total of 14 963 patients treated with DAPT after coronary stenting-largely consisting of aspirin and clopidogrel and without indication to oral anticoagulation-were pooled at a single-patient level from eight multicentre randomised clinical trials with independent adjudication of events...
March 11, 2017: Lancet
https://www.readbyqxmd.com/read/28290236/efficacy-of-cilostazol-based-dual-antiplatelet-treatment-in-patients-undergoing-carotid-artery-stenting
#10
Ichiro Nakagawa, Hun Soo Park, Takeshi Wada, Shohei Yokoyama, Syuichi Yamada, Yasushi Motoyama, Kimihiko Kichikawa, Hiroyuki Nakase
BACKGROUND: It is essential that patients undergoing carotid artery stenting (CAS) receive optimal antiplatelet inhibition. Although a reduction in platelet reactivity and improved clinical outcomes occur when using adjunctive cilostazol with dual antiplatelet therapy, this can lead to an increased risk of hemorrhagic complications. Therefore, our current study examined patients undergoing CAS and evaluated the impact of cilostazol-based dual antiplatelet treatment on the outcomes. METHODS: Between 2010 and 2015, 137 consecutive patients underwent CAS...
March 14, 2017: Neurological Research
https://www.readbyqxmd.com/read/28286920/blockade-of-notch-signaling-promotes-acetaminophen-induced-liver-injury
#11
Longfeng Jiang, Michael Ke, Shi Yue, Wen Xiao, Youde Yan, Xiaozhao Deng, Qi-Long Ying, Jun Li, Bibo Ke
Liver injury after experimental acetaminophen treatment is mediated both by direct hepatocyte injury through a P450-generated toxic metabolite and indirectly by activated liver Kupffer cells and neutrophils. This study was designed to investigate the role of Notch signaling in the regulation of innate immune responses in acetaminophen (APAP)-induced liver injury. Using a mouse model of APAP-induced liver injury, wild-type (WT) and toll-like receptor 4 knockout (TLR4 KO) mice were injected intraperitoneally with APAP or PBS...
March 13, 2017: Immunologic Research
https://www.readbyqxmd.com/read/28284499/the-optimal-discontinuation-of-dual-antiplatelet-therapy-in-patients-undergoing-percutaneous-coronary-intervention-with-drug-eluting-stents-a-meta-analysis-of-randomized-trials
#12
Wei Wang, Jing Liu, Jingxue Fang, Yang Liu, Tong An, Meijuan Zou, Gang Cheng
BACKGROUND: Current guidelines recommend prolonged dual antiplatelet therapy (DAPT) for patients with drug-eluting stents (DES) implantation. Nevertheless, optimal discontinuation of DAPT remains a controversy. We performed a meta-analysis of all randomized controlled trials (RCTs) that evaluate optimal discontinuation of DAPT in patients undergoing percutaneous coronary intervention (PCI) with DES. METHODS: We searched electronic databases including PubMed, Cochrane Library, EMBASE and ClinicalTrials...
February 24, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28284365/initiation-and-duration-of-dual-antiplatelet-therapy-after-inpatient-percutaneous-coronary-intervention-with-stent-implantation-in-germany-an-electronic-healthcare-database-cohort-study
#13
Andres Luque Ramos, Christoph Ohlmeier, Dirk Enders, Roland Linder, Dirk Horenkamp-Sonntag, Jürgen H Prochaska, Rafael Mikolajczyk, Edeltraut Garbe
BACKGROUND: Studies assessing the routine outpatient dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) in Germany are scarce. The aim of this study was (i) to investigate the initiation and duration of DAPT after inpatient PCI with stent implantation in Germany, and (ii) to identify factors associated with DAPT discontinuation during the recommended treatment period. METHODS: This retrospective cohort study was based on data from a large German electronic healthcare database of the years 2004 to 2009...
February 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28281736/optimal-antiplatelet-pharmacotherapy-guided-by-bedside-genetic-or-functional-testing-in-elective-pci-patients-a-pilot-study-onside-test-pilot
#14
Lukasz Koltowski, Mariusz Tomaniak, Daniel Aradi, Zenon Huczek, Krzysztof J Filipiak, Janusz Kochman, Sylwia Gajda, Paweł Balsam, Grzegorz Opolski
BACKGROUND: Dual antiplatelet therapy is recommended after elective percutaneous coronary intervention (PCI) in stable coronary artery disease (SCAD) patients; however, still one-third of patients do not obtain adequate platelet inhibition that may result in increased cardiovascular risk. The aim of the ONSIDE TEST study is to evaluate the clinical impact of point-of-care genotyping- and platelet function-based personalized dual antiplatelet strategies in SCAD individuals undergoing PCI...
March 10, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28279314/meta-analysis-of-randomized-clinical-trials-comparing-biodegradable-polymer-drug-eluting-stent-to-second-generation-durable-polymer-drug-eluting-stents
#15
Georges El-Hayek, Sripal Bangalore, Abel Casso Dominguez, Chandan Devireddy, Wissam Jaber, Gautam Kumar, Kreton Mavromatis, Jacqueline Tamis-Holland, Habib Samady
OBJECTIVES: The authors sought to perform a meta-analysis of randomized clinical trials (RCTs) comparing the safety and efficacy of biodegradable polymer drug-eluting stents (BP-DES) to second-generation durable polymer drug-eluting stents (DP-DES). BACKGROUND: Prior meta-analyses have established the superiority of BP-DES over bare-metal stents and first-generation DP-DES; however, their advantage compared with second-generation DP-DES remains controversial. METHODS: The authors searched PubMed and Scopus databases for RCTs comparing BP-DES to the second-generation DP-DES...
March 13, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28279311/antiplatelet-therapy-after-implantation-of%C3%A2-bioresorbable-vascular-scaffolds-a-review-of-the-published-data-practical-recommendations-and%C3%A2-future-directions
#16
REVIEW
Davide Capodanno, Dominick J Angiolillo
The introduction of bioresorbable vascular scaffolds (BVS) for clinical use has raised a number of questions on whether current dual-antiplatelet therapy (DAPT) recommendations after drug-eluting stent (DES) implantation, mostly deriving from data on second-generation DES, are also applicable to this completely different technology. This article aims to review the technical shortcomings of BVS-the most extensively studied fully bioresorbable coronary stent-and its contemporary rates of scaffold thrombosis, with a focus on recommendations for DAPT duration...
March 13, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28277060/thrombelastographic-hypercoagulability-and-antiplatelet-therapy-after-coronary-artery-bypass-surgery-teg-cabg-trial-a-randomized-controlled-trial
#17
Sulman Rafiq, Pär I Johansson, Klaus F Kofoed, Jens T Lund, Peter S Olsen, Simon Bentsen, Daniel A Steinbrüchel
A hypercoagulable state has, in observational studies, been associated with increased risk of thromboembolic events. The aim of this trial was to study whether dual antiplatelet therapy (DAPT) with clopidogrel in addition to aspirin could reduce the rate of graft occlusions, thromboembolic events, and death compared to aspirin monotherapy in hypercoagulable patients undergoing coronary artery bypass surgery. A total of 1683 patients were screened for eligibility, among which 165 patients were randomized and 133 patients underwent multislice computed tomography scan to evaluate their grafts...
February 22, 2017: Platelets
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
#18
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)...
February 21, 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
#19
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/28262548/notch-inhibition-enhances-cardiac-reprogramming-by-increasing-mef2c-transcriptional-activity
#20
Maria Abad, Hisayuki Hashimoto, Huanyu Zhou, Maria Gabriela Morales, Beibei Chen, Rhonda Bassel-Duby, Eric N Olson
Conversion of fibroblasts into functional cardiomyocytes represents a potential means of restoring cardiac function after myocardial infarction, but so far this process remains inefficient and little is known about its molecular mechanisms. Here we show that DAPT, a classical Notch inhibitor, enhances the conversion of mouse fibroblasts into induced cardiac-like myocytes by the transcription factors GATA4, HAND2, MEF2C, and TBX5. DAPT cooperates with AKT kinase to further augment this process, resulting in up to 70% conversion efficiency...
March 14, 2017: Stem Cell Reports
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