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PCI, ACS, stent

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https://www.readbyqxmd.com/read/27899940/staged-versus-one-time-multivessel-intervention-in-elderly-patients-with-non-st-elevation-acute-coronary-syndrome
#1
Xiao-Fan Yu, Yi Li, Qian-Cheng Wang, Xiao-Zeng Wang, Ming Liang, Xin Zhao, Kai Xu, Ya-Ling Han
OBJECTIVE: To evaluate the clinical outcomes of "one-time" versus staged multivessel stenting in elderly (≥ 60 years) patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) and multivessel disease (MVD). METHODS: We analyzed data of consecutive NSTE-ACS patients with multivessel percutaneous coronary intervention (PCI) who were enrolled in General Hospital of Shenyang Military Region between 2008 and 2012. A total of 1090 eligible patients aged ≥ 60 were further categorized into "one-time" group (n = 623) and staged PCI group (n = 467) according to intervention strategy...
September 2016: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/27860195/long-term-outcomes-in-patients-with-acute-coronary-syndromes-related-to-prolonging-dual-antiplatelet-therapy-more-than-12-months-after-coronary-stenting
#2
Neil J Wimmer, Alyssa B Dufour, Kelly Cho, David R Gagnon, Lien Quach, Samantha Ly, Jacquelyn-My Do, Simon Ostrowski, J Michael Gaziano, David P Faxon, Scott Kinlay
OBJECTIVES: To assess the impact of stent type on the risk of death or myocardial infarction (MI) related to dual antiplatelet therapy (DAPT) more than 12 months (prolonged DAPT) versus 12 or less months after PCI for an acute coronary syndrome (ACS). BACKGROUND: The recent DAPT study reported lower recurrent ischemic events from prolonged DAPT in patients treated with PCI for an ACS, but was underpowered to determine the impact of stent type. METHODS: We determined clinical outcomes after PCI for an ACS (median follow-up: DES = 26 months, BMS = 46 months) in 18,484 patients in the Veterans Affairs system treated with first generation drug-eluting stents (DES) or bare-metal stents (BMS)...
November 10, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27810295/association-of-pcsk9-with-platelet-reactivity-in-patients-with-acute-coronary-syndrome-treated-with-prasugrel-or-ticagrelor-the-pcsk9-react-study
#3
Eliano P Navarese, Michalina Kolodziejczak, Max-Paul Winter, Arman Alimohammad, Irene M Lang, Antonino Buffon, Gregory Yh Lip, Jolanta M Siller-Matula
BACKGROUND: Circulating proprotein convertase subtilisin/kexin type 9 (PCSK9) enzyme might be associated with increased activation of platelets. We aimed to assess the relationship between PCSK9 levels, platelet reactivity and ischemic outcomes. METHODS: Consecutive ACS patients receiving prasugrel or ticagrelor and undergoing percutaneous coronary intervention (PCI) were enrolled in a prospective, observational study. Adenosine diphosphate (ADP)-induced platelet aggregation was determined by Multiplate Analyzer in the maintenance phase of treatment with prasugrel or ticagrelor...
October 29, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27809713/improved-predictive-value-of-grace-risk-score-combined-with-platelet-reactivity-for-1-year-cardiovascular-risk-in-patients-with-acute-coronary-syndrome-who-underwent-coronary-stent-implantation
#4
Shan Li, Hongbin Liu, Jianfeng Liu, Haijun Wang
Both high platelet reactivity (HPR) and Global Registry of Acute Coronary Events (GRACE) risk score have moderate predictive value for major adverse cardiovascular disease (CVD) events in patients with acute coronary syndrome (ACS) who underwent percutaneous coronary intervention (PCI), whereas the prognostic significance of GRACE risk score combined with platelet function testing remains unclear. A total of 596 patients with non-ST elevation ACS who underwent PCI were enrolled. The P2Y12 reaction unit (PRU) value was measured by VerifyNow P2Y12 assay and GRACE score was calculated by GRACE risk 2...
November 2016: Platelets
https://www.readbyqxmd.com/read/27756119/two-year-clinical-outcomes-in-stable-angina-and-acute-coronary-syndrome-after-percutaneous-coronary-intervention-of-left-main-coronary-artery-disease
#5
Dae Young Hyun, Myung Ho Jeong, Doo Sun Sim, Yun Ah Jeong, Kyung Hoon Cho, Min Chul Kim, Hyun Kuk Kim, Hae Chang Jeong, Keun Ho Park, Young Joon Hong, Jun Han Kim, Youngkeun Ahn, Jung Chaee Kang
Background/Aims: This study appraised the long term clinical outcomes of patients treated with percutaneous coronary intervention (PCI) for unprotected left main coronary artery (ULMCA) disease. There are limited data regarding long-term clinical outcomes after PCI for ULMCA disease. Methods: From 2001 to 2011, a total of 448 patients who underwent PCI for ULMCA disease and had 2-year clinical follow-up, were analyzed. The study patients were divided into two groups: group I (stable angina pectoris [SAP], n = 60, 48 men, 62 ± 10 years) and group II (acute coronary syndrome [ACS], n = 388, 291 men, 64 ± 10 years)...
October 18, 2016: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/27737596/clinical-humanistic-and-economic-outcomes-between-drug-eluting-stent-des-and-bare-metal-stent-bms-18-month-follow-up-study
#6
Vivian W Y Lee, Franco W Cheng, Adrian Y Choi, Sam T Fong, Cheuk Man Yu, Bryan P Yan
BACKGROUND: Percutaneous coronary intervention (PCI) is one of the most performed interventions for ischemic heart diseases. In Hong Kong, the total number of patient discharges and deaths for ischemic heart diseases in 2009 was 33,363, including 4,360 deaths. There are over 5,000 cases of PCI yearly. This study aimed to compare clinical, economic and humanistic outcomes among patients receiving drug-eluting stent (DES) or bare metal stent (BMS) in Hong Kong. METHODS: Patients who received stent implantation between 15(th) September, 2009 and 11(th) October, 2010 in Prince of Wales Hospital, Hong Kong, were recruited and followed for 18 months...
October 14, 2016: Journal of Medical Economics
https://www.readbyqxmd.com/read/27715344/pharmacokinetics-and-pharmacodynamics-of-ticagrelor-in-the-treatment-of-cardiac-ischemia
#7
Gian Marco Rosa, Daniele Bianco, Alberto Valbusa, Laura Massobrio, Francesco Chiarella, Claudio Brunelli
After acute coronary syndromes (ACS), the so-called dual antiplatelet therapy (DAPT), which usually consists of low-dose of aspirin in combination with a thienopyridine (clopidogrel, prasugrel) or with a cyclopentyltriazolopyrimidine (ticagrelor), reduces the risk of ischemic events. Ticagrelor, un particular, is an effective drug as it isn' a prodrug, doesn't require metabolic activation and demonstrates a rapid onset and faster offset of action. Areas covered: This article evaluates the pharmacokinetics, efficacy, safety and tolerability of ticagrelor during DAPT after ACS and its potential use beyond the canonical twelve months after PCI...
December 2016: Expert Opinion on Drug Metabolism & Toxicology
https://www.readbyqxmd.com/read/27714719/platelet-distribution-width-predicts-left-ventricular-dysfunction-in-patients-with-acute-coronary-syndromes-treated-with-percutaneous-coronary-intervention
#8
Michał Kowara, Kajetan Grodecki, Zenon Huczek, Dominika Puchta, Katarzyna Paczwa, Bartosz Rymuza, Karol Zbroński, Krzysztof J Filipiak, Grzegorz Opolski
BACKGROUND: Platelets' role in pathophysiology of acute coronary syndromes (ACS) is undeniable, but precise relationships between platelet activity and treatment outcomes are matter of continuant investigation. Among platelet indices, mean platelet volume (MPV) has proven to be valuable predicting factor in cardiac patients. However platelet distribution width (PDW) is reported to be more specific marker of platelet reactivity. Thus, application of PDW in risk stratification of ACS treatment is up-to-date subject of research...
October 7, 2016: Kardiologia Polska
https://www.readbyqxmd.com/read/27701930/prasugrel-hydrochloride-for-the-treatment-of-acute-coronary-syndrome-patients
#9
Ashan Gunarathne, Shahana Hussain, Anthony H Gershlick
Dual antiplatelet therapy (DAPT) with aspirin combined with either a thienopyridine (clopidogrel or prasugrel) or acyclopentyl-triazolo-pyrimidine (ticagrelor) plays a vital role in the management of acute coronary syndrome (ACS) especially in those undergoing percutaneous coronary intervention (PCI) but even those being managed medically. Observational studies and some formal studies have shown patients on the standard dual antiplatelet regimen (clopidogrel and aspirin) continue to have further ischemic events and can suffer stent thrombosis...
October 4, 2016: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/27692158/soluble-adhesion-molecules-in-patients-with-acute-coronary-syndrome-after-percutaneous-coronary-intervention-with-drug-coated-balloon-drug-eluting-stent-or-bare-metal-stent
#10
Vjekoslav Tomulić, David Gobić, Davorka Lulić, David Židan, Luka Zaputović
Adhesion molecules play an important role in inflammation, atherosclerosis and coronary artery disease (CAD). These molecules are expressed on the surface of dysfunctional endothelial cells, causing inflammatory cells from the circulation to adhere and migrate through the endothelium. Their expression is upregulated in acute coronary syndrome (ACS) and after percutaneous coronary intervention (PCI). The contact between stent struts and endothelium upregulates endothelial cell gene expression, endothelial cell activation and inflammation...
October 2016: Medical Hypotheses
https://www.readbyqxmd.com/read/27677505/optimizing-the-use-of-cangrelor-in-the-real-world
#11
Arman Qamar, Deepak L Bhatt
Thrombotic events such as myocardial infarction or stent thrombosis are the major cause of adverse outcomes in patients undergoing percutaneous coronary intervention (PCI). While current antiplatelet agents, anticoagulants, and PCI techniques have reduced the risk of thrombotic events in PCI-treated patients, a considerable hazard still remains. Cangrelor is an intravenous P2Y12 receptor antagonist that provides a rapid onset and maximal platelet inhibition, which is quickly reversible. In the large-scale CHAMPION PHOENIX trial, cangrelor was shown to reduce ischemic events significantly, including myocardial infarction and stent thrombosis, without increasing the risk of severe bleeding across the full spectrum of patients undergoing PCI, with substantial benefits in all patient subgroups examined...
September 27, 2016: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/27676253/residual-thrombin-potential-predicts-cardiovascular-death-in-acute-coronary-syndrome-patients-undergoing-percutaneous-coronary-intervention
#12
Monica Attanasio, Rossella Marcucci, Anna Maria Gori, Rita Paniccia, Serafina Valente, Daniela Balzi, Alessandro Barchielli, Nazario Carrabba, Renato Valenti, David Antoniucci, Rosanna Abbate, Gian Franco Gensini
INTRODUCTION: Thrombin generation (TG) is a central step of the coagulation system involved in hemostatic and thrombotic roles. Scarce data evaluating in the acute phase the association between TG and the risk of cardiovascular death of acute coronary syndrome (ACS) patients are available, in the era of percutaneous coronary intervention (PCI) and stenting with the use of dual antiplatelet treatment. MATERIALS AND METHODS: We investigated TG in 292 ACS patients undergoing PCI with stent implantation on dual antiplatelet treatment...
November 2016: Thrombosis Research
https://www.readbyqxmd.com/read/27659566/efficacy-and-safety-of-cangrelor-in-preventing-periprocedural-complications-in-patients-with-stable-angina-and-acute%C3%A2-coronary-syndromes-undergoing-percutaneous-coronary-intervention-the-champion-phoenix-trial
#13
Jérémie Abtan, P Gabriel Steg, Gregg W Stone, Kenneth W Mahaffey, C Michael Gibson, Christian W Hamm, Matthew J Price, Freddy Abnousi, Jayne Prats, Efthymios N Deliargyris, Harvey D White, Robert A Harrington, Deepak L Bhatt
OBJECTIVES: The purpose of this study was to examine the safety and efficacy of cangrelor in patients with stable angina (SA) or acute coronary syndrome (ACS). BACKGROUND: The CHAMPION PHOENIX (A Clinical Trial Comparing Cangrelor to Clopidogrel Standard Therapy in Subjects Who Require Percutaneous Coronary Intervention) trial demonstrated that cangrelor significantly reduced periprocedural ischemic events in all-comer percutaneous coronary intervention with a modest increase in mild and moderate bleeding...
September 26, 2016: JACC. Cardiovascular Interventions
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
#14
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/27630146/short-duration-vs-standard-duration-of-dual-antiplatelet-therapy-after-percutaneous-coronary-intervention-with-second-generation-drug-eluting-stents-a-systematic-review-meta-analysis-and-meta-regression-analysis-of-randomized-controlled-trials
#15
Anthony W A Wassef, Hadi Khafaji, Ishba Syed, Andrew T Yan, Jacob A Udell, Shaun G Goodman, Asim N Cheema, Akshay Bagai
BACKGROUND: Current guidelines recommend 12 months of dual-antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) with drug-eluting stent (DES) implantation. Whether the duration of DAPT can be safely shortened with use of second-generation DESs is unclear. METHODS: We conducted a meta-analysis of randomized controlled trials comparing short duration (SD) (3-6 months) with standard longer duration (LD) (≥12 months) DAPT in patients treated with primarily second-generation DES implantation...
September 15, 2016: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/27577194/pericardial-tamponade-due-to-haemorrhagic-pericardial-effusion-as-a-complication-of-prasugrel-a-case-report
#16
Fathima Aaysha Cader, M Maksumul Haq, Sahela Nasrin, Md Rezaul Karim
BACKGROUND: Striking an adequate balance between bleeding risks and prevention of stent thrombosis can be challenging in the setting of percutaneous coronary intervention (PCI) with drug eluting stents (DES) in acute myocardial infarction (MI). This is more pronounced in patients treated with both low molecular weight heparin (LMWH) and dual antiplatelet therapy (DAPT). Prasugrel, a second generation thienopyridine with more potent platelet inhibition capability, is associated with significant bleeding risks...
August 30, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27502850/randomized-evaluation-of-short-term-dual-antiplatelet-therapy-in-patients-with-acute-coronary-syndrome-treated-with-the-combo-dual-therapy-stent-rationale-and-design-of-the-reduce-trial
#17
Cyril Camaro, Sander A J Damen, Marc A Brouwer, Elvin Kedhi, Stephan W Lee, Monica Verdoia, Lucia Barbieri, Andrea Rognoni, Arnoud W J van T Hof, Erik Ligtenberg, Menko-Jan de Boer, Harry Suryapranata, Giuseppe De Luca
BACKGROUND: The optimal duration of dual antiplatelet therapy (DAPT) in acute coronary syndrome (ACS) patients treated with drug eluting stents (DES) is still under debate. Recent meta-analyses on ≤6months versus 12months DAPT suggest that bleeding rates can be reduced, without a higher rate of thrombotic complications. In particular, the COMBO dual therapy stent, being associated with early re-endothelialization, may allow for a reduction of the duration of DAPT without increasing the thrombotic risk, while reducing the risk of bleeding complications...
August 2016: American Heart Journal
https://www.readbyqxmd.com/read/27497362/long-term-clinical-outcomes-after-percutaneous-coronary-intervention-versus-coronary-artery-bypass-grafting-for-acute-coronary-syndrome-from-the-delta-registry-a-multicentre-registry-evaluating-percutaneous-coronary-intervention-versus-coronary-artery-bypass
#18
Stylianos A Pyxaras, Lukas Hunziker, Alaide Chieffo, Emanuele Meliga, Azeem Latib, Seung-Jung Park, Yoshinobu Onuma, Piera Capranzano, Marco Valgimigli, Inga Narbute, Raj R Makkar, Igor F Palacios, Young-Hak Kim, Piotr P Buszman, Tarun Chakravarty, Imad Sheiban, Roxana Mehran, Ronan Margey, Arvind Agnihotri, Sebastiano Marra, Davide Capodanno, Martin B Leon, Jeffrey W Moses, Jean Fajadet, Thierry Lefevre, Marie-Claude Morice, Andrejs Erglis, Corrado Tamburino, Ottavio Alfieri, Patrick W Serruys, Antonio Colombo, Christoph K Naber
AIMS: Our aim was to compare, in a large unprotected left main coronary artery (ULMCA) all-comer registry, the long-term clinical outcome after percutaneous coronary intervention (PCI) with first-generation drug-eluting stents (DES) versus coronary artery bypass grafting (CABG) in patients with acute coronary syndrome (ACS). METHODS AND RESULTS: Of a total of 2,775 patients enrolled in the Drug Eluting Stents for Left Main Coronary Artery Disease (DELTA) multicentre registry, 379 (13...
2016: EuroIntervention
https://www.readbyqxmd.com/read/27485540/the-role-of-intracoronary-plaque-imaging-with-intravascular-ultrasound-optical-coherence-tomography-and-near-infrared-spectroscopy-in-patients-with-coronary-artery-disease
#19
REVIEW
Vu Hoang, Jill Grounds, Don Pham, Salim Virani, Ihab Hamzeh, Athar Mahmood Qureshi, Nasser Lakkis, Mahboob Alam
The development of multiple diagnostic intracoronary imaging modalities has increased our understanding of coronary atherosclerotic disease. These imaging modalities, intravascular ultrasound (IVUS), optical coherence tomography (OCT), and near-infrared spectroscopy (NIRS), have provided a method to study plaques and introduced the concept of plaque vulnerability. They are being increasingly used for percutaneous coronary intervention (PCI) optimization and are invaluable tools in research studying the pathophysiology of acute coronary syndrome (ACS), in-stent thrombosis and in-stent restenosis...
September 2016: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/27459657/clopidogrel-proton-pump-inhibitor-drug-drug-interaction-and-risk-of-adverse-clinical-outcomes-among-pci-treated-acs-patients-a-meta-analysis
#20
Michael A Serbin, Gregory F Guzauskas, David L Veenstra
BACKGROUND: Uncertainty regarding clopidogrel effectiveness attenuation because of a drug-drug interaction with proton pump inhibitors (PPI) has led to conflicting guidelines on concomitant therapy. In particular, the effect of this interaction in patients who undergo a percutaneous coronary intervention (PCI), a population known to have increased risk of adverse cardiovascular events, has not been systematically evaluated. OBJECTIVE: To synthesize the evidence of the effect of clopidogrel-PPI drug interaction on adverse cardiovascular outcomes in a PCI patient population...
August 2016: Journal of Managed Care & Specialty Pharmacy
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