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https://www.readbyqxmd.com/read/29776573/duration-of-dual-antiplatelet-therapy-and-outcome-in-patients-with-acute-coronary-syndrome-undergoing-percutaneous-revascularization-a-meta-analysis-of-11-randomized-trials
#1
Monica Verdoia, Elvin Khedi, Claudia Ceccon, Harry Suryapranata, Giuseppe De Luca
BACKGROUND: Acute coronary syndromes (ACS) represent a context of higher thrombotic risk, where larger advantages have been achieved by the administration of dual antiplatelet therapy (DAPT). However, the indication of 1 year DAPT after coronary angioplasty for ACS has been supported by an outdated randomized trial (PCI-CURE). In addition, the initial fear of late thrombotic events emerged with first generation drug-eluting stents (DES), that suggested the need of a prolonged DAPT prescription, has been completely overcome by the recent technological evolution of DES, that have shown faster re-endothelization and lower rates of late thrombotic complications...
August 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29769167/impact-of-sex-on-comparative-outcomes-of-bivalirudin-versus-unfractionated-heparin-in-patients-with-acute-coronary-syndromes-undergoing-invasive-management-a-pre-specified-analysis-of-the-matrix-trial
#2
Giuseppe Gargiulo, Bruno R da Costa, Enrico Frigoli, Cataldo Palmieri, Marco Stefano Nazzaro, Camillo Falcone, Armando Liso, Carlo Vigna, Fabio Abate, Marco Comeglio, Roberto Diletti, Gabriele Gabrielli, Emilio Di Lorenzo, Pietro Mazzarotto, Marco Zimarino, Claudio Moretti, Antonio Colombo, Carlo Penzo, Giampaolo Pasquetto, Salvatore Brugaletta, Fabio Ferrari, Gavino Casu, Vincenzo Guiducci, Antonio Dellavalle, Francesco Liistro, Ciro Mauro, Arnoud W J Van't Hof, Elmir Omerovic, Salvatore Curello, Jose Maria de la Torre Hernandez, Stefano De Servi, Flavia Belloni, Stephan Windecker, Marco Valgimigli
AIMS: To assess whether bivalirudin compared with unfractionated heparin (UFH) is associated with consistent outcomes in male and female patients with acute coronary syndrome (ACS) undergoing invasive management. METHODS AND RESULTS: In the MATRIX program,7213 patients were randomized to bivalirudin or UFH.Patients in bivalirudin group were subsequently assigned to receive or not to receive a post-PCI infusion.The 30-day coprimary outcomes were major adverse cardiovascular and cerebrovascular events (MACE),defined as death,myocardial infarction,or stroke,and net adverse clinical events (NACE),defined as MACE or major bleeding...
May 15, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29753418/-percutaneous-coronary-intervention-in-the-management-of-acute-coronary-syndromes-in-ivory-coast-challenges-and-outcomes
#3
R N'Guetta, A Ekou, H Yao, J B Anzouan-Kacou, B Gérardin, R Pillière, A M Adoh, R Seka
AIM: Assess the challenges and outcomes of percutaneous coronary intervention (PCI) in the management of ACS at Abidjan Heart Institute. PATIENTS AND METHODS: Prospective survey carried out from April, 1st, 2010 to April, 29th, 2016. Whole patients aged 18-year-old, admitted at Abidjan Heart Institute for ACS, and who underwent PCI were included in the Registre prospectif des actes de cardiologie interventionnelle de l'institut de cardiologie d'Abidjan (REPACI)...
May 9, 2018: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/29731189/potent-effect-of-prasugrel-on-acute-phase-resolution-of-intra-stent-athero-thrombotic-burden-after-percutaneous-intervention-to-acute-coronary-syndrome
#4
Yoshiro Tsukiyama, Amane Kozuki, Toshiro Shinke, Hiromasa Otake, Yoichi Kijima, Tomoya Masano, Ryoji Nagoshi, Hiroyuki Shibata, Ryo Takeshige, Ken-Ichi Yanaka, Junya Shite, Ken-Ichi Hirata
BACKGROUND: Recent studies suggested protruding thrombus and atheroma after stent placement could be a substrate for subsequent adverse ischemic events. Although protruded atherothrombotic burden can be assessed as intra-stent tissue (IST) by optical coherence tomography (OCT), the effects of potent antiplatelet therapy on the acute phase resolution of IST in patients with acute coronary syndrome (ACS) was unknown. METHODS: Ninety-six consecutive ACS patients with multi-vessel disease were enrolled in this prospective registry...
May 3, 2018: Journal of Cardiology
https://www.readbyqxmd.com/read/29716535/predictive-value-of-neutrophil-to-lymphocyte-ratio-in-patients-with-acute-st-segment-elevation-myocardial-infarction-after-percutaneous-coronary-intervention-a-meta-analysis
#5
Sai Zhang, Jun Diao, Chunmei Qi, Jingjing Jin, Li Li, Xingjuan Gao, Lei Gong, Weiheng Wu
BACKGROUND: The neutrophil to lymphocyte ratio (NLR) is an indicator of systemic inflammation and a prognostic marker in patients with acute coronary syndrome (ACS). This study aims to investigate the value of NLR to predict the in-hospital and long-term prognosis in patients with ST segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI) by meta-analysis. METHOD: The studies related to the prognosis of NLR and STEMI patients published in the Pubmed, Embase, and Ovid databases before June 2017 were retrieved...
May 2, 2018: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29705386/gender-is-not-a-predictor-of-mortality-or-major-adverse-cardiovascular-events-in-patients-undergoing-percutaneous-coronary-intervention-for-acute-coronary-syndromes
#6
Angeline Josiah, Ahmad Farshid
BACKGROUND: Historically, studies of percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) have reported worse outcomes for women. We sought to determine if contemporary PCI techniques eliminate gender differences in PCI outcomes. METHODS: This was a retrospective study of 4776 consecutive patients who underwent PCI for acute coronary syndromes between January 2008 and July 2015. Primary outcomes studied were major adverse cardiovascular events (MACE) and death at 1year...
April 4, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29691643/the-relationship-between-timing-of-prasugrel-pretreatment-and-in-stent-thrombus-immediately-after-percutaneous-coronary-intervention-for-acute-coronary-syndrome-an-optical-coherence-tomography-study
#7
Yosuke Katayama, Takashi Kubo, Yasushi Ino, Takeyoshi Kameyama, Yoshiki Matsuo, Hironori Kitabata, Kosei Terada, Hiroki Emori, Hiroshi Aoki, Akira Taruya, Kunihiro Shimamura, Shingo Ota, Atsushi Tanaka, Takeshi Hozumi, Takashi Akasaka
The optimal timing of pretreatment with prasugrel in percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) is unclear. We used optical coherence tomography (OCT) to compare in-stent thrombus volume immediately after PCI between the administration of low-dose prasugrel (20 mg loading dose) at the time of diagnosis of ACS (early prasugrel: n = 34) and the administration of low-dose prasugrel immediately after diagnostic angiography prior to PCI for ACS (late prasugrel: n = 56). The durations between the administration of prasugrel and OCT in the early prasugrel group and late prasugrel group were 5...
April 24, 2018: Heart and Vessels
https://www.readbyqxmd.com/read/29681571/the-outcome-of-percutaneous-coronary-intervention-for-significant-atherosclerotic-lesions-in-segment-proximal-to-myocardial-bridge-at-left-anterior-descending-coronary-artery
#8
Zhang Hao, Jia Xinwei, Zakarya Ahmed, Pan Huanjun, Wang Zhanqi, Wang Yanfei, Chen Chunhong, Zhang Chan, Fu Liqiang
This study aimed to evaluate the efficacy of percutaneous coronary intervention (PCI) for significant atherosclerosis lesions proximal to myocardial bridge (MB) at left anterior descending coronary artery (LAD).A total of 330 consecutive patients with LAD significant stenosis, diagnosed as acute coronary syndrome (ACS), were included. Based on whether combined with MB, the patients were divided into the MB group (MB, n = 48) and non-MB group (NMB, n = 282). Drug eluting stents (DES) were successfully implanted in the stenostic segments prior to MB...
April 20, 2018: International Heart Journal
https://www.readbyqxmd.com/read/29663443/time-trends-in-antithrombotic-management-of-patients-with-atrial-fibrillation-treated-with-coronary-stents-results-from-talent-af-the-international-stent-atrial-fibrillation-study-multicenter-registry
#9
Brian J Potter, Giuseppe Andò, Giovanni Cimmino, Ricardo Ladeiras-Lopes, Zied Frikah, Xin Yue Chen, Vittorio Virga, Joao Goncalves-Almeida, A John Camm, Keith A A Fox
BACKGROUND: Antithrombotic management of patients with atrial fibrillation (AF) requiring percutaneous coronary intervention (PCI) is highly variable; limited evidence-based guidelines exist to influence practice. HYPOTHESIS: Patient characteristics and availability of novel drugs may have contributed to practice variability. METHODS: We undertook an international multicenter retrospective registry of AF patients treated with PCI. The primary measures of interest were antiplatelet and OAC prescriptions at discharge...
April 17, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29642547/antiplatelet-therapy-in-coronary-artery-disease-a-daunting-dilemma
#10
REVIEW
Surya Chaturvedula, Daniel Diver, Aseem Vashist
Percutaneous coronary intervention (PCI) with stenting for the treatment of acute coronary syndrome (ACS) is the contemporary standard of care. Such treatment is followed by dual antiplatelet therapy (DAPT) comprising of aspirin and a P2Y12 inhibitor. The efficacy of this therapy has been well established but the optimal duration of DAPT remains elusive, and has thus far attracted a prodigious deal of scientific attention. The decision regarding DAPT duration can be clinically challenging in the modern era with the evolution of newer stents, more potent antiplatelet agents, and novel anticoagulant drugs in addition to an older patient population with multiple comorbidities...
April 9, 2018: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/29623770/atypical-presentation-of-acute-coronary-syndrome-acs-a-case-report
#11
Axel Van Damme, Philippe Vanderheeren, Tine De Backer, Françine Desimpel
Case A 45-year-old man presented at the emergency department (ED) with stomach pain since eight days. The patient was not worried about his symptoms and requested only pain relief. The emergency physician requested a consult of the gastroenterologist. Clinical examination was unremarkable. However, 12-lead ECG and ischemic markers were suggestive of acute coronary syndrome (ACS) which led to admission at the cardiology department. Despite delayed presentation, the patient was still referred for urgent coronary angiogram after receiving heparin, ticagrelor and acetylsalicylic acid because of persistent pain...
April 6, 2018: Acta Clinica Belgica
https://www.readbyqxmd.com/read/29595186/evaluation-of-the-patterns-of-non-adherence-to-anti-platelet-regimens-in-stented-patients-bleeding-score-for-predicting-the-long-term-out-of-hospital-bleeding-risk-in-chinese-patients-after-percutaneous-coronary-intervention
#12
Xue-Yan Zhao, Jian-Xin Li, Xiao-Fang Tang, Jing-Jing Xu, Ying Song, Lin Jiang, Jue Chen, Lei Song, Li-Jian Gao, Zhan Gao, Shu-Bin Qiao, Yue-Jin Yang, Run-Lin Gao, Bo Xu, Jin-Qing Yuan
Background: The Patterns of Non-Adherence to Anti-Platelet Regimens in Stented Patients (PARIS) bleeding score is a novel score for predicting the out-of-hospital bleeding risk after percutaneous coronary intervention (PCI). However, whether this score has the same value in non-European and American populations is unclear. This study aimed to assess the PARIS bleeding score's predictive value of bleeding in patients after PCI in the Chinese population. Methods: We performed a prospective, observational study of 10,724 patients who underwent PCI from January to December 2013, in Fuwai Hospital, China...
March 27, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29579602/high-on-treatment-platelet-reactivity-and-outcome-in-elderly-with-non-st-segment-elevation-acute-coronary-syndrome-insight-from-the-gepress-study
#13
Roberta De Rosa, Tullio Palmerini, Stefano De Servi, Marta Belmonte, Gabriele Crimi, Stefano Cornara, Paolo Calabrò, Marco Cattaneo, Diego Maffeo, Anna Toso, Antonio Bartorelli, Cataldo Palmieri, Marco De Carlo, Davide Capodanno, Philippe Genereux, Dominick Angiolillo, Federico Piscione, Gennaro Galasso
BACKGROUND: Elderly treated with dual antiplatelet therapy after percutaneous coronary intervention (PCI) represent a challenging population because of increased risk of both ischemic and bleeding events. We aimed to investigate the association between high on-treatment platelet reactivity (HPR) and long-term outcome in elderly with non-ST-elevated acute coronary syndromes (NSTE-ACS) undergoing PCI. METHODS: Platelet reactivity was measured by vasodilator-stimulated phosphoprotein (VASP) assay at three time-points (baseline, discharge, 1 month after PCI) in 1053 NSTE-ACS patients (311 elderly) treated with clopidogrel...
May 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29573537/comparison-of-the-planned-one-and-elective-two-stent-techniques-in-patients-with-coronary-bifurcation-lesions-with-or-without-acute-coronary-syndrome-from-the-cobis-ii-registry
#14
Min Chul Kim, Youngkeun Ahn, Doo Sun Sim, Young Joon Hong, Ju Han Kim, Myung Ho Jeong, Hyeon-Cheol Gwon, Hyo-Soo Kim, Seung Woon Rha, Jung Han Yoon, Yangsoo Jang, Seung-Jea Tahk, Ki Bae Seung
OBJECTIVES: To evaluate the impacts of stent techniques on long-term clinical outcomes after percutaneous coronary intervention (PCI) using drug-eluting stents (DES) for coronary bifurcation lesions in patients with or without acute coronary syndrome (ACS). BACKGROUND: Few studies have investigated the impacts of stent techniques for treating coronary bifurcation lesions in patients with and without ACS. METHODS: This multicenter registry enrolled 2,897 patients undergoing PCI with DES for coronary bifurcation lesions...
March 24, 2018: Catheterization and Cardiovascular Interventions
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
#15
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/29521570/platelet-reactivity-in-patients-with-acute-coronary-syndrome-treated-with-prasugrel-or-ticagrelor-in-comparison-to-clopidogrel-a-retrospective-pharmacodynamic-analysis
#16
Gerhard Selhorst, Fabian Schmidtler, Armin Ott, Evelyn Hitzke, June Tomelden, Diethmar Antoni, Ellen Hoffmann, Johannes Rieber
Dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 inhibitor is a mainstay of the prevention of stent thrombosis following percutaneous coronary intervention (PCI). In the 2015 European guidelines for the management of acute coronary syndrome (ACS), prasugrel (PRA) and ticagrelor (TICA) combined with aspirin are recommended as first-line therapy. Clopidogrel (CLO) is recommended as an alternative medication for patients with contradictions to these new drugs. This single-center study analyzed the platelet function of 809 ACS patients undergoing PCI and treatment with DAPT...
March 9, 2018: Platelets
https://www.readbyqxmd.com/read/29495217/-predictive-value-of-grace-discharge-score-for-long-term-out-of-hospital-death-in-acute-coronary-syndrome-after-percutaneous-coronary-intervention
#17
X Y Zhao, J X Li, X F Tang, J J Xu, Y Song, H H Wang, L J Xu, J Chen, Y Zhang, L Song, L J Gao, S B Qiao, Y J Yang, R L Gao, B Xu, J Q Yuan
Objective: To evaluate the prognostic value of Global Registry of Acute Coronary Events(GRACE) discharge score for long-term out-of-hospital death in acute coronary syndrome (ACS) after drug-eluting stents (DES) and with Dual-antiplatelet Therapy (DAPT). Methods: Our study was a prospective, observational, single center (Fuwai Hospital of China) study.A total of 6 431consecutive ACS patients underwent percutaneous coronary intervention(PCI)between January 2013 and December 2013 were involved.The primary endpoint was all-cause death and second endpoint was major adverse cardiovascular and cerebrovascular events (MACCE) as a composite of all-cause death, myocardial infarction, revascularization, stent thrombosis or stroke...
February 13, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29482688/complete-heart-block-due-to-occlusion-of-jailed-septal-perforator-after-percutaneous-coronay-intervention-of-proximal-left-anterior-descending-artery
#18
Ghazanfar Ali Shah, Jawaid Akbar Sial, Tahir Saghir
A 70-year diabetic and hypertensive lady admitted with acute coronary syndrome (ACS) underwent coronary angiography, which showed severe diffuse disease of proximal left anterior descending (LAD). She underwent percutaneous coronay intervention (PCI) of proximal LAD artery that resulted in occlusion of jailed first septal perforator. She remained stable and asymptomatic and was shifted to Coronary Care Unit (CCU) after successful procedure. Approximately five hours later, patient developed complete heart block (CHB) and became hemodynamically unstable...
March 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29475177/impact-of-pre-procedural-dual-antiplatelet-therapy-on-periprocedural-myocardial-infarction-in-patients-undergoing-percutaneous-coronary-interventions-with-adjunctive-tirofiban
#19
Monica Verdoia, Patrizia Pergolini, Lucia Barbieri, Roberta Rolla, Matteo Nardin, Federica Negro, Harry Suryapranata, Giuseppe De Luca
BACKGROUND: Recent trials have failed to demonstrate any clinical benefit from pre-treatment with dual antiplatelet therapy (DAPT) in patients undergoing percutaneous coronary interventions, (PCI), even in the setting of acute coronary syndrome. However, suboptimal platelet inhibition during (PCI) has been shown to enhance the risk of acute ischemic complications, such as stent thrombosis and periprocedural myocardial infarction (PMI), thus raising the attention on the potential advantages of adjunctive glycoprotein IIbIIIa inhibitors to obviate to the delayed onset of action of oral antiplatelet drugs...
April 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29459361/a-comparison-of-reduced-dose-prasugrel-and-standard-dose-clopidogrel-in-elderly-patients-with-acute-coronary-syndromes-undergoing-early-percutaneous-revascularization
#20
Stefano Savonitto, Luca A Ferri, Luigi Piatti, Daniele Grosseto, Giancarlo Piovaccari, Nuccia Morici, Irene Bossi, Paolo Sganzerla, Giovanni Tortorella, Michele Cacucci, Maurizio Ferrario, Ernesto Murena, Girolamo Sibilio, Stefano Tondi, Anna Toso, Sergio Bongioanni, Amelia Ravera, Elena Corrada, Matteo Mariani, Leonardo Di Ascenzo, A Sonia Petronio, Claudio Cavallini, Giancarlo Vitrella, Renata Rogacka, Roberto Antonicelli, Bruno M Cesana, Leonardo De Luca, Filippo Ottani, Giuseppe De Luca, Federico Piscione, Nadia Moffa, Stefano De Servi
Background -Elderly patients are at elevated risk of both ischemic and bleeding complications after an acute coronary syndrome (ACS), and display higher on-clopidogrel platelet reactivity as compared to younger patients. Prasugrel 5 mg provides more predictable platelet inhibition, as compared to clopidogrel, in the elderly, suggesting the possibility of reducing ischemic events without increasing bleeding. Methods -In a multicenter, randomized, open-label, blinded-endpoint trial, we compared a once daily maintenance dose of prasugrel 5 mg with the standard clopidogrel 75 mg in patients >74 years with ACS undergoing percutaneous coronary intervention (PCI)...
February 19, 2018: Circulation
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