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dual antiplatelet

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https://www.readbyqxmd.com/read/27914991/antiplatelet-therapy-in-patients-with-glucose-6-phosphate-dehydrogenases-deficiency-after-percutaneous-coronary-intervention-a-reappraisal-for-clinical-and-interventional-cardiologists
#1
REVIEW
Marco Zuin, Gianluca Rigatelli, Mauro Carraro, Maria Paola Galasso, Fabio Dell'Avvocata, Rossella Paolini, Giovanni Zuliani, Loris Roncon
Glucose-6-phosphate dehydrogenase (G6PD) deficiency represents one of the most common erythrocyte enzymopathy. In the era of drug-eluting stents (DESs), the use of prolonged dual antiplatelet therapy (DAPT) with aspirin (ASA) and thienopyridine (clopidogrel or ticlopidine) has become mandatory in the treatment of patients with acute coronary syndromes (ACS) and/or after percutaneous coronary intervention (PCI). However, the use of ASA, and more in general of antiplatelet drugs in patients with G6PD deficiency remains controversial, also for the absence of specific guidelines and scientific evidences...
November 28, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/27914492/ticagrelor-with-aspirin-or-alone-in-high-risk-patients-after-coronary-intervention-rationale-and-design-of-the-twilight-study
#2
Usman Baber, George Dangas, David J Cohen, C Michael Gibson, Shamir R Mehta, Dominick J Angiolillo, Stuart J Pocock, Mitchell W Krucoff, Adnan Kastrati, E Magnus Ohman, Philippe Gabriel Steg, Juan Badimon, M Urooj Zafar, Jaya Chandrasekhar, Samantha Sartori, Melissa Aquino, Roxana Mehran
BACKGROUND: Dual antiplatelet therapy (DAPT) is necessary to prevent thrombosis yet increases bleeding after percutaneous coronary intervention (PCI) with drug-eluting stents (DES). Antiplatelet monotherapy with a potent P2Y12 receptor antagonist may reduce bleeding while maintaining anti thrombotic efficacy compared with conventional DAPT. METHODS: TWILIGHT is a randomized, double-blind placebo-controlled trial evaluating the comparative efficacy and safety of antiplatelet monotherapy versus DAPT in up to 9000 high-risk patients undergoing PCI with DES...
December 2016: American Heart Journal
https://www.readbyqxmd.com/read/27914488/safety-of-6-month-duration-of-dual-antiplatelet-therapy-after-percutaneous-coronary-intervention-in-patients-with-acute-coronary-syndromes-rationale-and-design-of-the-smart-angioplasty-research-team-safety-of-6-month-duration-of-dual-antiplatelet-therapy-after
#3
Joo Myung Lee, Deok-Kyu Cho, Joo-Yong Hahn, Young Bin Song, Taek Kyu Park, Ju-Hyeon Oh, Jin Bae Lee, Joon-Hyung Doh, Sang-Hyun Kim, Jeong Hoon Yang, Jin-Ho Choi, Seung-Hyuck Choi, Sang Hoon Lee, Hyeon-Cheol Gwon
BACKGROUND AND RATIONALE: Dual antiplatelet therapy (DAPT) is a fundamental treatment that optimizes clinical outcomes after percutaneous coronary intervention, especially in patients with acute coronary syndrome (ACS). Although current international guidelines recommend DAPT for at least 12 months after implantation of a drug-eluting stent in patients with ACS, these recommendations are not based on randomized controlled trials dedicated to ACS population. STUDY DESIGN: The SMART-DATE trial is a prospective, multicenter, randomized, and open-label study to demonstrate the noninferiority of 6-month DAPT compared with 12 months or longer DAPT in patients with ACS undergoing percutaneous coronary intervention...
December 2016: American Heart Journal
https://www.readbyqxmd.com/read/27908388/the-unknown-association-of-ppis-with-chest-pain-in-patients-with-known-treated-coronary-artery-disease-a-diagnostic-dilemma
#4
Fahad Javed, Stephen Ramee
Patients with coronary artery disease (CAD) are destined to lifelong antiplatelet therapy in form of aspirin (acetylsalicylic acid) alone, or in combination with other P2Y2 inhibitors. Proton pump inhibitors (PPIs) are the preferred agents for the treatment and prophylaxis of gastrointestinal injury associated with nonsteroidal anti-inflammatory drug or acetylsalicylic acid or both,(1) but recent data has raised questions about their association with negative cardiovascular events. We report 2 cases of patients with known CAD presented with chest pain mimicking angina pectoris that successfully resolved on discontinuation of the PPIs...
July 2016: Current Problems in Cardiology
https://www.readbyqxmd.com/read/27905013/impact-of-stent-type-and-prolonged-dual-antiplatelet-therapy-on-long-term-clinical-outcomes-in-hemodialysis-patients-with-coronary-artery-disease
#5
Masahiko Asami, Jiro Aoki, Tatsuyuki Sato, Shuzou Tanimoto, Mika Watanabe, Yu Horiuchi, Koichi Furui, Kentaro Yasuhara, Yu Sato, Takuya Hashimoto, Sen Yachi, Kazuhiro Hara, Kengo Tanabe
The aim of this study was to address 7-year clinical outcomes and impact of prolonged dual antiplatelet therapy (DAPT) after coronary stenting in hemodialysis patients. Our study included 123 consecutive hemodialysis patients who had undergone percutaneous coronary intervention with a drug-eluting stent (DES) or bare-metal stent (BMS) (DES: 64, BMS: 59) in our institution. We compared long-term clinical outcomes following DES with BMS implantation as well as clinical outcomes in patients on DAPT for ≥1 year (DAPT on group, 89) with those on DAPT for <1 year (DAPT off group, 34)...
November 30, 2016: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/27904973/platelet-reactivity-and-clinical-outcomes-in-patients-using-cyp3a4-metabolized-statins-with-clopidogrel-in-percutaneous-coronary-intervention
#6
Jin Sup Park, Kwang Soo Cha, Hye Won Lee, Jun-Hyok Oh, Jung Hyun Choi, Han Cheol Lee, Taek Jong Hong, Hyo Soo Kim
Statins are primarily metabolized by cytochrome P450 3A4 (CYP3A4), which reduces clopidogrel to its active metabolite. Recent studies suggest that CYP3A4-metabolized statins attenuate clopidogrel's anti-aggregatory effect on platelets. We aimed to assess the impact of concomitant CYP3A4-metabolized statin and clopidogrel use on antiplatelet activity and clinical outcomes in patients undergoing percutaneous coronary intervention (PCI). We enrolled 1187 patients from the HOST-ASSURE trial with platelet reactivity unit (PRU) values at both baseline and 1 month...
November 30, 2016: Heart and Vessels
https://www.readbyqxmd.com/read/27903032/-interventional-left-atrial-appendage-closure-in-a-patient-with-gave-syndrome
#7
Christian Fastner, Sebastian Belle, Ibrahim Akin
History and findings | A 56-year-old female with a gastric antral vascular ectasia (GAVE) suffered from recurrent episodes of upper gastrointestinal bleeding. Because of a history of a permanent atrial fibrillation (CHA2DS2-VASc score 3 points) an oral anticoagulation therapy with phenprocoumon was carried out which even worsened the bleeding frequency and intensity. A change of medication to low-molecular weight heparin did not lead to success. The frequent periods in hospital limited the patient's quality of life...
November 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27901002/shorter-versus-longer-duration-dual-antiplatelet-therapy-in-patients-with-diabetes-mellitus-undergoing-drug-eluting-stents-implantation-a-meta-analysis-of-randomized-controlled-trials
#8
He Huang, Ya Li, Yu Chen, Guo-Sheng Fu
BACKGROUND: Patients with diabetes mellitus (DM) have a higher risk of thromboembolic events; however, the optimal duration of dual antiplatelet therapy (DAPT) remains unclear. The goal of this study was to assess the efficacy and safety of various DAPT durations in patients with DM undergoing drug-eluting stent implantation. METHODS: We conducted a literature search for randomized controlled trials (RCTs). We searched databases including EMBASE, PubMed, Cochrane Library, and Scopus up to June 2016...
2016: Chinese Medical Journal
https://www.readbyqxmd.com/read/27899203/bioresorbable-scaffold-implantation-in-patients-with-indication-for-oral-anticoagulation-a-propensity-matched-analysis
#9
Niklas F Boeder, Victoria Johnson, Oliver Dörr, Jens Wiebe, Albrecht Elsässer, Helge Möllmann, Christian W Hamm, Holger M Nef, Timm Bauer
OBJECTIVES: To examine ischemic and bleeding outcomes in patients on triple antithrombotic therapy (TAT) compared with dual antiplatelet therapy (DAPT) after the implantation of bioresorbable scaffolds (BRS). BACKGROUND: The optimal antithrombotic regimen in patients undergoing percutaneous coronary intervention that have an indication for oral anticoagulation is unclear, in particular among those undergoing BRS implantation. METHODS: Consecutive patients of a single-center, all-comers BRS registry were included...
November 24, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27894896/systematic-review-and-meta-analysis-of-dual-versus-single-antiplatelet-therapy-in-carotid-interventions
#10
REVIEW
M Barkat, S Hajibandeh, S Hajibandeh, F Torella, G A Antoniou
BACKGROUND: The importance of antiplatelet therapy for the management and prevention of ischaemic stroke cannot be overstated. Despite the established guidelines, there is no clear consensus on how to manage antiplatelet therapy during and after carotid interventions. OBJECTIVE: The objective was to undertake a systematic literature review and perform a meta-analysis to assess the effects of dual antiplatelet therapy in carotid endarterectomy (CEA) and stenting (CAS)...
November 26, 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27888209/optimal-duration-of-dual-antiplatelet-therapy-after-acute-coronary-syndromes-and-coronary-stenting
#11
Alon Eisen, Deepak L Bhatt
No abstract text is available yet for this article.
November 25, 2016: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/27886825/antiplatelet-and-antithrombotic-therapy-in-patients-with-atrial-fibrillation-undergoing-coronary-stenting
#12
REVIEW
Mikhail S Dzeshka, Richard A Brown, Davide Capodanno, Gregory Y H Lip
Stroke prevention is the main priority in the management cascade of atrial fibrillation. Most patients require long-term oral anticoagulation (OAC) and may require percutaneous coronary intervention. Prevention of recurrent cardiac ischemia and stent thrombosis necessitate dual antiplatelet therapy (DAPT) for up to 12 months. Triple antithrombotic therapy with OAC plus DAPT of shortest feasible duration is warranted, followed by dual antithrombotic therapy of OAC and antiplatelet agent, and OAC alone after 12 months...
January 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/27886820/optimal-duration-of-dual-antiplatelet-therapy-after-percutaneous-coronary-intervention
#13
REVIEW
Arjun Majithia, Deepak L Bhatt
Dual antiplatelet therapy (DAPT) is an essential component of treatment in patients with coronary artery disease treated with percutaneous coronary intervention (PCI). Recommendations for duration of DAPT after PCI should consider patient-specific risk, clinical presentation, stent characteristics, and procedural factors. Prolonged DAPT results in a reduction of stent thrombosis (ST) and myocardial infarction (MI) at the cost of increased bleeding. Studies of shorter-duration DAPT demonstrate similar mortality, MI, ST, and less bleeding when compared with longer DAPT duration...
January 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/27885830/extended-dual-antiplatelet-therapy-after-acute-coronary-syndrome-in-spain-results-from-the-epicor-study
#14
Alfredo Bardají, Manuel Leal, Vicente Arrarte, Xavier Garcia-Moll, Leopoldo Pérez de Isla, Héctor Bueno
INTRODUCTION: Real-world, country-specific studies of dual antiplatelet therapy (DAPT) duration among survivors of acute coronary syndrome (ACS) are important for improving long-term prognosis. AIMS: To investigate DAPT duration after hospital discharge for ACS in Spain. RESULTS: Data from patients enrolled in the Spanish cohort of the EPICOR (long-tErm follow-up of antithrombotic management Patterns In acute CORonary syndrome patients) study (NCT01171404) were analyzed for changes to antithrombotic medication up to 2 years post-discharge according to index event diagnosis and patient characteristics...
November 25, 2016: Cardiovascular Therapeutics
https://www.readbyqxmd.com/read/27885511/does-anticoagulation-therapy-prevent-thrombosis-in-coronary-stent-grafts
#15
Yuki Honda, Kohei Wakabayashi, Takayasu Suzuki, Hiroshi Suzuki
A polytetrafluoroethylene (PTFE)-covered stent was deployed for enlarging coronary aneurysms in a 73-year-old man. Optical coherence tomography (OCT) and coronary angioscopy performed 3 months later revealed naked stent struts and thin patches of red thrombi covering the PTFE membrane even under dual antiplatelet therapy (DAPT). After 5-month warfarin administration under DAPT, OCT and angioscopy showed a clear extinction of the thin patches of red thrombi on the PTFE membrane and stent struts, although most of the struts were still naked...
November 24, 2016: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/27883975/evaluation-of-current-practices-in-transcatheter-aortic-valve-implantation-the-written-worldwide-tavi-experience-survey
#16
Enrico Cerrato, Luis Nombela-Franco, Tamim M Nazif, Helene Eltchaninoff, Lars Søndergaard, Henrique B Ribeiro, Marco Barbanti, Fabian Nietlispach, Peter De Jaegere, Pierfrancesco Agostoni, Ramiro Trillo, Pilar Jimenez-Quevedo, Fabrizio D'Ascenzo, Olaf Wendler, Gabriel Maluenda, Mao Chen, Corrado Tamburino, Carlos Macaya, Martin B Leon, Josep Rodes-Cabau
BACKGROUND: Transcatheter aortic valve implantation (TAVI) has been adopted worldwide as the standard treatment for severe aortic stenosis in symptomatic patients at prohibitive or high surgical risk, but there are still several areas where consensus and evidence are lacking. The purpose was to obtain a global view of current practice related to TAVI with the potential to identify the main areas of consensus and divergence between centers. METHODS: An online questionnaire was distributed in centers performing TAVI including a total of 59 questions concerning pre-procedural evaluation, procedural practices and post-procedural management...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27881555/recurrent-hospitalization-among-patients-with-atrial-fibrillation-undergoing-intracoronary-stenting-treated-with-2-treatment-strategies-of-rivaroxaban-or-a-dose-adjusted-oral-vitamin-k-antagonist-treatment-strategy
#17
C Michael Gibson, Duane S Pinto, Gerald Chi, Douglas Arbetter, Megan Yee, Roxana Mehran, Christoph Bode, Jonathan Halperin, Freek W A Verheugt, Peter Wildgoose, Paul Burton, Martin van Eickels, Serge Korjian, Yazan Daaboul, Purva Jain, Gregory Y H Lip, Marc Cohen, Eric D Peterson, Keith A A Fox
BACKGROUND: -Patients with atrial fibrillation who undergo intracoronary stenting traditionally are treated with a vitamin K antagonist (VKA) plus dual antiplatelet therapy (DAPT), yet this treatment leads to high risks of bleeding. We hypothesized that a regimen of rivaroxaban plus a P2Y12 inhibitor monotherapy or rivaroxaban plus DAPT could reduce bleeding and thereby have a favorable impact on all-cause mortality and the need for rehospitalization. METHODS: -Stented subjects with nonvalvular atrial fibrillation (n=2124) were randomized 1:1:1 to administration of reduced-dose rivaroxaban 15 mg daily plus a P2Y12 inhibitor for 12 months (group 1); rivaroxaban 2...
November 14, 2016: Circulation
https://www.readbyqxmd.com/read/27879518/three-month-evaluation-of-strut-healing-using-a-novel-optical-coherence-tomography-analytical-method-following-bioresorbable-polymer-everolimus-eluting-stent-implantation-in-humans-the-timeless-study
#18
Boris Vesga, Hector Hernandez, Miguel Moncada, Pawel Gasior, Sergio A H Leal, Antonio Dager, Camilo Arana, Juan A Delgado, Philippe Généreux, Akiko Maehara, Juan F Granada
AIMS: Bioresorbable polymer drug-eluting stent technologies have been considered to have the potential to enhance vascular healing by reducing polymer exposure to the vessel wall, potentially allowing the earlier discontinuation of dual antiplatelet therapy. At present, the early vascular healing response to this type of technologies is still unclear. PATIENTS AND METHODS: The TIMELESS study is a multicenter, prospective, single-arm study that enrolled real-world patients undergoing percutaneous coronary intervention...
November 22, 2016: Coronary Artery Disease
https://www.readbyqxmd.com/read/27870977/longitudinal-treatment-patterns-with-adp-receptor-inhibitors-after-myocardial-infarction-insights-from-the-canadian-observational-antiplatelet-study
#19
Akshay Bagai, Tracy Y Wang, Shaun G Goodman, Harold N Fisher, Robert C Welsh, Jean-Pierre Dery, Xiang Zhang, Yajun E Zhu, Asim N Cheema, Payam Dehghani, Saleem A Kassam, John Ducas, Neil Brass, Hahn Hoe Kim, Anthony Fung, Erick Schampaert, Ata Ur Rehman Quraishi, Shamir R Mehta
BACKGROUND: After myocardial infarction (MI) treated with percutaneous coronary intervention (PCI), guidelines recommend dual antiplatelet therapy (DAPT) with aspirin and an ADP receptor inhibitor (ADPri) for at least 1year. However, whether real-world Canadian practice patterns reflect this recommendation is unknown. METHODS: We studied 2175 MI patients treated with PCI and discharged from 26 Canadian hospitals between 12/2011 and 05/2013 in the Canadian Observational Antiplatelet sTudy (COAPT)...
November 14, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27869899/-patients-with-non-st-elevation-acute-coronary-syndrome-managed-without-coronary-revascularization-an-undertreated-population
#20
Alberto Menozzi, Leonardo De Luca, Zoran Olivari, Roberta Rossini, Marco Ferlini, Daniela Lina, Maurizio Giuseppe Abrignani, Piera Capranzano, Nazario Carrabba, Marcello Galvani, Alfredo Marchese, Gianfranco Mazzotta, Luciano Moretti, Nicola Signore, Massimo Uguccioni, Stefano De Servi
Non-ST-elevation acute coronary syndromes (NSTE-ACS) represent one of the most common clinical presentations of ischemic heart disease. Patients with NSTE-ACS are a heterogeneous population, with different clinical features and prognosis. A significant proportion of this population is medically managed, without any revascularization. In the Italian EYESHOT and French FAST-MI registries, patients managed with a conservative strategy were 40% and 35%, respectively. NSTE-ACS patients not undergoing coronary revascularization are at higher risk of adverse cardiovascular events and have a worse prognosis, including short- and long-term mortality, compared with those receiving revascularization...
October 2016: Giornale Italiano di Cardiologia
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