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dual antiplatelet and OAC

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https://www.readbyqxmd.com/read/29679301/contemporary-antithrombotic-treatment-in-patients-with-non-valvular-atrial-fibrillation-undergoing-percutaneous-coronary-intervention-rationale-and-design-of-the-greek-antiplatelet-atrial-fibrillation-grape-af-registry
#1
Ioanna Xanthopoulou, Vasiliki-Maria Dragona, Periklis Davlouros, Costas Tsioufis, Efstathios Iliodromitis, Dimitrios Alexopoulos
BACKGROUND: Approximately 5 to 7% of patients undergoing percutaneous coronary intervention (PCI) for the treatment of coronary artery disease require chronic oral anticoagulation (OAC) on top of aspirin and a P2Y12 receptor antagonist, mainly due to non-valvular atrial fibrillation (AF). The advent of non-vitamin K antagonist oral anticoagulants (NOACs) increased treatment options, while there is cumulative evidence that dual combination of a NOAC and a P2Y12 receptor antagonist attenuates risk of bleeding, compared to traditional triple therapy, consisting of a vitamin K antagonist (VKA), aspirin, and a P2Y12 receptor antagonist, without significantly compromising efficacy...
April 20, 2018: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/29599096/antithrombotic-therapy-trends-in-non-valvular-atrial-fibrillation-patients-undergoing-percutaneous-coronary-stent-implantation-results-from-a-survey-among-fellows-at-the-japanese-college-of-cardiology
#2
Daisuke Fukamachi, Atsushi Hirayama, Katsumi Miyauchi, Satoshi Yasuda, Hisao Ogawa, Hiroshi Ito, Hiroyuki Daida
BACKGROUND: Antithrombotic therapy with oral anticoagulants (OAC) in patients with atrial fibrillation (AF) after stent implantation, where dual antiplatelet therapy (DAPT) is also recommended, is not established. Antithrombotic therapies prescribed vary widely among cardiologists and may change year by year, according to the accumulation of new evidence. METHODS: A questionnaire-based survey concerning the antithrombotic therapy prescribed for OAC-treated AF patients who underwent stent implantation was conducted from 2014 to 2016...
March 26, 2018: Journal of Cardiology
https://www.readbyqxmd.com/read/29581711/dual-versus-single-antiplatelet-therapy-for-patients-with-long-term-oral-anticoagulation-undergoing-coronary-intervention-a-systematic-review-and-meta-analysis
#3
Jing-Jing Yu, Chan Zou, Wen-Yu Liu, Guo-Ping Yang
Objective: The main aim of this meta-analysis is to compare the efficacy and safety of dual versus single antiplatelet therapy for patients taking oral anticoagulation (OAC) after coronary intervention. Background: The optimal regimen remains controversial for patients taking OAC after coronary intervention. Methods: PubMed, Embase and Cochrane Central Register of Controlled Trials were searched for eligible studies including data of triple therapy (TT) versus OAC plus single antiplatelet therapy for patients requiring OAC after coronary intervention...
December 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/29549436/real-world-antithrombotic-therapies-and-clinical-outcomes-after-second-generation-drug-eluting-stent-implantation-in-patients-with-atrial-fibrillation-a-multi-center-cohort-study
#4
Hisao Otsuki, Junichi Yamaguchi, Kazuho Kamishima, Hiroyuki Arashi, Nobuhisa Hagiwara
Previous reports have focused on cardiovascular and bleeding events in patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI). However, antithrombotic treatment strategies and clinical outcomes after second-generation drug-eluting stents (DES) implantation in AF patients remain to be determined. We enrolled 244 consecutive AF patients treated with second-generation DES. The study population was derived from multi-center AF registry (including 8 centers in Japan) from 2010 to 2012...
March 16, 2018: Heart and Vessels
https://www.readbyqxmd.com/read/29548674/meta-analysis-of-antithrombotic-therapy-in-atrial-fibrillation-after-percutaneous-coronary-intervention
#5
Safi U Khan, Muhammad U Khan, Ali Raza Ghani, Ahmad N Lone, Adeel Arshad, Edo Kaluski
Current clinical practice prefers oral anticoagulation (OAC) plus dual antiplatelet therapy (DAPT) in atrial fibrillation (AF) after percutaneous coronary intervention (PCI). We conducted a meta-analysis to test the hypothesis that the superiority of OAC plus DAPT is mainly endorsed by observational studies (OSs); conversely, randomized clinical trials (RCTs) have suggested that OAC plus a single antiplatelet (SAP) agent is a safer and equally effective approach. Nine studies (4 RCTs and 5 OSs) were selected using MEDLINE, EMBASE, and CENTRAL (Inception, October 31, 2017)...
February 14, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29447773/percutaneous-coronary-intervention-and-antiplatelet-therapy-in-patients-with-atrial-fibrillation-receiving-apixaban-or-warfarin-insights-from-the-aristotle-trial
#6
David Kopin, W Schuyler Jones, Matthew W Sherwood, Daniel M Wojdyla, Lars Wallentin, Basil S Lewis, Freek W A Verheugt, Dragos Vinereanu, M Cecilia Bahit, Sigrun Halvorsen, Kurt Huber, Alexander Parkhomenko, Christopher B Granger, Renato D Lopes, John H Alexander
BACKGROUND: We assessed antiplatelet therapy use and outcomes in patients undergoing percutaneous coronary intervention (PCI) during the ARISTOTLE trial. METHODS: Patients were categorized based on the occurrence of PCI during follow-up (median 1.8 years); PCI details and outcomes post-PCI are reported. Of the 18,201 trial participants, 316 (1.7%) underwent PCI (152 in apixaban group, 164 in warfarin group). RESULTS: At the time of PCI, 84% (267) were on study drug (either apixaban or warfarin)...
March 2018: American Heart Journal
https://www.readbyqxmd.com/read/29397950/triple-antithrombotic-therapy-for-patients-with-atrial-fibrillation-undergoing-percutaneous-coronary-intervention
#7
REVIEW
Mathieu Kerneis, Usama Talib, Tarek Nafee, Yazan Daaboul, Seyedmahdi Pahlavani, Anmol Pitliya, M M Furqan, Sudarshana Datta, Hassan A Kazmi, Ahmed Younes, C Michael Gibson
Dual antiplatelet therapy (DAPT) has been the cornerstone of antithrombotic management for patients undergoing percutaneous coronary intervention (PCI). However, approximately 10% of these patients have concomitant atrial fibrillation (AF) and require chronic oral anticoagulant (OAC) in addition to DAPT. This traditional "triple therapy" has been associated with a three to four-fold increased risk of bleeding. The safety of non-vitamin K OAC (NOAC)-based strategies, using a NOAC plus a P2Y12 inhibitor, has been compared to vitamin K antagonist (VKA)-based triple therapy in the PIONEER AF-PCI and REDUAL PCI randomized trials, both of which have demonstrated that NOAC-based strategies are safer and provide an attractive alternative to VKA-based triple therapy among AF patients who undergo PCI...
February 2, 2018: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/29373105/meta-analysis-comparing-the-safety-and-efficacy-of-dual-versus-triple-antithrombotic-therapy-in-patients-with-atrial-fibrillation-undergoing-percutaneous-coronary-intervention
#8
Ilaria Cavallari, Giuseppe Patti
In patients with atrial fibrillation undergoing percutaneous coronary intervention (PCI), the effectiveness and safety of dual compared with triple antithrombotic therapy are a matter of debate, especially when considering the prevention of end points at low incidence, such as myocardial infarction (MI), stent thrombosis, or mortality. This study-level meta-analysis included 4 controlled randomized trials and 6,036 patients with a clinical indication to chronic oral anticoagulation (OAC) after PCI, mainly for atrial fibrillation...
March 15, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29372247/association-of-intracerebral-hemorrhage-among-patients-taking-non-vitamin-k-antagonist-vs-vitamin-k-antagonist-oral-anticoagulants-with-in-hospital-mortality
#9
COMPARATIVE STUDY
Taku Inohara, Ying Xian, Li Liang, Roland A Matsouaka, Jeffrey L Saver, Eric E Smith, Lee H Schwamm, Mathew J Reeves, Adrian F Hernandez, Deepak L Bhatt, Eric D Peterson, Gregg C Fonarow
Importance: Although non-vitamin K antagonist oral anticoagulants (NOACs) are increasingly used to prevent thromboembolic disease, there are limited data on NOAC-related intracerebral hemorrhage (ICH). Objective: To assess the association between preceding oral anticoagulant use (warfarin, NOACs, and no oral anticoagulants [OACs]) and in-hospital mortality among patients with ICH. Design, Setting, and Participants: Retrospective cohort study of 141 311 patients with ICH admitted from October 2013 to December 2016 to 1662 Get With The Guidelines-Stroke hospitals...
February 6, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28969538/triple-therapy-versus-dual-antiplatelet-therapy-for-patients-with-atrial-fibrillation-and-acute-coronary-syndromes-a-systematic-literature-review
#10
REVIEW
Aimee Fake, Anil Ranchord, Scott Harding, Peter Larsen
BACKGROUND: Patients with acute coronary syndromes (ACS) and a history of atrial fibrillation (AF) have indications for both dual antiplatelet therapy (DAPT) and oral anticoagulation (OAC). Triple therapy (TT), the combination of DAPT and OAC, is recommended in guidelines. We examined studies comparing clinical outcomes on DAPT versus TT for patients with AF and ACS. METHODS: We searched Medline, Medline pending, EMBASE and Evidence-Based Medicine Reviews databases for studies published between January 2000 to December 2016 in AF patients with ACS that compared DAPT and TT that reported ischaemic and/or bleeding outcomes...
2017: Current Cardiology Reviews
https://www.readbyqxmd.com/read/28947725/-pioneer-af-pci-trial
#11
Murat Özdemir
The approach to patients with an indication for oral anticoagulation (OAC) for atrial fibrillation (AF) who undergo coronary stenting and thus need dual antiplatelet therapy has long been debated. Dual antiplatelet therapy accompanied by OAC (so called "triple therapy") carries a high bleeding risk and thus should either be avoided or used for a limited period. The lack of relevant prospective randomised trial data have largely been overcome by the recently published PIONEER AF-PCI trial, the results of which will be summarized in this article...
September 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28906384/the-safety-and-efficacy-of-oral-anticoagulants-with-dual-versus-single-antiplatelet-therapy-in-patients-after-percutaneous-coronary-intervention-a-meta-analysis
#12
REVIEW
Jie Chen, Li-Yu Wang, Chao Deng, Xing-Hua Jiang, Tu-Gang Chen
BACKGROUND: A growing number of patients require oral anticoagulant (OAC) after undergoing percutaneous coronary intervention (PCI) with stent implantation due to the development of atrial fibrillation, but the optimal antithrombotic regimen remains controversial in these patients. METHODS: We systematically searched PUBMED, EMBASE, and CENTRAL from inception until September 2016 for randomized controlled trials or cohort studies that evaluated the comparative effects of TT versus DT...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28838473/safety-and-efficacy-of-polymer-free-biolimus-a9-coated-versus-bare-metal-stents-in-orally-anticoagulated-patients-2-year-results-of-the-leaders-free-oral-anticoagulation-substudy
#13
Didier Carrié, Ian Menown, Keith Oldroyd, Samuel Copt, Suneel Talwar, Luc Maillard, Marie-Claude Morice, Lim Soo Teik, Irene Lang, Philip Urban
OBJECTIVES: The aim of this study was to compare the performance of drug-coated stents (DCS) versus bare-metal stents (BMS) in patients who are candidates for long-term oral anticoagulation (OAC) after percutaneous coronary interventions. BACKGROUND: The randomized controlled LEADERS FREE (A Randomized Clinical Evaluation of the BioFreedom™ Stent) trial demonstrated the superior safety and efficacy of a polymer-free biolimus A9 DCS compared with a similar BMS used with 1 month of dual antiplatelet therapy in 2,466 patients at high bleeding risk...
August 28, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28701676/efficacy-and-safety-of-triple-therapy-and-dual-therapy-with-direct-oral-anticoagulants-compared-to-warfarin
#14
Hideo Amano, Daiga Saito, Takayuki Yabe, Ryo Okubo, Mikihito Toda, Takanori Ikeda
The efficacy and safety of direct oral anticoagulants (DOAC) with antiplatelet therapy compared to warfarin are unclear. The subjects were 280 patients who received antiplatelet therapy with oral anticoagulation (OAC) for the treatment of or protection from thromboembolism between January 2012 and September 2015. Among the 280 subjects, 79 (28.2%) received dual therapy (OAC plus aspirin or P2Y12 inhibitor) with DOAC, 75 (26.8%) dual therapy with warfarin, 46 (16.4%) triple therapy (OAC plus aspirin and P2Y12 inhibitor) with DOAC, and 80 (28...
August 3, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28497845/comparison-of-dual-antiplatelet-therapy-versus-oral-anticoagulation-following-transcatheter-aortic-valve-replacement-a-retrospective-single-center-registry-analysis
#15
Erik W Holy, Julia Kebernik, Abdelhakim Allali, Mohamed El-Mawardy, Gert Richardt, Mohamed Abdel-Wahab
BACKGROUND: The choice of optimal antithrombotic regimen after transcatheter aortic valve replace-ment (TAVR) remains a matter of debate. The objective of this study was to compare both efficacy and safety outcomes based on the type of antithrombotic therapy prescribed after TAVR Methods: This is a retrospective analysis of 514 consecutive patients treated with either dual antiplate¬let therapy (DAPT) (n = 315; 61.3%) or oral anticoagulation (OAC) plus clopidogrel (n = 199; 38.7%) for a minimum of 3 months after TAVR followed by antiplatelet monotherapy or OAC only, respectively...
2017: Cardiology Journal
https://www.readbyqxmd.com/read/28457807/safety-and-efficacy-of-anti-thrombotic-regimens-in-patients-with-percutaneous-coronary-intervention-requiring-oral-anticoagulation-a-traditional-and-network-meta-analysis
#16
REVIEW
Safi U Khan, Muhammad A Saleem, Amirahwaty Abdullah, Subash Ghimire, Manidhar Lekkala, Hammad Rahman, Ahmad N Lone, Edo Kaluski
BACKGROUND: Previous reports have been inconsistent in generating a consensus for optimal treatment strategy for patients with percutaneous coronary intervention (PCI) who also require oral anticoagulation (OAC). We conducted a traditional and network meta-analysis to evaluate the safety and efficacy of anti-thrombotic regimens in this subset of patients. METHODS: 30 articles were recovered through preferred reporting items for systematic reviews and meta-analyses (PRISMA) using MEDLINE, EMBASE and Cochrane Central Register of Controlled Clinical Trials (CENTRAL) from inception to December 2016...
October 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28385406/clinical-bioprosthetic-heart-valve-thrombosis-after-transcatheter-aortic%C3%A2-valve-replacement-incidence-characteristics-and-treatment-outcomes
#17
John Jose, Dmitriy S Sulimov, Mohamed El-Mawardy, Takao Sato, Abdelhakim Allali, Erik W Holy, Björn Becker, Martin Landt, Julia Kebernik, Bettina Schwarz, Gert Richardt, Mohamed Abdel-Wahab
OBJECTIVES: The aim of this study was to determine the incidence, characteristics, and treatment outcomes of patients diagnosed with clinical transcatheter heart valve thrombosis. BACKGROUND: Limited data exists on clinical or manifest transcatheter heart valve thrombosis. Prior studies have focused on subclinical thrombosis. METHODS: A retrospective analysis was conducted of prospectively collected data from a single-center registry that included 642 consecutive patients who underwent transcatheter aortic valve replacement between 2007 and 2015 (305 patients had self-expanding valves; balloon-expandable, n = 281; mechanically expanding, n = 56)...
April 10, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28363682/twelve-month-outcome-of-patients-with-an-established-indication-for-oral-anticoagulation-undergoing-coronary-artery-stenting-and-stratified-by-the-baseline-risk-of-bleeding-insights-from-the-warfarin-and-coronary-stenting-war-stent-registry
#18
Andrea Rubboli, Francesco Saia, Alessandro Sciahbasi, Antonio M Leone, Cataldo Palmieri, Maria Letizia Bacchi-Reggiani, Paolo Calabrò, Barbara Bordoni, Giacomo Piccalò, Nicoletta Franco, Annamaria Nicolino, Paolo Magnavacchi, Luigi Vignali, Stefano Mameli, Michele Dallago, Stefano Maggiolini, Luigi Steffanon, Giancarlo Piovaccari, Giuseppe Di Pasquale
PURPOSE: To evaluate the outcome of patients with an established indication for oral anticoagulation (OAC) undergoing coronary stent implantation (PCI-S) and stratified by the baseline risk of bleeding. MATERIAL AND METHODS: The database of the prospective, multicentre, observational WAR-STENT registry (ClinicalTrials.gov identifier NCT00722319) was analyzed and patients with atrial fibrillation and CHA2 DS2 -VASc score ≥2, mechanical heart valve, prior cardiac embolism, intra-cardiac thrombus and recent venous thromboembolism who were treated with either triple (warfarin, aspirin and clopidogrel) or dual (warfarin and clopidogrel) or dual antiplatelet (aspirin and clopidogrel) therapy, identified...
September 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/27886825/antiplatelet-and-antithrombotic-therapy-in-patients-with-atrial-fibrillation-undergoing-coronary-stenting
#19
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/27757726/risk-and-benefits-of-triple-therapy-in-patients-undergoing-coronary-stent-implantation-requiring-oral-anticoagulation-a-meta-analysis-of-16-studies
#20
Lucia Barbieri, Monica Verdoia, Alon Schaffer, Harry Suryapranata, Giuseppe De Luca
BACKGROUND: Patients with coronary artery disease who undergo stent implantation and have concomitant indication for long-term oral anticoagulation represent a considerable proportion of the overall population. To date there is still no consensus about the optimal antithrombotic strategy to choose in this kind of patients, due to the difficult balance between an increased risk of bleeding and thromboembolic complications. Therefore, the aim of this study was to perform a meta-analysis to evaluate the risk and benefits of triple antithrombotic therapy versus dual antithrombotic therapy in patients undergoing coronary stent implantation, requiring long-term oral anticoagulation...
December 2016: Cardiovascular Drugs and Therapy
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