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triple antithrombotic therapy

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https://www.readbyqxmd.com/read/29156506/lower-gastrointestinal-bleeding-in-patients-with-coronary-artery-disease-on-antithrombotics-and-subsequent-mortality-risk
#1
Parita Patel, Neha Nigam, Neil Sengupta
BACKGROUND: Lower gastrointestinal bleeding (LGIB) is a common complication for patients with coronary artery disease (CAD) due to use of antithrombotic medications. Limited data exists describing which patients are at increased risk for mortality. AIM: To 1) determine whether patients on dual antiplatelet (DAPT) therapy or triple therapy are at higher risk of 90-day and 6-month mortality compared to patients on aspirin (ASA) alone and 2) evaluate risk factors for mortality in patients with CAD on antithrombotics hospitalized with LGIB...
November 20, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29126156/antithrombotic-therapy-after-myocardial-infarction-in-patients-with-atrial-fibrillation-undergoing-percutaneous-coronary-intervention
#2
Gorav Batra, Leif Friberg, David Erlinge, Stefan James, Tomas Jernberg, Bodil Svennblad, Lars Wallentin, Jonas Oldgren
Aims: Optimal antithrombotic therapy after percutaneous coronary intervention (PCI) in patients with myocardial infarction and atrial fibrillation is uncertain. In this study, we compared antithrombotic regimes with regard to a composite cardiovascular outcome of all-cause mortality, myocardial infarction or ischaemic stroke and major bleeds. Methods and results: Patients between October 2005 and December 2012 were identified in Swedish registries, n = 7,116...
November 6, 2017: European Heart Journal. Cardiovascular Pharmacotherapy
https://www.readbyqxmd.com/read/29113375/efficacy-and-safety-of-triple-versus-dual-antithrombotic-therapy-in-atrial-fibrillation-and-ischemic-heart-disease-a-systematic-review-and-meta-analysis
#3
Wengen Zhu, Linjuan Guo, Fadi Liu, Rong Wan, Yang Shen, Gregory Y H Lip, Kui Hong
The optimal antithrombotic regimen for patients with atrial fibrillation and ischemic heart disease remains unclear. Therefore, we aimed to compare the efficacy and safety of triple therapy (TT [an anticoagulant and 2 antiplatelet drugs]) with dual therapy (DAPT [2 antiplatelet drugs] or DT [an anticoagulant and a single antiplatelet drug]) in patients with atrial fibrillation and ischemic heart disease. We systematically searched the Cochrane Library, PubMed and Embase databases for all relevant studies up to August 2017...
October 6, 2017: Oncotarget
https://www.readbyqxmd.com/read/29023526/antithrombotic-therapy-strategies-for-atrial-fibrillation-patients-undergoing-percutaneous-coronary-intervention-a-systematic-review-and-network-meta-analysis
#4
REVIEW
Xiaoxuan Gong, Shaowen Tang, Jiangjin Li, Xiwen Zhang, Xiaoyi Tian, Shuren Ma
OBJECTIVE: The aim of this systematic review and network meta-analysis was to evaluate the comparative efficacy and safety of antiplatelet agents, vitamin K antagonist (VKA) and non-VKA oral anticoagulants (NOACs) in patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI). METHODS: PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials were searched to identify clinical trials comparing antiplatelet drugs with VKA and NOACs or their combination in AF patients undergoing PCI with a mean/median follow-up of at least 12 months...
2017: PloS One
https://www.readbyqxmd.com/read/28981961/contemporary-use-of-oral-antithrombotic-agents-focus-on-dual-and-triple-therapeutic-approaches
#5
Antoine T Jenkins, Alexander Kantorovich, Luba Burman
Atherosclerotic cardiovascular disease (ASCVD) represents a long-standing health care burden in most industrialized countries. Management of ASCVD is multifaceted, and utilization of antithrombotic agents is a key component of care to reduce vascular events. Minimizing thrombotic risk can be accomplished via antiplatelet or anticoagulant drugs; however, combination therapy is warranted for some indications. Although reducing thrombotic complications is important, it is equally vital to consider the safety of combination regimens...
October 5, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28844193/dual-antithrombotic-therapy-with-dabigatran-after-pci-in-atrial-fibrillation
#6
RANDOMIZED CONTROLLED TRIAL
Christopher P Cannon, Deepak L Bhatt, Jonas Oldgren, Gregory Y H Lip, Stephen G Ellis, Takeshi Kimura, Michael Maeng, Bela Merkely, Uwe Zeymer, Savion Gropper, Matias Nordaby, Eva Kleine, Ruth Harper, Jenny Manassie, James L Januzzi, Jurrien M Ten Berg, P Gabriel Steg, Stefan H Hohnloser
BACKGROUND: Triple antithrombotic therapy with warfarin plus two antiplatelet agents is the standard of care after percutaneous coronary intervention (PCI) for patients with atrial fibrillation, but this therapy is associated with a high risk of bleeding. METHODS: In this multicenter trial, we randomly assigned 2725 patients with atrial fibrillation who had undergone PCI to triple therapy with warfarin plus a P2Y12 inhibitor (clopidogrel or ticagrelor) and aspirin (for 1 to 3 months) (triple-therapy group) or dual therapy with dabigatran (110 mg or 150 mg twice daily) plus a P2Y12 inhibitor (clopidogrel or ticagrelor) and no aspirin (110-mg and 150-mg dual-therapy groups)...
October 19, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28818746/patients-with-atrial-fibrillation-and-coronary-artery-disease-double-trouble
#7
REVIEW
Ewelina Michniewicz, Elżbieta Mlodawska, Paulina Lopatowska, Anna Tomaszuk-Kazberuk, Jolanta Malyszko
Coronary artery disease (CAD) is the most common cardiovascular disease while atrial fibrillation (AF) is the most common cardiac arrhythmia. Both diseases share associated risk factors - hypertension, diabetes mellitus, sleep apnea, obesity and smoking. Moreover, inflammation plays a causative role in both diseases. The prevalence of CAD in patients with AF is from 17% to 46.5% while the prevalence of AF among patients with CAD is low and it is estimated from 0.2% to 5%. AF is a well-established factor of poor short- and long-term prognosis in patients with acute myocardial infarction (AMI) and is associated with a marked increase in overall mortality...
August 14, 2017: Advances in Medical Sciences
https://www.readbyqxmd.com/read/28762912/-the-experience-of-use-triple-antithrombotic-therapy-in-patients-with-acute-coronary-syndrome-and-atrial-fibrillation
#8
N G Lozhkina, M H Hasanova, E A Glebchenko, E A Naidena, V A Kozik, A D Kuimov
AIM: In real life to evaluate the effectiveness and safety of apixaban with double antiplatelet therapy for prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation and the recent episode of acute coronary syndrome without ST segment elevation. MATERIALS AND METHODS: 8 patients with atrial fibrillation and the recent (8-14 days after the onset of symptoms of ACS) episode of acute coronary syndrome without ST segment elevation were involved into the research...
April 2017: Kardiologiia
https://www.readbyqxmd.com/read/28760217/time-in-therapeutic-range-and-major-adverse-outcomes-in-atrial-fibrillation-patients-undergoing-percutaneous-coronary-intervention-the-atrial-fibrillation-undergoing-coronary-artery-stenting-afcas-registry
#9
MULTICENTER STUDY
Marco Proietti, K E Juhani Airaksinen, Andrea Rubboli, Axel Schlitt, Tuomas Kiviniemi, Pasi P Karjalainen, Gregory Yh Lip
BACKGROUND: Combination of oral anticoagulation (OAC) and antiplatelets is used in atrial fibrillation (AF) patients undergoing percutaneous coronary intervention and stent (PCI-S) procedure but is associated with increased bleeding when triple antithrombotic therapy (TAT) is used. Our aim was to analyze the impact of time in therapeutic range (TTR) on outcomes, in patients prescribed with TAT. METHODS: Ancillary analysis from the AFCAS registry in patients assigned to TAT...
August 2017: American Heart Journal
https://www.readbyqxmd.com/read/28748165/triple-antithrombotic-therapy-in-patients-undergoing-percutaneous-coronary-intervention-balancing-between-ischemia-and-bleeding
#10
Konstantinos C Koskinas, Lorenz Räber
No abstract text is available yet for this article.
June 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/28748150/duration-of-triple-antithrombotic-therapy-and-outcomes-among-patients-undergoing-percutaneous-coronary-intervention
#11
EDITORIAL
Rahman Shah, Glenda Delgado, Shannon W Finks
No abstract text is available yet for this article.
June 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/28660806/antiplatelet-therapy-for-non-st-segment-elevation-myocardial-infarction-in-complex-real-clinical-scenarios-a-consensus-document-of-the-campania-nstemi-study-group
#12
Marino Scherillo, Plinio Cirillo, Dario Formigli, Giulio Bonzani, Paolo Calabrò, Paolo Capogrosso, Rosario Farina, Tonino Lanzillo, Franco Mascia, Ciro Mauro, Bernardino Tuccillo, Alessandro Bellis, Renato Bianchi, Giovanni Cimmino, Orlando Piro, Amelia Ravera, Fortunato Scotto di Uccio, Paolo Tammaro, Alfredo Vetrano, Bruno Trimarco
The incidence of ST-segment elevation myocardial infarction (STEMI) has significantly decreased. Conversely, the rate of non-STEMI (NSTEMI) has increased. Patients with NSTEMI have lower short-term mortality compared to patients with STEMI, whereas at long-term follow-up, the mortality becomes comparable. This might be due to the differences in baseline characteristics, including older age and a greater prevalence of comorbidities in the NSTEMI population. Although antithrombotic strategies used in patients with NSTEMI have been well studied in clinical trials and updated guidelines are available, patterns of use and outcomes in clinical practice are less well described...
August 2017: Angiology
https://www.readbyqxmd.com/read/28648031/-impact-of-different-antithrombotic-therapy-strategy-on-prognosis-in-coronary-heart-disease-patients-combining-with-atrial-fibrillation-a-meta-analysis
#13
C Yuan, L Zhong, R C Huang
Objective: To evaluate the impact of various anticoagulation antiplatelet therapy strategies on the prognosis of patients with coronary heart disease combining with atrial fibrillation. Methods: Present meta analysis was performed according to search results on English EMBASE database by computer retrieval, Pubmed, the Cochrane Central Register of Controlled Trials, Medline, Chinese CBM database, CNKI database, Wan Fang database, China science and technology papers online electronic databases, manual retrieval for important international conference proceedings up to April 30 2016...
June 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/28643219/triple-antithrombotic-therapy-in-atrial-fibrillation-patients-undergoing-pci-a-fading-role
#14
Dimitrios Alexopoulos, Panagiotis Vlachakis, John Lekakis
Triple antithrombotic therapy (TAT), consisting of aspirin, a P2Y12 receptor antagonist and oral anticoagulant (OAC) medication has been considered as an 'unavoidable' strategy for a 1-12 months for atrial fibrillation (AF) patients post acute coronary syndrome or percutaneous coronary angioplasty with stenting. However, TAT has rather poorly been adopted in real life practice, mainly because of an accompanying increased bleeding potential and lack of definitive results of randomized clinical trials. Several registries, meta-analyses and small randomized trials have so far provided the base of guidelines recommendations...
June 22, 2017: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/28595745/antithrombotic-regimens-in-patients-with-atrial-fibrillation-and-coronary-artery-disease-after-percutaneous-coronary-intervention-a-focused-review
#15
Kay-Won Chang, Boris Arbit, Jonathan C Hsu
Atrial fibrillation and coronary artery disease are common comorbidities with increasing incidences worldwide. About 5-15% of atrial fibrillation patients will require coronary stenting at some point in their lives, which necessitates dual antiplatelet therapy with aspirin and a P2Y12 antagonist. Triple therapy refers to the clinical scenario in which a patient is prescribed aspirin, P2Y12 antagonist, and oral anticoagulant, usually in the setting of atrial fibrillation. Current guidelines on atrial fibrillation do not offer strong recommendations on triple therapy management...
September 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28584203/current-use-of-oral-anticoagulants-and-prognostic-analysis-in-patients-with-atrial-fibrillation-undergoing-coronary-stenting
#16
Heng-Bo Zhai, Jun Liu, Zhi-Chao Dong, Dong-Xia Wang, Bo Zhang
BACKGROUND: It is currently believed that triple oral antithrombotic therapy in patients with atrial fibrillation (AF) after percutaneous coronary intervention (PCI) should be recommended if there are no contraindications. However, selecting triple therapy for AF patients undergoing PCI is still challenging when bleeding risk is considered. This study aimed to investigate the current use of oral anticoagulants (Vitamin K antagonists [VKA]) and perform prognostic analysis in real-world patients with AF undergoing coronary stenting...
June 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28560486/new-scoring-model-darsym-score-to-predict-post-discharge-bleeding-after-successful-second-generation-drug-eluting-stent-implantation
#17
Yohsuke Honda, Masahiro Yamawaki, Keisuke Hirano, Motoharu Araki, Norihiro Kobayashi, Yasunari Sakamoto, Shinsuke Mori, Masakazu Tsutumi, Takuro Takama, Takahiro Tokuda, Kenji Makino, Shigemitsu Shirai, Yoshiaki Ito
We aimed to create a scoring model to predict post-discharge bleeding (PDB) after drug-eluting stent (DES) implantation in Japanese subjects. We enrolled 1912 consecutive patients undergoing DES implantation (age 70 ± 10 years; 72% male). PDB was defined as a composite of type 5, 3, and 2 bleeding using the Bleeding Academic Research Consortium criteria. A Cox proportional hazard model assessed predictors, and we then derived a clinical model stratifying risk of PDB after DES implantation. Ninety-eight patients (6...
November 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28527777/triple-antithrombotic-therapy-at%C3%A2-the%C3%A2-intercept-between-threats-and%C3%A2-opportunities-don-t-throw-out-the-baby-with-the-bath-water
#18
EDITORIAL
Davide Capodanno, Dominick J Angiolillo
No abstract text is available yet for this article.
June 12, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28527773/prevalence-management-and-long-term-6-year-outcomes-of-atrial%C3%A2-fibrillation-among-patients-receiving-drug-eluting-coronary-stents
#19
Hyo-In Choi, Jung-Min Ahn, Se Hun Kang, Pil Hyung Lee, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, Duk-Woo Park, Seung-Jung Park
OBJECTIVES: This study sought to investigate the incidence, management, and clinical relevance of atrial fibrillation (AF) during and after percutaneous coronary intervention (PCI) with drug-eluting stents (DES) and evaluate outcomes of different antithrombotic strategies. BACKGROUND: Uncertainty exists regarding the optimal antithrombotic strategy in patients with AF who are undergoing PCI with DES. METHODS: Using a consecutive series of 10,027 patients who underwent DES implantation between 2003 and 2011, we evaluated the overall prevalence and clinical impact of AF...
June 12, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28500198/triple-antithrombotic-therapy-for-atrial-fibrillation-and-coronary-stents
#20
Danielle Shmyr, Vanessa Van der Merwe, Erin Yakiwchuk, Arden Barry, Lynette Kosar
No abstract text is available yet for this article.
May 2017: Canadian Family Physician Médecin de Famille Canadien
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