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triple antithrombotic therapy

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https://www.readbyqxmd.com/read/29349596/concomitant-use-of-antiplatelets-and-anticoagulants-in-patients-with-coronary-heart-disease-and-atrial-fibrillation-what-do-recent-clinical-trials-teach-us
#1
REVIEW
David H Lam, Sean M Bell, Ravi S Hira
PURPOSE OF REVIEW: Coronary heart disease (CHD) and atrial fibrillation (AF) are among the most common cardiovascular diseases. A significant proportion of patients have both CHD and AF and are at increased risk for thrombotic complications. Current therapy for CHD and AF includes antiplatelet and anticoagulant medications, respectively. Patients with concurrent CHD and AF may be prescribed dual antiplatelet therapy (DAPT) in addition to anticoagulation, which increases their bleeding risk...
January 19, 2018: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/29345587/is-there-a-role-for-oral-triple-therapy-in-patients-with-acute-coronary-syndromes-without-atrial-fibrillation
#2
Nikolaos Spinthakis, Mohamed Farag, Zaki Akhtar, Diana Adrienne Gorog
BACKGROUND: Acute coronary syndrome (ACS) patients, despite treatment with dual antiplatelet therapy (DAPT), have up to 10% risk of recurrent major adverse cardiac events (MACE) in the short term. METHODS: Here we review studies using more potent antithrombotic agent combinations to reduce this risk, namely triple therapy (TT) with the addition of an oral anticoagulant, PAR-1 antagonist, or cilostazol to DAPT (mainly aspirin and clopidogrel), and discuss the limitations of trials to date...
January 16, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29343478/treatment-of-gastrointestinal-bleeding-with-idarucizumab-in-a-patient-receiving-dabigatran
#3
Jennifer Mourafetis, Norman Doctor, Simon Leung
PURPOSE: A case report describing use of idarucizumab for dabigatran reversal without the use of hemostatic agents in a patient who developed acute upper gastrointestinal (GI) bleeding while receiving triple antithrombotic therapy is presented. SUMMARY: A 77-year-old man with a complex cardiac history presented to the emergency room with chief complaints of black tarry stools and low blood pressures for 4 days. His past medical history included recent percutaneous coronary intervention (PCI) and drug-eluting stent (DES) placement, atrial fibrillation, hypertension, hyperlipidemia, coronary artery disease, coronary artery bypass graft surgery, stage 3 chronic kidney disease, and cholecystectomy...
January 17, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29337447/-geriatric-medicine
#4
Gabriel Gold, Christophe Büla, Pierre Olivier Lang, Philippe Chassagne
2017 highlights benefits of prevention. Better control of cardiovascular risk reduces the incidence of dementia and monthly high-dose vitamin D the incidence of respiratory infections in nursing home. Pre-operative geriatric assessment lowers by 20% the rate of delirium after hip-fracture surgery and complications in vascular surgery. Deleterious effects are also reported. High-dose vitamin D triples the rate of falls in supplemented residents and doesn't improve gait speed in sedentary men. Widely used in cardiovascular prevention, antithrombotic therapy is associated with an astonishing risk of subdural bleeding that further increases with the number of drugs combined together...
January 10, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29321798/impact-of-triple-antithrombotic-therapy-in-patients-with-acute-coronary-syndrome-undergoing-percutaneous-coronary-intervention-in-real-world-practice
#5
Yan Yan, Xiao Wang, Jing-Yao Fan, Shao-Ping Nie, Sergio Raposeiras-Roubín, Emad Abu-Assi, Jose P Simao Henriques, Fabrizio D'Ascenzo, Jorge Saucedo, José R González-Juanatey, Stephen B Wilton, Wouter J Kikkert, Iván Nuñez-Gil, Albert Ariza-Sole, Xian-Tao Song, Dimitrios Alexopoulos, Christoph Liebetrau, Tetsuma Kawaji, Claudio Moretti, Zenon Huczek, Toshiharu Fujii, Luis Cl Correia, Masa-Aki Kawashiri, Sasko Kedev
Objective: The optimal antithrombotic regimen for patients on oral anticoagulation (OAC) after acute coronary syndrome (ACS) and percutaneous coronary intervention (PCI) remains debated. This study sought to evaluate the efficacy and safety of OAC plus clopidogrel with or without aspirin in a real-world setting. Methods: We retrospectively analyzed data from an international, multi-center registry between 2003 and 2014 (n = 15,401). Patients with ACS and receiving OAC after PCI were screened...
November 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/29274198/dabigatran-versus-vitamin-k-antagonist-an-observational-across-cohort-comparison-in-acute-coronary-syndrome-patients-with-atrial-fibrillation
#6
Mélanie Gaubert, Noémie Resseguier, Marc Laine, Laurent Bonello, Laurence Camoin-Jau, Franck Paganelli
BACKGROUND: Dual antithrombotic therapy comprising a vitamin K antagonist (VKA) plus clopidogrel reduces the incidence of major bleeding compared with triple therapy (VKA+clopidogrel+aspirin) in acute coronary syndrome (ACS) patients with atrial fibrillation (AF), with a similar thrombotic risk. The oral thrombin inhibitor dabigatran (150 mg twice a day) showed superiority over VKA in non-valvular AF, but data supporting its use in AF patients presenting with ACS are limited. OBJECTIVE: We sought to evaluate the efficacy of dabigatran versus VKA in the management of AF patients undergoing percutaneous coronary intervention for an ACS...
December 23, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29200825/efficacy-and-safety-of-quadruple-therapy-including-tirofiban-in-the-treatment-of-chinese-nste-acs-patients-failing-to-receive-timely-percutaneous-coronary-intervention
#7
Lan Li, Zhenrong Ge, Dengke Zhang, Jun Kuang, Xiang Ma, Shubin Jiang
Background: Although it has been shown to be superior to simple antithrombotic drug therapy, most patients are unable to receive timely percutaneous coronary intervention (PCI) and are treated with conventional triple antithrombotic therapy (aspirin, clopidogrel, low-molecular-weight heparin). Here, we evaluate the efficacy and safety of adding low-dose tirofiban to this regimen. Methods: A total of 1,783 patient records (unable to receive PCI) indicating non-ST-segment elevation acute coronary syndrome (NSTE-ACS) were included...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/29156506/lower-gastrointestinal-bleeding-in-patients-with-coronary-artery-disease-on-antithrombotics-and-subsequent-mortality-risk
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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