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dual antiplatelet therapy

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https://www.readbyqxmd.com/read/29790480/two-year-clinical-outcome-of-all-comers-treated-with-three-highly-dissimilar-contemporary-coronary-drug-eluting-stents-in-the-randomised-bio-resort-trial
#1
Marlies M Kok, Paolo Zocca, Rosaly A Buiten, Peter W Danse, Carl E Schotborgh, Martijn Scholte, Marc Hartmann, Martin G Stoel, Gert van Houwelingen, Gerard C M Linssen, Carine J M Doggen, Clemens von Birgelen
AIMS: The aim of the study was to evaluate the two-year clinical outcome of all-comer trial participants who were treated with two very different thin-strut biodegradable polymer versus thin-strut durable polymer drug-eluting stents (DES). Prolonged clinical outcome after discontinuation of dual antiplatelet therapy is of particular interest, given the highly dissimilar polymer types, amount, distribution, and degradation speed of both biodegradable polymer DES. METHODS AND RESULTS: The BIO-RESORT trial (NCT01674803) randomly assigned 3,514 patients to treatment with biodegradable polymer SYNERGY everolimus-eluting stents (EES) or Orsiro sirolimus-eluting stents (SES), or durable polymer Resolute Integrity zotarolimus-eluting stents (ZES)...
May 23, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29790477/biolimus-a9-polymer-free-coated-stents-in-high-bleeding-risk-patients-undergoing-complex-pci-evidence-from-the-leaders-free-randomised-clinical-trial
#2
Janusz Lipiecki, Philippe Brunel, Marie-Claude Morice, Christan Roguelov, Simon J Walsh, Gert Richardt, Pedro Eerdmans, Robaayah Zambahari, Jacques Berland, Samuel Copt, Hans-Peter Stoll, Philip Urban
AIMS: The LEADERS FREE trial has demonstrated that a polymer-free Biolimus A9-coated stent (BA9-DCS) is superior to a bare metal stent (BMS) for high bleeding risk (HBR) patients when treated with one month of dual antiplatelet therapy (DAPT). This analysis aimed to determine the impact of PCI procedure complexity on the two-year results. METHODS AND RESULTS: Six hundred and sixty-seven (667) patients enrolled in the LEADERS FREE (BA9-DCS 346, BMS 321) underwent a complex PCI, defined by one or more of eight characteristics: total stent length ≥60 mm, ≥3 vessels or lesions treated, ≥3 stents implanted, bifurcation lesion treated with ≥2 stents, chronically occluded, restenotic or saphenous vein graft lesion...
May 23, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29784631/safety-and-efficacy-of-polymer-free-biolimus-eluting-stents-in-all-comer-patients-the-rudi-free-study
#3
Gennaro Sardella, Giulio G Stefanini, Carlo Briguori, Corrado Tamburino, Franco Fabbiocchi, Francesco Rotolo, Fabrizio Tomai, Anita Paggi, Mario Lombardi, Gaetano Gioffrè, Rocco Sclafani, Andrea Rolandi, Alessandro Sciahbasi, Francesco Scardaci, Nicola Signore, Simone Calcagno, Massimo Mancone, Mauro Chiarito, Arturo Giordano
AIMS: Polymer-free biolimus-eluting stents (PF-BES) have been shown superior to bare metal stents in high bleeding risk (HBR) patients treated with 1-month dual antiplatelet therapy (DAPT). However, limited evidence is available on PF-BES in non-HBR patients. We aim to evaluate the safety and efficacy of PF-BES in all-comer patients undergoing percutaneous coronary interventions (PCI). METHODS AND RESULTS: Patients with stable coronary artery disease or acute coronary syndromes (ACS) undergoing PCI with PF-BES in routine clinical practice were included in a multicenter, prospective registry...
May 21, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29782272/-duration-and-timing-of-initiation-of-therapy-with-platelet-p2y12-inhibitors-in-the-treatment-of-patients-with-acute-coronary-syndrome
#4
S V SHalaev, Z M Safiullina
In recent years, the issues of choice of an agent for dual antiplatelet therapy (DAPT) as well as timing of initiation and duration of DAPT in patients with acute coronary syndrome (ACS) have been actively discussed. In this article we present data of major randomized trials of clopidogrel and novel P2Y12 inhibitors - prasugrel, ticagrelor, cangrelor - assessing strategy of administration of antiaggregants in patients with ACS before coronary angiography / percutaneous coronary intervention. The article also contains analysis of differences between recommendations of the European Society of Cardiology and American College of Cardiology/American Heart Association on therapy with oral P2Y12 inhibitors in the management of patients with ACS...
March 2018: Kardiologiia
https://www.readbyqxmd.com/read/29782255/-high-on-treatment-platelet-reactivity-determinants-on-dual-antiplatelet-therapy-in-patients-with-ischemic-heart-disease-before-elective-percutaneous-coronary-intervention
#5
E Z Golukhova, M V Grigoryan, M N Ryabinina, N I Bulaeva
OBJECTIVE: to determine impact of different laboratory and genetic factors on high on-treatment platelet reactivity (HOPR) during dual antiplatelet therapy (DAPT). METHODS: We included in this study 94 patients with stable ischemic heart disease (mean age 59±9.67 years). All patients underwent elective PCI with implantation of drug eluting stents at the background of dual antiplatelet therapy (DAPT) with aspirin and clopidogrel. Platelet reactivity was assessed using light transmission aggregometry with 5 μmol/L ADP (LTA 5ADP) and VerifyNow assay before PCI...
April 2018: Kardiologiia
https://www.readbyqxmd.com/read/29781070/antiplatelet-therapy-for-patients-undergoing-coronary-artery-bypass-surgery
#6
Christine M DeStephan, David J Schneider
Considerable variation in the use and duration of antiplatelet medications during the perioperative and postoperative care of patients undergoing coronary artery bypass grafting (CABG) reflects limited studies focused directly on these patients as well as variation in the results reported. In this review we will highlight the incidence and mechanisms of graft closure as well as the evidence in support of antiplatelet therapy that is balanced by the impact of antiplatelet therapy on the risk of bleeding to provide recommendations for the use of antiplatelet therapy in patients undergoing CABG...
May 21, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29781069/dual-and-triple-antithrombotic-therapies-current-patterns-of-practice-and-controversies
#7
Mark Crowther, John Eikelboom
Dual antiplatelet therapy (DAPT) has been the cornerstone of antithrombotic management for patients undergoing percutaneous coronary intervention (PCI). Despite low-quality evidence, triple antithrombotic therapy involving acetylsalicylic acid, clopidogrel and warfarin or non-vitamin K antagonist oral anticoagulant (NOAC) has been recommended in patients with concomitant atrial fibrillation undergoing PCI, who require long-term oral anticoagulation, although such strategy is associated with a substantially increased risk of bleeding compared with DAPT...
May 21, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29780330/application-of-feedback-system-control-optimization-technique-in-combined-use-of-dual-antiplatelet-therapy-and-herbal-medicines
#8
Wang Liu, Yu-Long Li, Mu-Ting Feng, Yu-Wei Zhao, Xianting Ding, Ben He, Xuan Liu
Aim: Combined use of herbal medicines in patients underwent dual antiplatelet therapy (DAPT) might cause bleeding or thrombosis because herbal medicines with anti-platelet activities may exhibit interactions with DAPT. In this study, we tried to use a feedback system control (FSC) optimization technique to optimize dose strategy and clarify possible interactions in combined use of DAPT and herbal medicines. Methods: Herbal medicines with reported anti-platelet activities were selected by searching related references in Pubmed...
2018: Frontiers in Physiology
https://www.readbyqxmd.com/read/29779587/meta-analysis-of-studies-comparing-dual-versus-mono-antiplatelet-therapy-following-transcatheter-aortic-valve-implantation
#9
Shadi Al Halabi, Joshua Newman, Michael E Farkouh, David Fortuin, Fred Leya, John Sweeney, Amir Darki, John Lopez, Lowell Steen, Bruce Lewis, John Webb, Martin B Leon, Verghese Mathew
Current guidelines recommend dual-antiplatelet therapy (DAPT) after transcatheter aortic valve implantation (TAVI), although some studies suggest mono-antiplatelet therapy is equally efficacious with an improved safety profile. We performed a meta-analysis of studies comparing DAPT with mono-antiplatelet therapy after TAVI. Study quality and heterogeneity were assessed using Jadad score, Newcastle-Ottawa Scale, and Cochran's Q statistics. Mantel-Haenszel odds ratios (ORs) were calculated using fixed effect models as the primary analysis...
March 28, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29779200/impact-of-antithrombotic-regimen-on-mortality-ischemic-and-bleeding-outcomes-after-transcatheter-aortic-valve-replacement
#10
Anubodh Varshney, Ryan A Watson, Andrew Noll, KyungAh Im, Jeffrey Rossi, Pinak Shah, Robert P Giugliano
INTRODUCTION: Optimal antithrombotic therapy after transcatheter aortic valve replacement (TAVR) remains unclear. We evaluated the association between antithrombotic regimens and outcomes in TAVR patients. METHODS: We retrospectively analyzed consecutive patients who underwent TAVR at a single academic center from April 2009 to March 2014. Antithrombotic regimens were classified as single or dual antiplatelet therapy (AP), single antiplatelet plus anticoagulant (SAC), or triple therapy (TT)...
May 19, 2018: Cardiology and Therapy
https://www.readbyqxmd.com/read/29778598/relevance-of-antiplatelet-therapy-duration-after-stent-assisted-coil-embolization-for-unruptured-intracranial-aneurysms
#11
Tackeun Kim, Chang Hyeun Kim, Si-Hyuck Kang, Seung Pil Ban, O-Ki Kwon
BACKGROUND: The optimal duration of dual antiplatelet therapy (DAPT) for preventing delayed thromboembolic events (DTEs) remains unclear. We aimed to determine whether longer DAPT provides improved protection against delayed DTEs. METHODS: This retrospective cohort study included 507 stent-assisted coil embolization procedures using a single stent for unruptured intracranial aneurysms. We performed coarsened exact matching according to the duration of maintenance DAPT...
May 17, 2018: World Neurosurgery
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
#12
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/29774986/everolimus-drug-eluting-stent-performance-in-patients-with-long-coronary-lesions-the-multicenter-longprime-registry
#13
José Francisco Díaz Fernández, Santiago Jesús Camacho Freire, Juan Carlos Fernández Guerrero, Nicolas Delarche, Christophe Bretelle, Javier Zueco Gil, Ramón López Palop, Bruno García Del Blanco, Vicente Mainar Tello, Franck Albert
OBJECTIVES: To assess the efficacy and safety of the Xience Prime everolimus-eluting stent (EES) in long coronary lesions in a real-world population. BACKGROUND: Long lesions are considered difficult technically and in terms of achieving successful clinical outcomes. With first generation DES, MACE can be as high as 10% at a short-medium term follow-up. There are a few data available in this subset regarding the use of second generation DES METHODS: A prospective, multicenter registry of consecutive patients (aged 64...
May 18, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29774880/leukocyte-mir-223-3p-is-not-associated-with-altered-platelet-responses-to-clopidogrel-in-patients-with-coronary-artery-disease
#14
Wenjian Xie, Qian Yin, Mengran Zhang, Shengnan Li, Shaoliang Chen
To investigate the potential correlation between miR-223 level in leukocytes and platelet responses to clopidogrel in patients with coronary artery disease.
 Methods: A cohort of 188 outpatients, who conducted percutaneous coronary intervention (PCI) and received dual antiplatelet therapy, were recruited. The patient's electronic health data were collected, and their blood samples were obtained for measurement of adenosine diphosphate (ADP)-induced whole-blood platelet aggregation. Extreme cases of platelet responses to clopidogrel (ultra- vs...
April 28, 2018: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/29773949/effect-of-dual-antiplatelet-on-recurrent-stroke-in-minor-stroke-or-tia-depends-on-bodyweight
#15
Yan Ma, Ying Liu, Jie Xu, Yilong Wang, Yongjun Wang, Fenghe Du
Objective: To assess whether bodyweight influences the efficacy and safety of dual antiplatelet therapy (DAT) in male patients with minor stroke or transient ischemic attack patients. Materials and methods: All 3,420 male participants coming from the Clopidogrel in High-Risk Patients with Acute Non-disabling Cerebrovascular Events trial were divided into 3 groups based on bodyweight (<65 kg, 65-75 kg, and ≥75 kg). The stroke outcomes included stroke recurrence, combined vascular events, and bleeding events during 90 days of follow-up...
2018: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29770334/optimum-antithrombotic-therapy-in-patients-requiring-long-term-anticoagulation-and-undergoing-percutaneous-coronary-intervention
#16
REVIEW
Nayan Agarwal, Dhruv Mahtta, Cecil A Rambarat, Islam Elgendy, Ahmed N Mahmoud
Management of patients on long-term anticoagulation requiring percutaneous coronary intervention is challenging. Triple therapy with oral anticoagulant and dual antiplatelet therapy is the standard of care. However, there is no strong evidence to support this strategy. There is emerging data regarding the safety and efficacy of dual therapy with oral anticoagulant and single antiplatelet therapy in these patients. In this comprehensive review we highlight available evidence regarding various antithrombotic regimens' efficacy and safety in patient with coronary artery disease undergoing percutaneous coronary intervention with long-term anticoagulation therapy requirements...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29768314/medication-administration-delays-in-non-st-elevation-myocardial-infarction-analysis-of-1002-patients-admitted-to-an-academic-medical-center
#17
LeAnn N Denlinger, Ellen C Keeley
Our goal was to assess adherence to American College of Cardiology/American Heart Association guideline-based medical therapy in patients admitted with type I non-ST elevation myocardial infarction (NSTEMI) and to determine factors associated with medication administration delay. We performed a retrospective analysis using data from the Acute Coronary Treatment and Intervention Outcomes Network (ACTION) Registry. Baseline patient demographics, 12-lead electrocardiogram (ECG) findings, laboratory values, medications administered and the time they were administered, and in-hospital clinical outcomes were collected...
June 2018: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29766335/ticagrelor-versus-clopidogrel-as-part-of-dual-or-triple-antithrombotic-therapy-a-systematic-review-and-meta-analysis
#18
Ioannis Andreou, Alexandros Briasoulis, Christos Pappas, Ignatios Ikonomidis, Dimitrios Alexopoulos
PURPOSE: Clopidogrel is the standard P2Y12 receptor inhibitor used in patients requiring both antiplatelet therapy and oral anticoagulation (OAC). We investigated the safety and efficacy of ticagrelor as an alternative to clopidogrel in patients on OAC. METHODS: A systematic electronic literature search was performed in MEDLINE, EMBASE, and the Cochrane Library for randomised controlled studies that examined the relative safety and efficacy of clopidogrel versus ticagrelor among patients requiring therapy with antiplatelet agents plus OAC...
May 15, 2018: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/29765392/carotid-stenting-for-treatment-of-symptomatic-carotid-webs-a-single-center-case-series
#19
Waleed Brinjikji, Ronit Agid, Vitor M Pereira
Background and Purpose: Carotid webs are an increasingly recognized cause of acute is-chemic stroke, particularly in younger adults. The optimal medical and surgical strategies for managing these lesions have not been well established. We report a single-center case series of carotid stenting for treatment of symptomatic carotid webs. Materials and Methods: Consecutive patients undergoing stent placement for treatment of symptomatic carotid webs were included. Carotid webs were defined as a thin intraluminal filling defect along the posterior wall of the carotid bulb just beyond the carotid bifurcation on CTA...
April 2018: Interventional Neurology
https://www.readbyqxmd.com/read/29764713/utility-of-grace-and-acuity-horizons-risk-scores-to-guide-dual-antiplatelet-therapy-in-korean-patients-with-acute-myocardial-infarction-undergoing-drug-eluting-stenting
#20
Doo Sun Sim, Myung Ho Jeong, Hyo Soo Kim, Hyeon Cheol Gwon, Ki Bae Seung, Seung Woon Rha, Shung Chull Chae, Chong Jin Kim, Kwang Soo Cha, Jong Sun Park, Jung Han Yoon, Jei Keon Chae, Seung Jae Joo, Dong Ju Choi, Seung Ho Hur, In Whan Seong, Myeong Chan Cho, Doo Il Kim, Seok Kyu Oh, Tae Hoon Ahn, Jin Yong Hwang
BACKGROUND: Dual antiplatelet therapy (DAPT) is recommended in patients receiving drug-eluting stents (DES). However, bleeding risk should be weighed against ischemic risk. Utility of GRACE risk score and ACUITY-HORIZONS bleeding risk score was assessed in patients with acute myocardial infarction (MI) according to use of P2Y12 blocker. METHODS: From the Korea Acute Myocardial Infarction Registry-National Institute of Health database, 7791 patients with acute MI receiving DES were divided into ticagrelor (n=1554) and clopidogrel (n=6237) groups...
May 12, 2018: Journal of Cardiology
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