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dual antiplatelet therapy

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https://www.readbyqxmd.com/read/28938240/atrial-fibrillation-bleeding-and-coronary-intervention-current-recommendations
#1
Serdar Farhan, Roxana Mehran
The patient population with the need for oral anticoagulation to reduce stroke risk associated with atrial fibrillation (AF) and dual antiplatelet therapy to prevent stent thrombosis and myocardial infarction after percutaneous coronary intervention is increasing. However, patients treated with a triple therapy consisting of oral anticoagulation, aspirin, and a P2Y12 inhibitor have been demonstrated to be at high bleeding risk. The best combination of these agents and the duration of the different therapies are still uncertain...
September 21, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28937039/safety-and-necessity-of-antiplatelet-therapy-on-patients-underwent-endovascular-aortic-repair-with-both-stanford-type-b-aortic-dissection-and-coronary-heart-disease
#2
Rui-Xia He, Lei Zhang, Tie-Nan Zhou, Wen-Jie Yuan, Yan-Jie Liu, Wen-Xia Fu, Quan-Min Jing, Hai-Wei Liu, Xiao-Zeng Wang
BACKGROUND: Acute aortic dissection is known as the most dangerous aortic disease, with management and prognosis determined as the disruption of the medial layer provoked by intramural bleeding. The objective of this study was to evaluate the safety and necessity of antiplatelet therapy on patients with Stanford Type B aortic dissection (TBAD) who underwent endovascular aortic repair (EVAR). METHODS: The present study retrospectively analyzed 388 patients with TBAD who underwent EVAR and coronary angiography...
October 5, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28935077/a-prospective-evaluation-of-a-pre-specified-absorb-bvs-implantation-strategy-in-st-segment-elevation-myocardial-infarction-the-bvs-stemi-strategy-it-study
#3
Alfonso Ielasi, Gianluca Campo, Claudio Rapetto, Attilio Varricchio, Bernardo Cortese, Salvatore Brugaletta, Salvatore Geraci, Paolo Vicinelli, Fortunato Scotto di Uccio, Gioel Gabrio Secco, Arnaldo Poli, Elisa Nicolini, Kohki Ishida, Azeem Latib, Maurizio Tespili
OBJECTIVES: The aim of this study was to assess the feasibility and clinical results following a pre-specified bioresorbable scaffold (Absorb BVS) implantation strategy in patients with ST-segment elevation myocardial infarction (STEMI). BACKGROUND: Concerns were raised about the safety of Absorb because a non-negligible rate of thrombosis was reported within 30 days and at midterm follow-up after primary percutaneous coronary intervention. METHODS: This was a prospective, multicenter study of patients with STEMI (<75 years of age with symptom onset <12 h) undergoing primary percutaneous coronary intervention with Absorb following a dedicated implantation protocol...
September 25, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28935071/clinical-angiographic-and-procedural-correlates-of-acute-subacute-and-late-absorb-scaffold-thrombosis
#4
Stephen G Ellis, Giuseppe Steffenino, Dean J Kereiakes, Gregg W Stone, R J van Geuns, Alexandre Abizaid, Holger Nef, Bernardo Cortese, Luca Testa, Maurizio Menichelli, Corrado Tamburino, Tommaso Gori, Takeshi Kimura, Patrick W Serruys, Salvatore Brugaletta, Manel Sabaté, Run-Lin Gao
OBJECTIVES: The authors sought to identify and verify independent correlates of device thrombosis from an analysis of multicenter trials and registries. BACKGROUND: Recent analyses suggest an increased risk of device thrombosis with Absorb bioresorbable vascular scaffold (Abbott Vascular, Santa Clara, California) implantation compared with metallic drug-eluting stents, and data from moderate size studies suggest a risk relationship to vessel size and technique. METHODS: From 8,771 consecutively treated patients, 105 patients (1...
September 25, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28935032/effect-of-definition-on-incidence-and-prognosis-of-type-2-myocardial-infarction
#5
Thomas Nestelberger, Jasper Boeddinghaus, Patrick Badertscher, Raphael Twerenbold, Karin Wildi, Dominik Breitenbücher, Zaid Sabti, Christian Puelacher, Maria Rubini Giménez, Nikola Kozhuharov, Ivo Strebel, Lorraine Sazgary, Deborah Schneider, Janina Jann, Jeanne du Fay de Lavallaz, Òscar Miró, F Javier Martin-Sanchez, Beata Morawiec, Damian Kawecki, Piotr Muzyk, Dagmar I Keller, Nicolas Geigy, Stefan Osswald, Tobias Reichlin, Christian Mueller
BACKGROUND: Uncertainties regarding the most appropriate definition and treatment of type 2 myocardial infarction (T2MI) due to supply-demand mismatch have contributed to inconsistent adoption in clinical practice. OBJECTIVES: This study sought a better understanding of the effect of the definition of T2MI on its incidence, treatment, and event-related mortality, thereby addressing an important unmet clinical need. METHODS: The final diagnosis was adjudicated in patients presenting with symptoms suggestive of myocardial infarction by 2 independent cardiologists by 2 methods: 1 method required the presence of coronary artery disease, a common interpretation of the 2007 universal definition (T2MI2007); and 1 method did not require coronary artery disease, the 2012 universal definition (T2MI2012)...
September 26, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28933520/anticoagulation-and-antiplatelet-therapy-in-patients-with-peripheral-arterial-disease-of-the-femoro-popliteal-arteries
#6
Cornelis G Vos, Anco Vahl
Peripheral arterial disease (PAD) is associated with a substantial cardiovascular risk and secondary prevention is recommended for all patients. In this report the literature on anticoagulant and antiplatelet drugs for patients with PAD in the femoro-popliteal segment is reviewed. PubMED/MEDLINE and Cochrane Database was searched for studies published between January 1966 and August 2017. Meta-analyses and randomized controlled trials describing outcome of anticoagulants or antiplatelet drugs for secondary prevention or following vascular interventions in patients with PAD were included...
September 20, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28933424/the-efficacy-and-safety-of-cilostazol-as-an-alternative-to-aspirin-in-chinese-patients-with-aspirin-intolerance-after-coronary-stent-implantation-a-combined-clinical-study-and-computational-system-pharmacology-analysis
#7
Ying Xue, Zhi-Wei Feng, Xiao-Ye Li, Zi-Heng Hu, Qing Xu, Zi Wang, Jia-Hui Cheng, Hong-Tao Shi, Qi-Bing Wang, Hong-Yi Wu, Xiang-Qun Xie, Qian-Zhou Lv
Dual antiplatelet therapy (DAT) with aspirin and clopidogrel is the standard regimen to achieve rapid platelet inhibition and prevent thrombotic events. Currently, little information is available regarding alternative antiplatelet therapy in patients with an allergy or intolerance to aspirin. Although cilostazol is already a common alternative to aspirin in clinical practice in China, its efficacy and safety remain to be determined. We retrospectively analyzed 613 Chinese patients who had undergone primary percutaneous coronary intervention (PCI)...
September 21, 2017: Acta Pharmacologica Sinica
https://www.readbyqxmd.com/read/28932360/very-late-bioresorbable-scaffold-thrombosis-and-reoccurrence-of-dissection-two-years-later-chronic-total-occlusion-recanalization-of-the-left-anterior-descending-artery
#8
Luigi Di Serafino, Plinio Cirillo, Tullio Niglio, Francesco Borgia, Bruno Trimarco, Giovanni Esposito, Eugenio Stabile
We describe the case of a patient presenting with ST-segment elevation myocardial infarction due to very late scaffold thrombosis. The patient was already admitted for an elective percutaneous recanalization of a chronically occluded left anterior descending artery (LAD). The procedure was performed according the sub-intimal tracking and re-entry (STAR) technique with 4 bioresorbable vascular scaffolds implantation. However, even though the coronary flow was preserved at the end of the procedure, the dissected segment was only partially sealed at the distal segment of the LAD...
August 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28931362/dual-antiplatelet-therapy-is-associated-with-coagulopathy-detectable-by-thrombelastography-in-acute-stroke
#9
Mark M McDonald, Tareq S Almaghrabi, Daniel M Saenz, Chunyan Cai, Mohammad H Rahbar, H Alex Choi, Kiwon Lee, James C Grotta, Tiffany R Chang
BACKGROUND: Thrombelastography (TEG) provides a global, dynamic measure of coagulation. We examined the effect of antiplatelet (AP) medications on coagulation in patients with acute stroke as measured by TEG. METHODS: We reviewed prospectively collected data on patients presenting with acute ischemic stroke (AIS) and spontaneous intracerebral hemorrhage (ICH) between 2009 and 2014. Patient demographics and baseline TEG values were compared among 4 different drug use groups: aspirin only, clopidogrel only, both aspirin and clopidogrel, and no AP...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28931024/formal-comment-to-toyota-et-al-short-versus-prolonged-dual-antiplatelet-therapy-dapt-duration-after-coronary-stent-implantation-a-comparison-between-the-dapt-study-and-9-other-trials-evaluating-dapt-duration
#10
https://www.readbyqxmd.com/read/28931015/short-versus-prolonged-dual-antiplatelet-therapy-dapt-duration-after-coronary-stent-implantation-a-comparison-between-the-dapt-study-and-9-other-trials-evaluating-dapt-duration
#11
Toshiaki Toyota, Hiroki Shiomi, Takeshi Morimoto, Masahiro Natsuaki, Takeshi Kimura
AIMS: The Dual Antiplatelet Therapy (DAPT) study demonstrated that DAPT beyond 1-year after drug-eluting stent (DES) implantation, as compared with aspirin therapy alone, significantly reduced the risk of major cardiovascular and cerebrovascular events, which was mainly driven by the large risk reduction for myocardial infarction (MI). We sought to compare the largest DAPT study with other trials evaluating DAPT durations after DES implantation. METHODS AND RESULTS: By a systematic literature search, we identified 9 trials comparing prolonged- versus short-DAPT in addition to the DAPT study...
2017: PloS One
https://www.readbyqxmd.com/read/28930072/oral-antithrombotic-therapy-after-acute-coronary-syndromes-dual-antiplatelet-or-dual-pathway
#12
Davide Capodanno
No abstract text is available yet for this article.
September 20, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28923692/polymer-free-biolimus-a9-coated-stents-in-the-treatment-of-de-novo-coronary-lesions-with-short-dapt-9-month-angiographic-and-clinical-follow-up-of-the-prospective-multicenter-biofreedom-usa-clinical-trial
#13
Ron Waksman, Guy N Piegari, Ameer Kabour, Louis Cannon, John Wang, George Adams, Naresh Solankhi, Anthony Smeglin, Dean J Kereiakes, Roy Leiboff, Mia-Ashley Spad, Rebecca Torguson, Nina Chandra, Roshni Bastian, Jolanda DeGroot, Margaret W Kayo, Hans-Peter Stoll, Hector M Garcia-Garcia
BACKGROUND: BioFreedom is a polymer- and carrier-free drug-coated stent that delivers Biolimus A9 to the vessel wall. Our purpose was to evaluate the efficacy and safety of this DCS in patients with short-duration dual antiplatelet therapy. METHODS: The BioFreedom US IDE feasibility trial was a single-arm, open-label, prospective study of patients requiring stenting of de novo lesions. Patients received 3 months of DAPT, repeat angiography at 9 months, and clinical follow-up at multiple intervals...
July 31, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
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
#14
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/28904820/successful-cerebral-thrombectomy-for-a-nonagenarian-with-stroke-in-the-subacute-phase-after-transcatheter-aortic-valve-implantation
#15
Kazuya Matsuo, Atsushi Fujita, Jun Tanaka, Tomoaki Nakai, Masaaki Kohta, Kohkichi Hosoda, Toshiro Shinke, Ken-Ichi Hirata, Eiji Kohmura
BACKGROUND: Thromboembolic events are infrequent but serious complications of transcatheter aortic valve implantation (TAVI), occurring in 2.3-10% of the patients. However, the cause of post-TAVI stroke is unclear. CASE DESCRIPTION: A 90-year-old female underwent transfemoral-TAVI for severe aortic stenosis. Ten days later, she presented with an ischemic stroke of the left middle cerebral artery territory due to new-onset atrial fibrillation (NOAF). She underwent emergent endovascular thrombectomy with good reperfusion approximately 6 hours after onset of symptoms...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28895303/coronary-angiography-with-or-without-percutaneous-coronary-intervention-in-patients-with-hemophilia-systematic-review
#16
Christian Boehnel, Hans Rickli, Lukas Graf, Micha T Maeder
OBJECTIVES: We aimed to summarize the evidence for periprocedural and long-term strategies to both minimize the bleeding risk and ensure sufficient anticoagulation and antiaggregation in hemophilia patients undergoing coronary angiography with or without percutaneous coronary interventions (PCI). BACKGROUND: Hemophilia patients undergoing coronary angiography and PCI are at risk of bleeding due to deficiency of the essential clotting factors VIII or IX combined with the need of peri-interventional anticoagulation and antiaggregation and dual antiplatelet therapy (DAPT) after PCI...
September 12, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28888408/atrial-fibrillation-and-stent-selection-bare-metal-vs-drug-eluting-from-medicare-claims
#17
Greg Dadekian, Aaron V Kaplan, Chiang-Hua Chang, Nancy E Morden
In treating coronary artery disease, many factors influence the choice of bare metal stent (BMS) or drug-eluting stent (DES), including bleed risk and suitability for prolonged dual antiplatelet therapy. Atrial fibrillation (AF) further complicates this choice, due to common use of anticoagulation. We examined stent selection in the United States by AF status and across academic medical centers (AMCs) to explore how cardiologists are managing this complex choice. Using a 100% Medicare denominator file and associated claims (2008 to 2012), we identified patients over age 65 receiving inpatient coronary artery stents...
August 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28886622/2017-esc-focused-update-on-dual-antiplatelet-therapy-in-coronary-artery-disease-developed-in-collaboration-with-eacts-the-task-force-for-dual-antiplatelet-therapy-in-coronary-artery-disease-of-the-european-society-of-cardiology-esc-and-of-the-european-association
#18
Marco Valgimigli, Héctor Bueno, Robert A Byrne, Jean-Philippe Collet, Francesco Costa, Anders Jeppsson, Peter Jüni, Adnan Kastrati, Philippe Kolh, Laura Mauri, Gilles Montalescot, Franz-Josef Neumann, Mate Petricevic, Marco Roffi, Philippe Gabriel Steg, Stephan Windecker, Jose Luis Zamorano
No abstract text is available yet for this article.
August 26, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28885201/the-mechanisms-of-late-scaffold-thrombosis
#19
Remzi Anadol, Tommaso Gori
Coronary scaffolds have been recently developed to address the long-term limitations of metallic drug eluting stents. Concerns have however been expressed on the safety of these devices, with evidence of both early and late scaffold thrombosis. While early thrombosis has been associated with incomplete scaffold expansion, leading to flow disturbances, blood recirculation, and platelet activation, the pathophysiology of late events remains less understood. Recent cases series have shown that malapposition and scaffold dismantling might play a role in this phenomenon, an observation that further confirms the importance of an accurate implantation...
September 4, 2017: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/28877643/a-case-series-of-18-patients-receiving-ticagrelor-after-carotid-stenting
#20
Elizabeth M Olafson, Jodi R DeGrote, Alexander Drofa, Evgueni Kouznetsov, Michael Manchak, Nathan D Leedahl, David D Leedahl
PURPOSE: Dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 receptor antagonist is often used to prevent thrombotic complications after endovascular stent placement. Most of the published experience surrounding DAPT after carotid stenting is with clopidogrel. Ticagrelor may be a promising alternative, especially in patients who may be considered nonresponders to clopidogrel. However, clinical outcomes utilizing DAPT with ticagrelor in a cohort with carotid stenting is lacking. In this case series, we describe our experience with systematic prescribing of ticagrelor after carotid stent placement in 18 patients...
January 1, 2017: Journal of Pharmacy Practice
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