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antithrombotic triple therapy

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https://www.readbyqxmd.com/read/27899203/bioresorbable-scaffold-implantation-in-patients-with-indication-for-oral-anticoagulation-a-propensity-matched-analysis
#1
Niklas F Boeder, Victoria Johnson, Oliver Dörr, Jens Wiebe, Albrecht Elsässer, Helge Möllmann, Christian W Hamm, Holger M Nef, Timm Bauer
OBJECTIVES: To examine ischemic and bleeding outcomes in patients on triple antithrombotic therapy (TAT) compared with dual antiplatelet therapy (DAPT) after the implantation of bioresorbable scaffolds (BRS). BACKGROUND: The optimal antithrombotic regimen in patients undergoing percutaneous coronary intervention that have an indication for oral anticoagulation is unclear, in particular among those undergoing BRS implantation. METHODS: Consecutive patients of a single-center, all-comers BRS registry were included...
November 24, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27886825/antiplatelet-and-antithrombotic-therapy-in-patients-with-atrial-fibrillation-undergoing-coronary-stenting
#2
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/27883975/evaluation-of-current-practices-in-transcatheter-aortic-valve-implantation-the-written-worldwide-tavi-experience-survey
#3
Enrico Cerrato, Luis Nombela-Franco, Tamim M Nazif, Helene Eltchaninoff, Lars Søndergaard, Henrique B Ribeiro, Marco Barbanti, Fabian Nietlispach, Peter De Jaegere, Pierfrancesco Agostoni, Ramiro Trillo, Pilar Jimenez-Quevedo, Fabrizio D'Ascenzo, Olaf Wendler, Gabriel Maluenda, Mao Chen, Corrado Tamburino, Carlos Macaya, Martin B Leon, Josep Rodes-Cabau
BACKGROUND: Transcatheter aortic valve implantation (TAVI) has been adopted worldwide as the standard treatment for severe aortic stenosis in symptomatic patients at prohibitive or high surgical risk, but there are still several areas where consensus and evidence are lacking. The purpose was to obtain a global view of current practice related to TAVI with the potential to identify the main areas of consensus and divergence between centers. METHODS: An online questionnaire was distributed in centers performing TAVI including a total of 59 questions concerning pre-procedural evaluation, procedural practices and post-procedural management...
November 9, 2016: International Journal of Cardiology
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
#4
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...
October 18, 2016: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/27734083/triple-antithrombotic-therapy-and-outcomes-in-post-pci-patients-undergoing-non-cardiac-surgery
#5
Javier A Valle, Laura Graham, Aerin DeRussy, Kamal Itani, Mary T Hawn, Thomas M Maddox
BACKGROUND: Triple therapy, or the use of anticoagulants with dual antiplatelet therapy (DAPT), is often used to protect against ischemic events in post-percutaneous coronary intervention (PCI) patients with indications for anticoagulation, but is associated with increased bleeding. As both ischemic and bleeding risks increase in the perioperative period, the impact of triple therapy may be especially pronounced in patients undergoing surgery. Outcomes in this population are currently unknown...
October 12, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27723533/new-oral-anticoagulants-and-dual-antiplatelet-therapy-focus-on-apixaban
#6
REVIEW
Francesco Pelliccia, Fabiana Rollini, Giuseppe Marazzi, Cesare Greco, Carlo Gaudio, Dominick J Angiolillo, Giuseppe Rosano
The combination of AF and coronary artery disease not only is a common clinical setting, it is also a complex setting to deal with anticoagulation and antiplatelet therapy, and it is associated with significantly higher mortality rates. Unfortunately, there are no sufficient data available to optimally guide clinical practice in such settings. This review focuses specifically on newer oral anticoagulants (NOACs) associated with dual antiplatelet therapy (DAPT) in patients with coronary artery disease undergoing percutaneous coronary intervention (PCI)...
December 15, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27659886/ischemic-and-bleeding-events-in-patients-with-myocardial-infarction-undergoing-percutaneous-coronary-intervention-who-require-oral-anticoagulation-insights-from-the-canadian-observational-antiplatelet-study
#7
Steven Sra, Mary K Tan, Shamir R Mehta, Harold N Fisher, Jean-Pierre Déry, Robert C Welsh, Mark J Eisenberg, Christopher B Overgaard, Barry F Rose, Anthony J Della Siega, Asim N Cheema, Brian Y L Wong, Mark A Henderson, Sohrab Lutchmedial, Shahar Lavi, Shaun G Goodman, Andrew T Yan
BACKGROUND: Since the introduction of newer, more potent P2Y12 receptor inhibitors (P2Y12ris), practice patterns and associated clinical outcomes in patients with myocardial infarction (MI) undergoing percutaneous coronary intervention (PCI) and also requiring oral anticoagulation (OAC) have not been fully characterized. METHODS: The Canadian Observational Antiplatelet Study was a prospective, multicenter, longitudinal, observational study (26 hospitals, December 2011 to May 2013) describing P2Y12ri treatment patterns and outcomes in patients with ST-elevation and non-ST-elevation MI undergoing PCI...
October 2016: American Heart Journal
https://www.readbyqxmd.com/read/27641219/short-and-long-term-efficacy-and-safety-of-triple-vs-dual-antithrombotic-therapy-in-patients-with-drug-eluting-stent-implantation-and-an-indication-for-oral-anticoagulation-a-meta-analysis
#8
Yong Cao, Xiao-Yan Tian, Ran Zhang, Jia-Qi Zhao, Meng Zhang, Yun-Tao Cheng, Chuan-Fang Li, Gen-Li Liu, Yi An
BACKGROUND: The optimal antithrombotic regimen after coronary stenting in patients taking oral anticoagulants (OACs) is still unclear. Therefore, this meta-analysis focused on the short- and long-term efficacy and safety of triple therapy (TT: OAC, aspirin, and thienopyridine) and dual therapy (DT: OAC plus single antiplatelet drug or aspirin plus thienopyridine). METHODS: We searched PubMed, Embase, the Cochrane Library, Wangfang database, and Google Scholar up to December 1, 2015 (January 1, 2000 - December 2015), from randomized and nonrandomized studies comparing TT and DT in patients with OACs undergoing drug-eluting stent (DES) implantation...
December 2016: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/27621487/anticoagulant-and-antiplatelet-prescribing-patterns-for-patients-with-atrial-fibrillation-after-percutaneous-coronary-intervention
#9
Erin A Woods, Margaret L Ackman, Michelle M Graham, Sheri L Koshman, Rosaleen M Boswell, Arden R Barry
BACKGROUND: Current guidelines recommend triple antithrombotic therapy (TAT), defined as acetylsalicylic acid (ASA), clopidogrel, and warfarin, for patients with nonvalvular atrial fibrillation who have undergone percutaneous coronary intervention with stent implantation. The choice of anticoagulant/antiplatelet therapy in this population is ambiguous and complex, and prescribing patterns are not well documented. OBJECTIVE: To characterize local prescribing patterns for anticoagulant/antiplatelet therapy after percutaneous coronary intervention in patients with nonvalvular atrial fibrillation...
July 2016: Canadian Journal of Hospital Pharmacy
https://www.readbyqxmd.com/read/27619744/to-neither-bleed-nor-clot-that-is-the-question
#10
EDITORIAL
Rhian E Davies, Ian C Gilchrist
Patients with atrial fibrillation (AF) when stented with thin-strut colbalt chrome stents may have a similar outcome to patients without AF. Management of patients with AF potentially place patients at enhanced bleeding risk with triple antithrombotic therapy, or potential thrombotic risk if either oral anticoagulation is held or anti-platelet therapy is truncated. Guideline-based oral anticoagulation for AF is expanding this patient group presenting to the cardiac catheterization laboratory, yet management decisions are still based on limited studies and rely on expert concensus...
September 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27591697/a-new-scoring-system-daiga-for-predicting-bleeding-complications-in-atrial-fibrillation-patients-after-drug-eluting-stent-implantation-with-triple-antithrombotic-therapy
#11
Norihiro Kobayashi, Masahiro Yamawaki, Masatsugu Nakano, Keisuke Hirano, Motoharu Araki, Hideyuki Takimura, Yasunari Sakamoto, Shinsuke Mori, Masakazu Tsutsumi, Yoshiaki Ito
BACKGROUND: No scoring system for evaluating the bleeding risk of atrial fibrillation (AF) patients after drug-eluting stent (DES) implantation with triple antithrombotic therapy (TAT) is available. We aimed to develop a new scoring system for predicting bleeding complications in AF patients after DES implantation with TAT. METHODS AND RESULTS: Between April 2007 and April 2014, 227 AF patients undergoing DES implantation with TAT were enrolled. Bleeding incidence defined as Bleeding Academic Research Consortium criteria≥2 was investigated and predictors of bleeding complications were evaluated using multivariate analysis...
November 15, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27565018/design-and-rationale-of-the-re-dual-pci-trial-a-prospective-randomized-phase-3b-study-comparing-the-safety-and-efficacy-of-dual-antithrombotic-therapy-with-dabigatran-etexilate-versus-warfarin-triple-therapy-in-patients-with-nonvalvular-atrial-fibrillation
#12
Christopher P Cannon, Savion Gropper, Deepak L Bhatt, Stephen G Ellis, Takeshi Kimura, Gregory Y H Lip, Ph Gabriel Steg, Jurriën M Ten Berg, Jenny Manassie, Jörg Kreuzer, Jon Blatchford, Joseph M Massaro, Martina Brueckmann, Ernesto Ferreiros Ripoll, Jonas Oldgren, Stefan H Hohnloser
Antithrombotic management of patients with atrial fibrillation (AF) undergoing coronary stenting is complicated by the need for anticoagulant therapy for stroke prevention and dual antiplatelet therapy for prevention of stent thrombosis and coronary events. Triple antithrombotic therapy, typically comprising warfarin, aspirin, and clopidogrel, is associated with a high risk of bleeding. A modest-sized trial of oral anticoagulation with warfarin and clopidogrel without aspirin showed improvements in both bleeding and thrombotic events compared with triple therapy, but large trials are lacking...
October 2016: Clinical Cardiology
https://www.readbyqxmd.com/read/27532936/triple-oral-antithrombotic-therapy-a-teachable-moment
#13
Shayan Nabavi Nouri, Brian L Block
No abstract text is available yet for this article.
October 1, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/27514627/non-vitamin-k-oral-anticoagulant-treatment-in-elderly-patients-with-atrial-fibrillation-and-coronary-heart-disease
#14
REVIEW
Xavier Humbert, Vincent Roule, Mathieu Chequel, Sophie Fedrizzi, Marie Brionne, Véronique Lelong-Boulouard, Paul Milliez, Joachim Alexandre
Atrial fibrillation (AF) is the most frequent sustained arrhythmia. Overall prevalence is estimated to 5.5% and the incidence increases with age. As the population ages, the prevalence and costs of AF are expected to increase. AF is the most important cause of stroke in patients >75years. Until recently, Vitamin K antagonists (VKAs) were the only available oral anticoagulants (OACs) evaluated for long-term treatment of patients with AF with or without coronary heart disease (CHD). This situation was challenged by introduction of non-VKA oral anticoagulants (NOACs)...
November 1, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27478115/duration-of-triple-antithrombotic-therapy%C3%A2-and-outcomes-among-patients%C3%A2-undergoing-percutaneous-coronary-intervention
#15
Konstantinos C Koskinas, Lorenz Räber, Thomas Zanchin, Thomas Pilgrim, Stefan Stortecky, Lukas Hunziker, Stefan Blöchlinger, Michael Billinger, Fabienne Gartwyl, Christina Moro, Aris Moschovitis, Peter Jüni, Dik Heg, Stephan Windecker
OBJECTIVES: The aim of this study was to compare clinical outcomes in relation to the duration of triple antithrombotic therapy (TAT) among patients with indications for oral anticoagulation undergoing percutaneous coronary intervention (PCI). BACKGROUND: TAT is recommended for patients undergoing PCI with a firm indication for oral anticoagulation. Duration of TAT may influence outcomes, but the optimal period of TAT remains uncertain. METHODS: Between 2009 and 2013, 8,772 consecutive patients undergoing PCI for stable coronary artery disease or acute coronary syndrome were prospectively included in the Bern PCI Registry (NCT02241291)...
July 25, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27469320/risk-factors-associated-with-bleeding-after-multi-antithrombotic-therapy-during-implantation-of-cardiac-implantable-electronic-devices
#16
Kohei Ishibashi, Koji Miyamoto, Tsukasa Kamakura, Mitsuru Wada, Ikutaro Nakajima, Yuko Inoue, Hideo Okamura, Takashi Noda, Takeshi Aiba, Shiro Kamakura, Wataru Shimizu, Satoshi Yasuda, Takashi Akasaka, Kengo Kusano
Previous studies showed that continuous anticoagulation or single antiplatelet therapy during implantations of cardiac implantable electronic devices (CIED) was relatively safe. However, the safety of continuous multi antithrombotic therapy (AT) in patients undergoing CIED interventions has not been clearly defined. We sought to evaluate the safety of this therapy during CIED implantations. A total of 300 consecutive patients (mean 69 years old, 171 males) with CIED implantations were enrolled in this study...
July 28, 2016: Heart and Vessels
https://www.readbyqxmd.com/read/27443596/rationale-and-design-of-the-safe-a-study-safety-and-effectiveness-trial-of-apixaban-use-in-association-with-dual-antiplatelet-therapy-in-patients-with-atrial-fibrillation-undergoing-percutaneous-coronary-intervention
#17
Tomoya Hoshi, Akira Sato, Akihiko Nogami, Masahiko Gosho, Kazutaka Aonuma
BACKGROUND: Patients with atrial fibrillation who undergo coronary stenting require triple antithrombotic therapy, including aspirin, a P2Y12 inhibitor, and anticoagulation, to prevent both stroke and stent thrombosis. However, triple therapy may increase the risk of bleeding complications. The optimal management of triple therapy still presents a challenge in these patients. HYPOTHESIS: We hypothesized that 1-month P2Y12 inhibitor treatment after drug-eluting stent (DES) implantation, as compared with 6-month P2Y12 inhibitor treatment, in combination with aspirin and apixaban, would be associated with a decrease in the incidence of bleeding complications in patients with atrial fibrillation who undergo DES implantation...
July 18, 2016: Journal of Cardiology
https://www.readbyqxmd.com/read/27443472/pre-and-in-hospital-antithrombotic-management-patterns-and-in-hospital-outcomes-in-patients-with-acute-coronary-syndrome-data-from-the-turkish-arm-of-the-epicor-study
#18
Fatih Sinan Ertaş, Lale Tokgözoğlu
OBJECTIVE: To evaluate the acute phase (pre- and in-hospital) antithrombotic management patterns (AMPs) and in-hospital outcomes for patients hospitalized with an acute coronary syndrome (ACS). METHODS: In total, 1034 patients [514 patients with ST-segment elevation myocardial infarction (STEMI) and 520 with unstable angina/non-STEMI (UA/NSTEMI)] hospitalized for ACS within 24 h of symptom onset were included in this multicenter prospective registry study conducted at 34 hospitals across Turkey...
June 29, 2016: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/27399131/the-effect-of-a-dual-or-a-triple-antithrombotic-therapy-with-apixaban-on-thrombus-formation-in-vivo-and-in-an-ex-vivo-perfusion-chamber-model-an-open-label-controlled-sequential-study
#19
Stefan Weisshaar, Brigitte Litschauer, Sebastian Bucher, Martin Riesenhuber, Stylianos Kapiotis, Paul Alexander Kyrle, Michael Wolzt
BACKGROUND: There is a need to optimize pharmacological treatment in patients with acute coronary syndrome and concomitant atrial fibrillation, in particular with newer antithrombotic medicines. We have therefore studied if dual or triple combination of antithrombotic agents exert similar effects on coagulation activation in an in vivo model in the skin microvasculature and in an ex vivo perfusion chamber. METHODS AND RESULTS: Shed blood platelet activation (β-thromboglobulin [β-TG]), thrombin generation (thrombin-antithrombin complex [TAT]) and volume as well as markers of thrombus size (D-dimer) and its platelet content (P-selectin) in a perfusion chamber were studied in a sequential, open-label, parallel group trial in 40 healthy male volunteers (n = 20 per group)...
July 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27392808/upper-gastrointestinal-bleeding-following-transcatheter-aortic-valve-replacement-a-retrospective-analysis
#20
Dylan E Stanger, Alym H Abdulla, Frank T Wong, Sina Alipour, Brian L Bressler, David A Wood, John G Webb
OBJECTIVES: The aim of this study was to identify the incidence of upper gastrointestinal bleeding (UGIB) in the postprocedural period following transcatheter aortic valve replacement (TAVR). BACKGROUND: As TAVR moves into intermediate- and low-risk patients, it has become increasingly important to understand its extracardiac complications. The patient population undergoing TAVR have clinical and demographic characteristics that place them at significant risk of UGIB...
July 9, 2016: Catheterization and Cardiovascular Interventions
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