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Anticoagulation in PCI

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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
#1
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/29224652/primary-percutaneous-coronary-intervention-at-centers-with-and-without-on-site-surgical-support-insights-from-the-blue-cross-blue-shield-of-michigan-cardiovascular-consortium-bmc2
#2
MULTICENTER STUDY
Majed Afana, Hitinder S Gurm, Milan Seth, Kathleen M Frazier, Sheryl Fielding, Gerald C Koenig
BACKGROUND: Primary percutaneous coronary intervention (PPCI) is being increasingly performed nationally at sites without on-site cardiac surgery; however, recent guidelines only provide a Class IIa recommendation for this practice. The state of Michigan has permitted PPCI without on-site surgery under a closely monitored system that mandates auditing of all procedures and quarterly feedback on quality and outcomes. This study sought to compare outcomes of patients undergoing PPCI at centers with and without on-site surgery in the state of Michigan...
January 2018: American Heart Journal
https://www.readbyqxmd.com/read/29198572/acute-myocardial-infarction-as-the-initial-manifestation-of-delayed-bioprosthesis-thrombosis-after-transcatheter-aortic-valve-replacement
#3
Yi-Jian Li, Yan-Biao Liao, Xin Wei, Yuan Feng, Mao Chen
Bioprosthesis thrombosis after transcatheter aortic valve replacement (TAVR) raised concerns about further clinical events. We report the case of a patient who suffered acute myocardial infarction (AMI) after TAVR for 3 years. Thrombosis was confirmed in the right coronary sinus of Valsalva by transthoracic echocardiography. Coronary angiography demonstrated the ostium of the right coronary artery was occluded. As an attempt to perform percutaneous coronary intervention (PCI) was unsuccessful, long-term therapeutic anticoagulation with warfarin was undertaken...
November 14, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29188358/anticoagulation-strategies-in-patients-with-atrial-fibrillation-after-pci-or-with-acs-the-end-of-triple-therapy
#4
N Fluschnik, P M Becher, R Schnabel, S Blankenberg, D Westermann
Clinicians struggle daily with the optimal regimen for patients with an indication for antiplatelet therapy after stenting and in patients needing oral anticoagulation treatment for atrial fibrillation (AF). This is not only difficult in patients with acute coronary syndrome (ACS) but also in the large number of patients with AF undergoing elective percutaneous coronary intervention (PCI). The challenge is to strike a balance between the increasing risk of bleeding events and ischemic or thrombotic events. Until recently, guidelines were based on expert consensus and a few small, many of them retrospective, trials...
November 29, 2017: Herz
https://www.readbyqxmd.com/read/29186454/external-applicability-of-the-compass-trial-an-analysis-of-the-reduction-of-atherothrombosis-for-continued-health-reach-registry
#5
Arthur Darmon, Deepak L Bhatt, Yedid Elbez, Victor Aboyans, Sonia Anand, Jackie Bosch, Kelley R Branch, Stuart J Connolly, Leanne Dyal, John W Eikelboom, Keith A A Fox, Katalin Keltai, Jeffrey Probstfield, Salim Yusuf, Jérémie Abtan, Emmanuel Sorbets, Kim A Eagle, Gregory Ducrocq, Philippe Gabriel Steg
Aims: The aims of the present study were to describe the proportion of patients eligible for the COMPASS trial within the Reduction of Atherothrombosis for Continued Health (REACH) registry, the reasons for ineligibility, and to put in perspective the characteristics and outcomes of trial-eligible patients from the REACH registry compared with those of patients enrolled in the reference aspirin arm of the COMPASS trial. Methods and results: The COMPASS selection and exclusion criteria were applied to REACH patients with either coronary artery disease (CAD) or peripheral artery disease (PAD)...
November 23, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29162782/recurrent-early-coronary-stent-thrombosis-under-chronic-disseminated-intravascular-coagulation
#6
Yusuke Oba, Satoshi Hoshide, Tadayuki Mitama, Hajime Shinohara, Takahiro Komori, Tomoyuki Kabutoya, Yasushi Imai, Nobuhiko Ogata, Kazuomi Kario
A 62-year-old Japanese man presented with chest pain indicating that acute myocardial infarction had occurred. Eleven years earlier, he underwent a splenectomy due to idiopathic portal hypertension. Coronary angiography revealed diffuse stenosis, with calcification in the left anterior descending coronary artery (LAD). We performed a primary percutaneous coronary intervention (PCI). We deployed two drug-eluting stents with sufficient minimal cross-sectional stent area by intravascular ultrasound and thrombolysis in myocardial infarction (TIMI) 3 flow...
November 22, 2017: International Heart Journal
https://www.readbyqxmd.com/read/29119223/-acute-myocardial-infarction-in-patients-with-st-segment-elevation-myocardial-infarction-esc-guidelines-2017
#7
REVIEW
H Thiele, S Desch, S de Waha
This article gives an update on the management of acute ST-segment elevation myocardial infarction (STEMI) according to the recently released European Society of Cardiology guidelines 2017 and the modifications are compared to the previous STEMI guidelines from 2012. Primary percutaneous coronary intervention (PCI) remains the preferred reperfusion strategy. New guideline recommendations relate to the access site with a clear preference for the radial artery, use of drug-eluting stents over bare metal stents, complete revascularization during the index hospitalization, and avoidance of routine thrombus aspiration...
November 8, 2017: Herz
https://www.readbyqxmd.com/read/29105331/anticoagulation-with-heparin-the-art-of-simplicity-even-in-patients-on-dialysis
#8
EDITORIAL
Jorge A Belardi, Mariano Albertal
In current PCI practice, anticoagulation with either bivalirudin or unfractionated heparin in patients with ACS share comparable efficacy and safety. Nonetheless, their individual performance in patients on dialysis remains unclear. This observational PCI study reported in-hospital clinical outcome in patients on dialysis undergoing PCI according to drug regimen: bivalirudin versus heparin. Similar clinical outcome was observed with both drug regimens.
November 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29103603/in-hospital-outcome-comparing-bivalirudin-to-heparin-in-real-world-primary-percutaneous-coronary-intervention
#9
Matthias Hasun, Jakob Dörler, Michael Edlinger, Hannes Alber, Dirk Von Lewinski, Bernd Eber, Franz Xaver Roithinger, Rudolf Berger, Peter Siostrzonek, Georg Grimm, Werner Benzer, Wilfried Wintersteller, Kurt Huber, Herwig Schuchlenz, Franz Weidinger
Randomized controlled trials have shown conflicting results regarding the outcome of bivalirudin in primary percutaneous coronary intervention (PPCI). The aim of this study was to evaluate the in-hospital outcomes of patients receiving heparin or bivalirudin in a real-world setting of PPCI: 7,023 consecutive patients enrolled in the Austrian Acute PCI Registry were included between January 2010 and December 2014. Patients were classified according to the peri-interventional anticoagulation regimen receiving heparin (n = 6430) or bivalirudin (n = 593) with or without GpIIb/IIIa inhibitors (GPIs)...
September 20, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29092916/use-of-oral-anticoagulants-in-combination-with-antiplatelet-s-in-atrial-fibrillation
#10
Caroline Sindet-Pedersen, Laila Staerk, Morten Lamberts, Thomas Alexander Gerds, Jeffrey S Berger, Anders Nissen Bonde, Jannik Langtved Pallisgaard, Morten Lock Hansen, Christian Torp-Pedersen, Gunnar H Gislason, Jonas Bjerring Olesen
OBJECTIVES: To investigate temporal trends in the use of non-vitamin K oral anticoagulants (NOACs) and vitamin K antagonists (VKAs) in combination with aspirin and/or clopidogrel in patients with atrial fibrillation (AF) following acute myocardial infarction (MI) and/or percutaneous coronary intervention (PCI). METHODS: Using Danish nationwide registries, all patients with AF who survived 30 days after discharge from MI and/or PCI between 22 August 2011 and 30 September 2016 were identified...
November 1, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29046319/effect-of-intravenous-fentanyl-on-ticagrelor-absorption-and-platelet-inhibition-among-patients-undergoing-percutaneous-coronary-intervention-the-pacify-randomized-clinical-trial
#11
John W McEvoy, Khalil Ibrahim, Thomas S Kickler, William A Clarke, Rani K Hasan, Matthew J Czarny, Ali R Keramati, Rakesh R Goli, Travis P Gratton, Jeffrey A Brinker, Matthews Chacko, Chao-Wei Hwang, Peter V Johnston, Julie M Miller, Jeffrey C Trost, William R Herzog, Roger S Blumenthal, David R Thiemann, Jon R Resar, Steven P Schulman
Fentanyl is a potent opiate commonly administered during cardiac catheterization procedures in North America. The question of whether fentanyl could have adverse consequences in patients undergoing percutaneous coronary intervention (PCI) is raised by recent research demonstrating that intravenous morphine significantly delays the absorption of oral P2Y12 platelet inhibitors. The presumed mechanism is slowed gastric emptying. The single-center Platelet Aggregation with tiCagrelor Inhibition and FentanYl (PACIFY) trial randomized adults undergoing clinically-indicated elective coronary angiography to receive the procedure with or without intravenous fentanyl (NCT02683707)...
October 18, 2017: Circulation
https://www.readbyqxmd.com/read/29023526/antithrombotic-therapy-strategies-for-atrial-fibrillation-patients-undergoing-percutaneous-coronary-intervention-a-systematic-review-and-network-meta-analysis
#12
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/28947725/-pioneer-af-pci-trial
#13
Murat Özdemir
The approach to patients with an indication for oral anticoagulation (OAC) for atrial fibrillation (AF) who undergo coronary stenting and thus need dual antiplatelet therapy has long been debated. Dual antiplatelet therapy accompanied by OAC (so called "triple therapy") carries a high bleeding risk and thus should either be avoided or used for a limited period. The lack of relevant prospective randomised trial data have largely been overcome by the recently published PIONEER AF-PCI trial, the results of which will be summarized in this article...
September 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28941605/prevention-of-left-ventricular-thrombus-formation-and-systemic-embolism-after-anterior-myocardial-infarction-a%C3%A2-systematic-literature-review
#14
REVIEW
Alexandra Bastiany, Marie-Eve Grenier, Alexis Matteau, Samer Mansour, Benoit Daneault, Brian J Potter
BACKGROUND: Anterior myocardial infarction (MI) with apical dysfunction is associated with an increased risk of left ventricular thrombus (LVT) formation and systemic embolism (SE). However, the role for prophylactic anticoagulation in current practice is a matter of debate. METHODS: We conducted a systematic review of peer-reviewed original articles in either English or French on the benefit of combining anticoagulation with standard therapy for the prevention of LVT/SE after MI by searching PubMed, Ovid/MedLine/Embase, the Cochrane Library, and Google Scholar...
October 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28928186/recombinant-human-tnk-tissue-type-plasminogen-activator-rhtnk-tpa-versus-alteplase-rt-pa-as-fibrinolytic-therapy-for-acute-st-segment-elevation-myocardial-infarction-china-tnk-stemi-protocol-for-a-randomised-controlled-non-inferiority-trial
#15
Hai-Bo Wang, Ping Ji, Xing-Shan Zhao, Haiyan Xu, Xiao-Yan Yan, Qin Yang, Chen Yao, Run-Lin Gao, Yang-Feng Wu, Shu-Bin Qiao
AIM: To evaluate the efficacy and safety of recombinant human TNK tissue-type plasminogen activator (rhTNK-tPA) in lowering major adverse cardiovascular and cerebrovascular events (MACCEs) in Chinese acute ST-segment elevation myocardial infarction (STEMI) patients. METHODS AND ANALYSIS: The study is designed as a multicentre, randomised, controlled non-inferiority phase IV trial with balanced randomisation (1:1) in patients with STEMI. The planned sample size is 6200 participants (or 3100 per arm)...
September 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28919628/coronary-artery-bypass-graft-with-endarterectomy-and-stent-removal-in-patient-with-multivessel-in-stent-restenosis
#16
S S Husain, C M Ahmed, A B Adhikary, S A Sunny, M N Hasan
In the age of stent deployment after balloon angioplasty. In stent restenosis (ISR) has become a major concern. Various coronary interventional measures and coronary artery bypass graft (CABG) has employed to manage the ISR. Although CABG seems to offer advantages over other coronary intervention methods in patients with multi vessel ISR; lack of appropriate graftable vessels often make the surgery difficult and end up with incomplete revascularization. Coronary endarterectomy with stent removal mitigated some of the limitations of CABG but initial results of this surgical measure were not favorable...
July 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28910988/anticoagulation-after-coronary-stenting-a-systemic-review
#17
Zhe Dong, Jingang Zheng
Introduction or background: Anticoagulant therapy is mainly used to prevent patients from suffering coronary and systemic thromboembolism after stenting. Many studies have been done to formulate an optimized regimen of a post-PCI or long-time anticoagulant therapy. Recent advances in the selection and duration of anticoagulant agents will be conducive to the management of patients who are considered to need anticoagulant therapy after stenting. Sources of data: Key recent published literature, including international guidelines and relevant reviews...
September 1, 2017: British Medical Bulletin
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
#18
REVIEW
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/28905866/anticoagulation-therapy-bivalirudin-not-superior-to-heparin-in-pci
#19
Gregory B Lim
No abstract text is available yet for this article.
November 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/28895303/coronary-angiography-with-or-without-percutaneous-coronary-intervention-in-patients-with-hemophilia-systematic-review
#20
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
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