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Anticoagulation in PCI

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https://www.readbyqxmd.com/read/28919628/coronary-artery-bypass-graft-with-endarterectomy-and-stent-removal-in-patient-with-multivessel-in-stent-restenosis
#1
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
#2
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
#3
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
#4
Gregory B Lim
No abstract text is available yet for this article.
September 14, 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/28895303/coronary-angiography-with-or-without-percutaneous-coronary-intervention-in-patients-with-hemophilia-systematic-review
#5
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/28891164/heparin-or-bivalirudin-for-non-primary-pci-beware-of-neat-and-simple-answers%C3%A2
#6
EDITORIAL
Efthymios N Deliargyris, Carey Kimmelstiel
The debate regarding the choice of heparin or bivalirudin as the preferred anticoagulant in PCI is still ongoing Nonrandomized registry data are severely limited for comparative analyses and should therefore always be interpreted with caution Clinicians should resist simplistic data interpretations or populist cries relating to cost, but rather focus on valid benefit:risk analyses for their clinical decision making.
September 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28883227/utilization-of-anticoagulant-and-antiplatelet-agents-among-patients-with-atrial-fibrillation-undergoing-percutaneous-coronary-intervention%C3%A3-retrospective-cohort-study-using-a-nationwide-claims-database-in-japan
#7
Fumiko Ono, Shiro Tanaka, Yoko M Nakao, Koji Kawakami
BACKGROUND: The European Society of Cardiology recommends a risk-based antithrombotic strategy for patients with atrial fibrillation (AF) who undergo percutaneous coronary intervention (PCI) based on CHA2DS2-VASc and HAS-BLED scores. However, because it is unclear if that strategy can be generalized to Asians, we aimed to describe antithrombotic therapies among Japanese patients.Methods and Results:Using a nationwide claims database in Japan, this retrospective cohort study identified AF patients who underwent PCI from April 1, 2014 to March 31, 2015...
September 7, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28867189/modified-high-throughput-quantification-of-plasma-micrornas-in-heparinized-patients-with-coronary-artery-disease-using-heparinase
#8
Sufang Li, Feng Zhang, Yuxia Cui, Manyan Wu, Chongyou Lee, Junxian Song, Chengfu Cao, Hong Chen
Heparin, a widely used anticoagulant in cardiovascular diseases, is notorious for its inhibitory effect on qRT-PCR-based detection. Heparinase I could degrade heparin in RNA. qRT-PCR-based TaqMan Low Density Array (TLDA) technology is commonly used for circulating microRNAs (miRNAs) profiling analysis. However, the effect of heparin contamination on inhibition of miRNAs TLDA amplification, as well as the method for removing heparin during this process, are not yet well investigated. We obtained the plasma RNA samples from patients undergoing percutaneous coronary intervention (PCI) before and after heparinization (n = 26)...
September 1, 2017: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/28855222/practice-patterns-and-in-hospital-outcomes-associated-with-bivalirudin-use-among-patients-with-non-st-segment-elevation-myocardial-infarction-undergoing-percutaneous-coronary-intervention-in-the-united-states
#9
Eric A Secemsky, Ajay Kirtane, Sripal Bangalore, Ion S Jovin, Dhavalkumar Patel, Enrico G Ferro, Neil J Wimmer, Matthew Roe, David Dai, Laura Mauri, Robert W Yeh
BACKGROUND: Practice patterns in anticoagulant strategies used during percutaneous coronary intervention (PCI) in the United States for patients with non-ST-segment-elevation myocardial infarction and the comparative outcomes between bivalirudin and unfractionated heparin (UFH) have not been well described. METHODS AND RESULTS: Trends in anticoagulant use were examined among 553 562 PCIs performed by 9254 operators at 1538 hospitals for non-ST-segment-elevation myocardial infarction from 2009 to 2014 within the CathPCI Registry...
September 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28844201/bivalirudin-versus-heparin-monotherapy-in-myocardial-infarction
#10
David Erlinge, Elmir Omerovic, Ole Fröbert, Rikard Linder, Mikael Danielewicz, Mehmet Hamid, Eva Swahn, Loghman Henareh, Henrik Wagner, Peter Hårdhammar, Iwar Sjögren, Jason Stewart, Per Grimfjärd, Jens Jensen, Mikael Aasa, Lotta Robertsson, Pontus Lindroos, Jan Haupt, Helena Wikström, Anders Ulvenstam, Pallonji Bhiladvala, Bo Lindvall, Anders Lundin, Tim Tödt, Dan Ioanes, Truls Råmunddal, Thomas Kellerth, Leszek Zagozdzon, Matthias Götberg, Jonas Andersson, Oskar Angerås, Ollie Östlund, Bo Lagerqvist, Claes Held, Lars Wallentin, Fredrik Scherstén, Peter Eriksson, Sasha Koul, Stefan James
Background The comparative efficacy of various anticoagulation strategies has not been clearly established in patients with acute myocardial infarction who are undergoing percutaneous coronary intervention (PCI) according to current practice, which includes the use of radial-artery access for PCI and administration of potent P2Y12 inhibitors without the planned use of glycoprotein IIb/IIIa inhibitors. Methods In this multicenter, randomized, registry-based, open-label clinical trial, we enrolled patients with either ST-segment elevation myocardial infarction (STEMI) or non-STEMI (NSTEMI) who were undergoing PCI and receiving treatment with a potent P2Y12 inhibitor (ticagrelor, prasugrel, or cangrelor) without the planned use of glycoprotein IIb/IIIa inhibitors...
August 27, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28841229/effect-of-vitamin-d-in-the-prevention-of-myocardial-injury-following-elective-percutaneous-coronary-intervention-a-pilot-randomized-clinical-trial
#11
Naser Aslanabadi, Iraj Jafaripor, Selda Sadeghi, Hadi Hamishehkar, Samad Ghaffari, Mehdi Toluey, Hanieh Azizi, Taher Entezari-Maleki
Myocardial injury following elective percutaneous coronary intervention (PCI) occurs in about one-third of patients and is associated with mortality. Platelet aggregation, thrombosis formation, and inflammation are the main causes of cardiac injury during PCI. Vitamin D plays a key role in the cardiovascular system by exerting antiplatelet, anticoagulant, and anti-inflammatory properties. There is no published study that investigated the effect of vitamin D in the prevention of cardiac injury following elective PCI...
August 25, 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28826893/effect-of-bleeding-risk-on-type-of-stent-used-in-patients-presenting-with-acute-coronary-syndrome
#12
M Chadi Alraies, Sang Yeub Lee, Michael J Lipinski, Kyle Buchanan, Arie Steinvil, Toby Rogers, Edward Koifman, Jiaxiang Gai, Rebecca Torguson, Itsik Ben-Dor, Lowell F Satler, Augusto D Pichard, Ron Waksman
Patients at high bleeding risk (HBR) are at increased risk of bleeding following percutaneous coronary intervention (PCI) with drug-eluting stents (DES) due to the need for longer dual antiplatelet duration. We sought to evaluate the likelihood of receiving DES during PCI in HBR populations and to characterize DES utilization trends over time. Consecutive patients who underwent PCI from April 2003 to September 2015 were identified. HBR is defined as patients fulfilling 1 or more of the HBR criteria: age ≥75 years, anticoagulation use at discharge, history of stroke, cancer in previous 3 years, glucocorticoid use, hemoglobin (Hgb) <11 g/dl, platelet count <100,000/mm(3), or creatinine clearance (CCr) <40 ml/min...
July 24, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28802512/cangrelor-versus-clopidogrel-on-a-background-of-unfractionated-heparin-from-champion-phoenix
#13
RANDOMIZED CONTROLLED TRIAL
Muthiah Vaduganathan, Robert A Harrington, Gregg W Stone, Ph Gabriel Steg, C Michael Gibson, Christian W Hamm, Matthew J Price, Efthymios N Deliargyris, Jayne Prats, Kenneth W Mahaffey, Harvey D White, Deepak L Bhatt
Cangrelor is approved for use during percutaneous coronary intervention (PCI) and is administered with different parenteral anticoagulants. We examined the efficacy and safety of cangrelor in the subgroup of patients who received unfractionated heparin (UFH) during PCI in the modified intention-to-treat population of the randomized CHAMPION PHOENIX trial (cangrelor vs clopidogrel; n = 10,939). The primary efficacy end point was the composite of death, myocardial infarction, ischemia-driven revascularization, or stent thrombosis (ST) at 48 hours...
October 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28766879/bivalirudin-in-percutaneous-coronary-intervention-for-chronic-total-occlusion-a-single-center-pilot-study
#14
Chenguang Li, Rende Xu, Yi Shen, Yuxiang Dai, Feng Zhang, Jianying Ma, Lei Ge, Juying Qian, Junbo Ge
BACKGROUND: Bivalirudin has been reported to be an alternative to unfractionated heparin (UFH) for anticoagulation during percutaneous coronary intervention (PCI) and associated with less bleeding risk. However, the feasibility of bivalirudin during PCI of chronic total occlusion lesions (CTO) remains unknown. OBJECTIVE: To evaluate the efficacy and safety of bivalirudin versus UFH in CTO PCI. METHODS: In this prospective and randomized controlled trial in single center, CTO patients with high bleeding risk were randomized to treatment with bivalirudin (bolus 0...
August 2, 2017: Catheterization and Cardiovascular Interventions
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
#15
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/28749044/video-assisted-thoracoscopic-lobectomy-after-percutaneous-coronary-intervention-in-lung-cancer-patients-with-concomitant-coronary-heart-disease
#16
Xin Li, YiLi Fu, JinBai Miao, Hui Li, Bin Hu
BACKGROUND: In recent years, based on clinical observations, the number of lung cancer patients with concomitant coronary heart disease (CHD) has gradually increased. However, because of the requirement of long-term anticoagulant therapy after percutaneous coronary intervention (PCI), some of these patients lose the opportunity for surgical treatment, resulting in tumor progression. The objective of this study was to determine the appropriate timing of video-assisted thoracic surgery (VATS) lobectomy after PCI without increasing perioperative cardiovascular risk...
September 2017: Thoracic Cancer
https://www.readbyqxmd.com/read/28741720/alteplase-for-acute-ischemic-stroke-after-heparin-reversal-with-protamine-a-case-report-and-review
#17
Gabriel V Fontaine, Shawn M Smith
BACKGROUND: Few patients presenting with acute ischemic stroke (AIS) are eligible for alteplase, especially those receiving ongoing anticoagulation. We describe the first reported case of a patient receiving full-dose intravenous (IV) alteplase for AIS after heparin reversal with protamine. CASE: A 73-year-old male presented with AIS. He was treated with IV heparin, tirofiban, loading-dose prasugrel, and aspirin prior to percutaneous coronary intervention (PCI) for placement of a right coronary artery stent...
July 25, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28643219/triple-antithrombotic-therapy-in-atrial-fibrillation-patients-undergoing-pci-a-fading-role
#18
Dimitrios Alexopoulos, Panagiotis Vlachakis, John Lekakis
Triple antithrombotic therapy (TAT), consisting of aspirin, a P2Y12 receptor antagonist and oral anticoagulant (OAC) medication has been considered as an 'unavoidable' strategy for a 1-12 months for atrial fibrillation (AF) patients post acute coronary syndrome or percutaneous coronary angioplasty with stenting. However, TAT has rather poorly been adopted in real life practice, mainly because of an accompanying increased bleeding potential and lack of definitive results of randomized clinical trials. Several registries, meta-analyses and small randomized trials have so far provided the base of guidelines recommendations...
June 22, 2017: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/28624360/association-between-arterial-access-site-and-anticoagulation-strategy-on-major-bleeding-and-mortality-a-historical-cohort-analysis-in-the-veteran-population
#19
Jayant Bagai, Bert Little, Subhash Banerjee
BACKGROUND: Studies have shown reduction in major bleeding with trans-radial intervention (TRI) compared with trans-femoral intervention (TFI), and with use of bivalirudin compared with heparin+glycoprotein IIb/IIIa inhibitors (GPI). We compared major bleeding, mortality and the interaction between arterial access site and the anticoagulant used for PCI in Veterans. METHODS: A retrospective cohort of 1192 consecutive patients who underwent PCI at a VA hospital between 2006 and 2012 was divided into TFI-heparin (n=192), TFI-bivalirudin (n=272), TRI-heparin (n=274) and TRI-bivalirudin (n=454) groups...
June 8, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28593631/bivalirudin-versus-heparin-and-provisional-gp-iib-iiia-inhibitors-in-patients-treated-for-st-segment-elevation-myocardial-infarctions-comparison-of-outcomes-in-a-real-world-setting
#20
Andreas Fach, Tina Backhaus, Johannes Schmucker, Robert Zabrocki, Daniela Garstka, Janina Stehmeier, Eduard Fiehn, Rainer Hambrecht, Harm Wienbergen
INTRODUCTION: The beneficial effects of bivalirudin during primary PCIs are controversially discussed, data on unselected patients are rare. It was the aim of the study to compare bivalirudin versus heparin and provisional glycoprotein IIb/IIIa inhibitors (GPIs) in a "real-world" study. METHODS: From 05/2013 until 11/2014, the STEMI-patients in the Bremen STEMI registry were treated with periinterventional bivalirudin; before and after this period the standard anticoagulative treatment was heparin and provisional GPIs...
June 7, 2017: Journal of Interventional Cardiology
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