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Keywords anticoagulants plus antiplatel...

anticoagulants plus antiplatelets atrial fibrillation

https://read.qxmd.com/read/38475752/the-optimal-antithrombotic-strategy-for-post-stroke-patients-with-atrial-fibrillation-and-extracranial-artery-stenosis-a-nationwide-cohort-study
#1
JOURNAL ARTICLE
Chuan-Tsai Tsai, Yi-Hsin Chan, Jo-Nan Liao, Tzeng-Ji Chen, Gregory Y H Lip, Shih-Ann Chen, Tze-Fan Chao
BACKGROUND: In post-stroke atrial fibrillation (AF) patients who have indications for both oral anticoagulant (OAC) and antiplatelet agent (AP), e.g., those with carotid artery stenosis, there is debate over the best antithrombotic strategy. We aimed to compare the risks of ischemic stroke, composite of ischemic stroke/major bleeding and composite of ischemic stroke/intracranial hemorrhage (ICH) between different antithrombotic strategies. METHODS: This study included post-stroke AF patients with and without extracranial artery stenosis (ECAS) (n = 6390 and 28,093, respectively) identified from the Taiwan National Health Insurance Research Database...
March 13, 2024: BMC Medicine
https://read.qxmd.com/read/38401647/optimal-antithrombotic-strategy-in-patients-with-atrial-fibrillation-beyond-1-year-after-drug-eluting-stent-implantation-design-and-rationale-of-the-randomized-adapt-af-des-trial
#2
JOURNAL ARTICLE
Sang-Hyup Lee, Seung-Jun Lee, Jung Ho Heo, Sung Gyun Ahn, Joon-Hyoung Doh, Sanghoon Shin, Jaemin Shim, Ae-Young Her, Byung Gyu Kim, Sang Wook Lim, Taek-Geun Kwon, Kyoung-Hoon Lee, Daehoon Kim, Yong-Joon Lee, Hee Tae Yu, Tae-Hoon Kim, Dong-Ho Shin, Hui-Nam Pak, Jung-Sun Kim
BACKGROUND: Both anticoagulation and antiplatelet therapies are recommended after percutaneous coronary intervention (PCI) in patients with atrial fibrillation (AF). Although contemporary guidelines recommend discontinuation of antiplatelet therapy 1 year after drug-eluting stent (DES) implantation due to excessive bleeding risk, supporting randomized trials are still lacking. METHODS: The ADAPT AF-DES trial is a multicenter, prospective, open-label, randomized, non-inferiority trial, enrolling 960 patients with AF with a CHA2 DS2 -VASc score > 1, who underwent PCI with DES implantation at least 12 months before enrollment...
February 22, 2024: American Heart Journal
https://read.qxmd.com/read/38264795/non-vitamin-k-antagonist-oral-anticoagulants-noacs-after-acute-myocardial-infarction-a-network-meta-analysis
#3
REVIEW
Samer Al Said, Klaus Kaier, Wael Sumaya, Dima Alsaid, Daniel Duerschmied, Robert F Storey, C Michael Gibson, Dirk Westermann, Samer Alabed
BACKGROUND: Balancing the risk of bleeding and thrombosis after acute myocardial infarction (AMI) is challenging, and the optimal antithrombotic therapy remains uncertain. The potential of non-vitamin K antagonist oral anticoagulants (NOACs) to prevent ischaemic cardiovascular events is promising, but the evidence remains limited. OBJECTIVES: To evaluate the efficacy and safety of non-vitamin-K-antagonist oral anticoagulants (NOACs) in addition to background antiplatelet therapy, compared with placebo, antiplatelet therapy, or both, after acute myocardial infarction (AMI) in people without an indication for anticoagulation (i...
January 24, 2024: Cochrane Database of Systematic Reviews
https://read.qxmd.com/read/38202105/antithrombotic-therapy-optimization-in-patients-with-atrial-fibrillation-undergoing-percutaneous-coronary-intervention
#4
REVIEW
Felice Gragnano, Antonio Capolongo, Antonio Micari, Francesco Costa, Victoria Garcia-Ruiz, Vincenzo De Sio, Fabrizia Terracciano, Arturo Cesaro, Elisabetta Moscarella, Silvio Coletta, Pasquale Raucci, Fabio Fimiani, Leonardo De Luca, Giuseppe Gargiulo, Giuseppe Andò, Paolo Calabrò
The antithrombotic management of patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI) poses numerous challenges. Triple antithrombotic therapy (TAT), which combines dual antiplatelet therapy (DAPT) with oral anticoagulation (OAC), provides anti-ischemic protection but increases the risk of bleeding. Therefore, TAT is generally limited to a short phase (1 week) after PCI, followed by aspirin withdrawal and continuation of 6-12 months of dual antithrombotic therapy (DAT), comprising OAC plus clopidogrel, followed by OAC alone...
December 23, 2023: Journal of Clinical Medicine
https://read.qxmd.com/read/37835798/two-approaches-to-triple-antithrombotic-therapy-in-patients-with-acute-coronary-syndrome-and-non-valvular-atrial-fibrillation-treated-with-percutaneous-coronary-intervention-which-is-more-efficient-and-safer
#5
JOURNAL ARTICLE
Witold Bachorski, Jakub Bychowski, Marcin Gruchała, Miłosz Jaguszewski
INTRODUCTION: Patients with acute coronary syndrome (ACS) and atrial fibrillation (AF) treated with percutaneous coronary intervention (PCI) are at high risk of bleeding and thromboembolic events. Thus, optimal treatment strategies in this challenging subset have been controversial. Herein, we aim to investigate different triple antithrombotic treatment (TAT) strategies in patients with ACS and AF after PCI. METHODS: This was a retrospective, single-center study based on all consecutive patients with the diagnosis of ACS and AF treated with vitamin K antagonists (VKA) or non-vitamin K antagonist oral anticoagulants (NOAC) plus dual antiplatelet therapy using a P2Y12 inhibitor (clopidogrel) and aspirin (for 1 to 3 months) and observed for 12 months for major adverse cardiac events (MACE) and major or clinically relevant non-major bleeding incidents...
September 26, 2023: Diagnostics
https://read.qxmd.com/read/37611779/network-meta-analysis-of-initial-antithrombotic-regimens-after-left-atrial-appendage-occlusion
#6
JOURNAL ARTICLE
Pedro E P Carvalho, Douglas M Gewehr, Isabele A Miyawaki, Alleh Nogueira, Nicole Felix, Philippe Garot, Arthur Darmon, Patrizio Mazzone, Alberto Preda, Bruno R Nascimento, Luiz F Kubrusly, Rhanderson Cardoso
BACKGROUND: The optimal antithrombotic therapy following left atrial appendage occlusion (LAAO) in patients with nonvalvular atrial fibrillation (AF) remains uncertain. OBJECTIVES: In this study, the authors sought to compare the efficacy and safety of various antithrombotic strategies after LAAO. METHODS: We searched the Medline, Cochrane, EMBASE, LILACS, and ClinicalTrials.gov databases for studies reporting outcomes after LAAO, stratified by antithrombotic therapy prescribed at postprocedural discharge...
October 31, 2023: Journal of the American College of Cardiology
https://read.qxmd.com/read/37188504/antiplatelets-and-antithrombotics-in-neurointerventional-procedures-guideline-update
#7
JOURNAL ARTICLE
Clemens M Schirmer, Ketan R Bulsara, Fawaz Al-Mufti, Neil Haranhalli, Lucie Thibault, Steven W Hetts
BACKGROUND: Antiplatelet and antithrombotic medication management before, during, and after neurointerventional procedures has significant practice variation. This document updates and builds upon the 2014 Society of NeuroInterventional Surgery (SNIS) Guideline 'Platelet function inhibitor and platelet function testing in neurointerventional procedures', providing updates based on the treatment of specific pathologies and for patients with specific comorbidities. METHODS: We performed a structured literature review of studies that have become available since the 2014 SNIS Guideline...
November 2023: Journal of Neurointerventional Surgery
https://read.qxmd.com/read/37100602/direct-oral-anticoagulants-would-be-best-choice-for-atrial-fibrillation-patients-after-coronary-stenting-retrospective-study-in-a-japanese-population
#8
JOURNAL ARTICLE
Hiroshi Koiwaya, Nozomi Watanabe, Nehiro Kuriyama, Yoshisato Shibata
BACKGROUND: The combination of dual antiplatelet therapy (DAPT) plus warfarin in atrial fibrillation (AF) patients after coronary stenting has been reported to confer a significant risk of bleeding complications. Direct oral anticoagulants (DOAC) reduce the risk of stroke and bleeding complications in AF patients compared to warfarin. The optimal anticoagulation strategy for Japanese non-valvular AF patients after coronary stenting remains unclear. METHODS: A total of 3230 patients who underwent coronary stenting were retrospectively reviewed...
April 26, 2023: Kurume Medical Journal
https://read.qxmd.com/read/36945020/efficacy-and-safety-of-rivaroxaban-plus-clopidogrel-versus-aspirin-plus-clopidogrel-in-patients-with-coronary-atherosclerotic-heart-disease-and-gastrointestinal-disease-undergoing-percutaneous-coronary-intervention-study-protocol-for-a-non-inferiority-randomized
#9
JOURNAL ARTICLE
Tienan Zhou, Yinghui Gong, Jingyuan Li, Yasong Wang, Xiaozeng Wang
BACKGROUND: Dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 inhibitor is recommended for patients with coronary heart disease (CHD) undergoing percutaneous coronary intervention (PCI) to antithrombosis, meanwhile, increasing the risks of gastrointestinal bleeding. Rivaroxaban, a novel oral anticoagulant, combined with a P2Y12 receptor inhibitor reduces adverse events in patients with CHD and atrial fibrillation who underwent PCI. The effect of rivaroxaban plus P2Y12 inhibitor on reducing bleeding events in patients with CHD and gastrointestinal disease (GID) undergoing PCI remains unclear...
March 21, 2023: Trials
https://read.qxmd.com/read/36909213/dabigatran-clinical-correlation-of-drug-and-its-dose-with-risk-of-stroke-and-bleeding
#10
JOURNAL ARTICLE
Anitta Shaji, Doody Thomas, Midhuna Saju, Suja Abraham, Ramdas Nayak
BACKGROUND: Dabigatran is the first oral direct thrombin inhibitor which is endorsed by Food and Drug Administration in the prevention of embolic events in patients with nonvalvular atrial fibrillation. Suitable dose of the drug for the patient is selected based on CHA2DS2-VASc score and HAS-BLED score. AIM: To determine and compare the risk of occurrence of stroke and bleeding after the initiation of dabigatran therapy in patients prescribed with this drug. METHODS: Patients with more than 18 years who were prescribed with dabigatran during 2017-2019 in a tertiary care hospital were selected for the study...
2023: Perspectives in Clinical Research
https://read.qxmd.com/read/36748980/optimal-use-of-antithrombotic-agents-in-ischemic-stroke-with-atrial-fibrillation-and-large-artery-atherosclerosis
#11
JOURNAL ARTICLE
Tae Jung Kim, Ji Sung Lee, Jae Sun Yoon, Mi Sun Oh, Ji-Woo Kim, Soo-Hyun Park, Keun-Hwa Jung, Hyun Young Kim, Jee-Hyun Kwon, Hye-Yeon Choi, Hahn Young Kim, Kyung Yoon Eah, Sang Won Han, Hyung-Geun Oh, Young-Jae Kim, Byoung-Soo Shin, Chang Hun Kim, Chi Kyung Kim, Jong-Moo Park, Kyung Bok Lee, Tai Hwan Park, Jun Lee, Man-Seok Park, Jay Chol Choi, Chulho Kim, Dong-Ick Shin, Soo Joo Lee, Dong-Eog Kim, Jae-Kwan Cha, Eung-Gyu Kim, Kyung-Ho Yu, Keun-Sik Hong, Young-Seok Lee, Ju-Hun Lee, Sung Il Sohn, Hee-Joon Bae, Young-Bae Lee, Jun Hong Lee, Joung-Ho Rha, Byung-Chul Lee, Dae-Il Chang, Sang-Bae Ko, Byung-Woo Yoon
BACKGROUND: Optimal antithrombotic regimens to prevent recurrent stroke in patients with ischemic stroke due to atrial fibrillation (AF) and atherosclerotic large-vessel stenosis remain unknown. AIMS: This study aimed to evaluate the effect of multiple antithrombotic therapies on outcomes at 1 year after ischemic stroke due to two or more causes. METHODS: We identified 862 patients with ischemic stroke due to AF and large artery atherosclerosis from the linked data...
August 2023: International Journal of Stroke: Official Journal of the International Stroke Society
https://read.qxmd.com/read/36713761/rivaroxaban-monotherapy-in-atrial%C3%A2-fibrillation-and-stable-coronary-artery-disease-across-body-mass-index%C3%A2-categories
#12
JOURNAL ARTICLE
Masanobu Ishii, Koichi Kaikita, Satoshi Yasuda, Masaharu Akao, Junya Ako, Tetsuya Matoba, Masato Nakamura, Katsumi Miyauchi, Nobuhisa Hagiwara, Kazuo Kimura, Atsushi Hirayama, Kunihiko Matsui, Hisao Ogawa, Kenichi Tsujita
BACKGROUND: The AFIRE (Atrial Fibrillation and Ischemic Events With Rivaroxaban in Patients With Stable Coronary Artery Disease) trial showed both noninferiority for efficacy and superiority for safety endpoints of rivaroxaban monotherapy compared with those of rivaroxaban plus antiplatelet therapy (combination therapy) in patients with atrial fibrillation and stable coronary artery disease. OBJECTIVES: This study sought to evaluate outcomes of rivaroxaban monotherapy in those patients across body mass index (BMI) categories...
December 2022: JACC Asia
https://read.qxmd.com/read/36692658/antiplatelet-agents-and-oral-anticoagulant-use-in-patients-with-atrial-fibrillation-and-carotid-artery-disease-after-first-time-ischaemic-stroke
#13
JOURNAL ARTICLE
Stephanie L Harrison, Benjamin J R Buckley, Deirdre A Lane, Elnara Fazio-Eynullayeva, Paula Underhill, Andrew Hill, David J Werring, Gregory Y H Lip
INTRODUCTION: People with atrial fibrillation (AF) frequently have competing mechanisms for ischaemic stroke, including extracranial carotid atherosclerosis. The objective of this study was to determine associations between use of oral anticoagulants (OACs) plus antiplatelet agents (APA) after ischaemic stroke and outcomes for patients with AF and carotid artery disease. PATIENTS AND METHODS: A retrospective cohort study was conducted. Participants receiving OACs with or without APA were propensity score-matched for age, sex, ethnicity, co-morbidities and presence of cardiac and vascular implants and grafts...
January 24, 2023: Cardiovascular Drugs and Therapy
https://read.qxmd.com/read/36324348/comparison-of-efficacy-and-safety-of-anticoagulant-monotherapy-and-combined-therapy-of-anticoagulant-and-antiplatelets-in-patients-with-stable-coronary-artery-disease-and-atrial-fibrillation-a-meta-analysis
#14
REVIEW
Niharika Tentu, Aqsa Ijaz, Saima Batool, Rubba S Khan, Fathia Mohammed, Maryam H Khan, Qudsia I Sandhu, Neelum Ali
It is still uncertain whether patients with atrial fibrillation (AF) and stable coronary artery disease (CAD) who require long-term oral anticoagulation (OAC) should also receive antiplatelet treatment (APT). This meta-analysis aims to compare the efficacy and safety of OAC alone with OAC plus APT in individuals with AF and stable CAD. The current meta-analysis was conducted as per the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the Meta-analysis of Observational Studies in Epidemiology (MOOSE)...
September 2022: Curēus
https://read.qxmd.com/read/36242677/is-oral-anticoagulation-plus-antiplatelet-therapy-superior-to-oral-anticoagulation-alone-in-patients-with-atrial-fibrillation-and-stable-coronary-artery-disease
#15
EDITORIAL
Virginia Laura Gonzalez, Mario Daniel Gonzalez
No abstract text is available yet for this article.
October 15, 2022: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://read.qxmd.com/read/36072876/net-clinical-benefit-of-antithrombotic-therapy-for-atrial-fibrillation-patients-with-stable-coronary-artery-disease
#16
JOURNAL ARTICLE
So-Ryoung Lee, Jin-Hyung Jung, Eue-Keun Choi, Seung-Woo Lee, Soonil Kwon, Ji-Suck Park, Jeehoon Kang, Kyung-Do Han, Kyung Woo Park, Seil Oh, Gregory Y H Lip
Objectives: To compare the net clinical benefit of oral anticoagulant (OAC) monotherapy to OAC plus single antiplatelet therapy (SAPT) in patients with atrial fibrillation (AF) and stable coronary artery disease (CAD) at 1- and 3-year after percutaneous coronary intervention (PCI). Background: It has not been studied whether the net clinical benefit of the antithrombotic treatment options differs depending on the elapsed time from the index PCI. Methods: Using the Korean nationwide claims database, we included AF patients who underwent PCI from 2009 to 2019 and constructed two cohorts: 1- and 3-year after PCI...
2022: Frontiers in Cardiovascular Medicine
https://read.qxmd.com/read/35680555/comparative-effectiveness-and-safety-of-different-combinations-of-antithrombotic-regimens-in-atrial-fibrillation-patients-with-stent-insertions
#17
JOURNAL ARTICLE
Han-Hsin Chueh, Shih-Tsung Huang, Shang-Hung Chang, Shin-Yi Lin, Fei-Yuan Hsiao
This study aims to compare the risks of major adverse cardiac events (MACEs), including cardiovascular death, myocardial infarction, ischemic stroke and transient ischemic attack, and major bleeding across different antithrombotic regimens in Asian atrial fibrillation (AF) patients with stent insertions. We conducted a retrospective cohort study using Taiwan's National Health Insurance Research Database and National Mortality Registry. A total of 10,208 nonvalvular AF patients who had undergone percutaneous coronary intervention (PCI) with stents for the first time in 2007-2017 were identified...
June 9, 2022: Clinical Pharmacology and Therapeutics
https://read.qxmd.com/read/35623935/evolving-concepts-in-the-management-of-antithrombotic-therapy-in-patients-undergoing-transcatheter-aortic-valve-implantation
#18
REVIEW
Dirk Jan van Ginkel, Willem L Bor, Leo Veenstra, Arnoud W J van 't Hof, Enrico Fabris
Thromboembolic and bleeding complications negatively impact recovery and survival after transcatheter aortic valve implantation (TAVI). Particularly, there is a considerable risk of ischaemic stroke and vascular access related bleeding, as well as spontaneous gastro-intestinal bleeding. Therefore, benefit and harm of antithrombotic therapy should be carefully balanced. This review summarizes current evidence on peri- and post-procedural antithrombotic treatment. Indeed, in recent years, the management of antithrombotic therapy after TAVI has evolved from intensive, expert opinion-based strategies, towards a deescalated, evidence-based approach...
July 2022: European Journal of Internal Medicine
https://read.qxmd.com/read/35393364/antithrombotic-treatment-after-carotid-stenting-in-patients-with-concomitant-atrial-fibrillation
#19
JOURNAL ARTICLE
B Pardo-Galiana, M Medina-Rodriguez, M Millan-Vazquez, J A Cabezas-Rodriguez, L Lebrato-Hernandez, L Ainz-Gomez, E Zapata-Arriaza, J Ortega, A de Albóniga-Chindurza, J Montaner, A Gonzalez, F Moniche
BACKGROUND AND PURPOSE: Antithrombotic therapy following carotid artery stent placement with concomitant atrial fibrillation is not well-established. Our aim was to assess the safety and efficacy of the combination of direct oral anticoagulants and a P2Y12 inhibitor at 30 days after carotid artery stent placement in patients with atrial fibrillation. MATERIALS AND METHODS: We designed an observational single-center study including patients who underwent carotid artery stent placement with concomitant atrial fibrillation...
May 2022: AJNR. American Journal of Neuroradiology
https://read.qxmd.com/read/35112242/is-there-a-role-for-triple-therapy-after-acs
#20
REVIEW
Sukhdeep Bhogal, Mohamad Alkhouli, Christopher J White, Steven Bailey, Mamas Mamas, Elias Haddad, Timir K Paul
PURPOSE OF REVIEW: The optimal antithrombotic strategy in patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI) remains the subject of controversy. In this article, we review the current evidence for the use of triple therapy in acute coronary syndrome (ACS) patients. RECENT FINDINGS: The recently published trials of AF patients undergoing PCI have shown that combination of non-vitamin K oral anticoagulants (NOACs) with an antiplatelet agent is either superior or non-inferior to vitamin K antagonist (VKA) plus dual antiplatelet therapy (DAPT) in reducing bleeding complications with no difference in regard to thromboembolic events...
February 2, 2022: Current Cardiology Reports
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