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https://www.readbyqxmd.com/read/28605779/use-of-the-dual-antiplatelet-therapy-score-to-guide-treatment-duration-after-percutaneous-coronary-intervention
#1
Raffaele Piccolo, Giuseppe Gargiulo, Anna Franzone, Andrea Santucci, Sara Ariotti, Andrea Baldo, Carlo Tumscitz, Aris Moschovitis, Stephan Windecker, Marco Valgimigli
Background: The dual-antiplatelet therapy (DAPT) score was developed to identify patients more likely to derive harm (score <2) or benefit (score ≥2) from prolonged DAPT after percutaneous coronary intervention (PCI). Objective: To evaluate the safety and efficacy of DAPT duration according to DAPT score. Design: Retrospective assessment of DAPT score-guided treatment duration in a randomized clinical trial. (ClinicalTrials.gov: NCT00611286)...
June 13, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28596132/crusade-score-is-superior-to-platelet-function-testing-for-prediction-of-bleeding-in-patients-following-coronary-interventions
#2
Junghee Bang, Sun Young Choi, Moo Hyun Kim, Victor Serebruany
Hypothetically, diminished platelet reactivity (PR) during dual antiplatelet therapy (DAPT) should cause extra major bleeding events (MBE), although definite evidence is lacking. Multiple scores have been proposed to stratify bleeding risk, but their predictive value during DAPT is unclear. We compared the performance of the Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes with Early Implementation of the ACC/AHA Guidelines (CRUSADE) with PR testing to predict MBE in Korean patients with acute coronary syndrome...
June 1, 2017: EBioMedicine
https://www.readbyqxmd.com/read/28587584/strategies-to-optimize-dual-antiplatelet-therapy-after-coronary-artery-stenting-in-acute-coronary-syndrome
#3
Bridget Paravattil, Hazem Elewa
The use of aspirin and a P2Y12 receptor antagonist as dual antiplatelet therapy (DAPT) has become the treatment of choice in patients with acute coronary syndrome (ACS) and percutaneous coronary intervention to prevent recurrent thrombotic events. Although DAPT is beneficial for most patients, few patients still experience recurrent thrombotic events and increased bleeding episodes. This article reviews current literature to identify various approaches that may enhance the DAPT benefit-risk ratio in patients with ACS...
July 2017: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28565887/safety-and-efficacy-of-catheter-based-left-atrial-appendage-closure-in-patients-with-contraindications-for-long-term-anticoagulation
#4
Adrian Seidel, Abdul S Parwani, Florian Krackhardt, Martin Huemer, Philipp Attanasio, Wilhelm Haverkamp, Burkert Pieske, Leif-Hendrik Boldt
BACKGROUND: Percutaneous left atrial appendage closure (LAAC) and the role of post interventional anticoagulation often evokes controversy in daily practice. This study aimed to evaluate LAAC in patients with non-rheumatic atrial fibrillation, high thromboembolic risk and contraindications for long-term anticoagulation in a clinical scenario. METHODS AND RESULTS: Between 2010-2015, LAAC was attempted in 118 patients (47 women). Devices were successfully implanted in 95% (Watchman™ device n=97, St...
May 31, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/28504270/antiplatelet-therapy-new-score-for-predicting-bleeding-risk-after-dapt
#5
Bastiaan Zwart, Jurriën M Ten Berg
No abstract text is available yet for this article.
May 15, 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/28488370/patients-with-cirrhosis-who-have-coronary-artery-disease-treated-with-cardiac-stents-have-high-rates-of-gastrointestinal-bleeding-but-no-increased-mortality
#6
T Krill, G Brown, R A Weideman, D J Cipher, S J Spechler, E Brilakis, L A Feagins
BACKGROUND: Patients with coronary artery disease (CAD) treated with stents require dual antiplatelet therapy (DAPT). For cirrhotics, who often have varices and coagulopathy, it is not clear if the risk of gastrointestinal bleeding (GIB) should preclude use of DAPT. AIM: To compare GIB and mortality rates in cirrhotics with CAD treated medically or with stents. METHODS: Using institutional databases, we identified patients with cirrhosis and CAD treated with stents or medical therapy between January 2000-September 2015...
May 9, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28387790/impact-of-dual-antiplatelet-therapy-after-coronary-artery-bypass-surgery-on-1-year-outcomes-in-the-arterial-revascularization-trial%C3%A2
#7
Umberto Benedetto, Douglas G Altman, Stephen Gerry, Alastair Gray, Belinda Lees, Marcus Flather, David P Taggart
OBJECTIVES: There is still little evidence to boldport routine dual antiplatelet therapy (DAPT) with P 2 Y 12 antagonists following coronary artery bypass grafting (CABG). The Arterial Revascularization Trial (ART) was designed to compare 10-year survival after bilateral versus single internal thoracic artery grafting. We aimed to get insights into the effect of DAPT (with clopidogrel) following CABG on 1-year outcomes by performing a post hoc ART analysis. METHODS: Among patients enrolled in the ART ( n  = 3102), 609 (21%) and 2308 (79%) were discharged on DAPT or aspirin alone, respectively...
April 6, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28291000/tailoring-duration-of-dapt-with-risk-scores
#8
Davide Capodanno, Dominick J Angiolillo
No abstract text is available yet for this article.
March 11, 2017: Lancet
https://www.readbyqxmd.com/read/28290994/derivation-and-validation-of-the-predicting-bleeding-complications-in-patients-undergoing-stent-implantation-and-subsequent-dual-antiplatelet-therapy-precise-dapt-score-a-pooled-analysis-of-individual-patient-datasets-from-clinical-trials
#9
Francesco Costa, David van Klaveren, Stefan James, Dik Heg, Lorenz Räber, Fausto Feres, Thomas Pilgrim, Myeong-Ki Hong, Hyo-Soo Kim, Antonio Colombo, Philippe Gabriel Steg, Thomas Zanchin, Tullio Palmerini, Lars Wallentin, Deepak L Bhatt, Gregg W Stone, Stephan Windecker, Ewout W Steyerberg, Marco Valgimigli
BACKGROUND: Dual antiplatelet therapy (DAPT) with aspirin plus a P2Y12 inhibitor prevents ischaemic events after coronary stenting, but increases bleeding. Guidelines support weighting bleeding risk before the selection of treatment duration, but no standardised tool exists for this purpose. METHODS: A total of 14 963 patients treated with DAPT after coronary stenting-largely consisting of aspirin and clopidogrel and without indication to oral anticoagulation-were pooled at a single-patient level from eight multicentre randomised clinical trials with independent adjudication of events...
March 11, 2017: Lancet
https://www.readbyqxmd.com/read/28251238/mortality-and-cancer-after-12-versus-30-months-dual-antiplatelet-therapy-the-korean-outcomes-registry-evaluating-antithrombotics-korea
#10
Victor L Serebruany, Moo Hyun Kim, Hector A Cabrera-Fuentes, Kwangmin Lee, Young Rak Cho, Kyungil Park, Tae Ho Park, Young Dae Kim, Sung-Cheol Yoon
The optimal duration and cancer risks of antiplatelet therapy following percutaneous coronary intervention (PCI) are unclear. We compared cancer and all-cause mortality after dual antiplatelet therapy (DAPT) for the combination of clopidogrel and aspirin (ASA) versus ASA alone over 18 months follow-up in event-free patients at 12 months DAPT from the Health Insurance Review and Assessment (HIRA) dataset via the Korean Outcomes Registry Evaluating Antithrombotics (KOREA). We selected PCI patients who were event free for 12 months and maintained a consistent antiplatelet regimen for 18 more months...
March 2, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28242589/intravenous-beta-blocker-therapy-in-st-segment-elevation-myocardial-infarction-treated-with-primary-percutaneous-coronary-intervention-is-not-associated-with-benefit-regarding-short-term-mortality-a-swedish-nationwide-observational-study
#11
Moman A Mohammad, Pontus Andell, Sasha Koul, Liyew Desta, Tomas Jernberg, Elmir Omerovic, Jonas Spaak, Ole Fröbert, Jens Jensen, Thomas Engstrøm, Claes Hofman-Bang, Hans Persson, David Erlinge
AIMS: To investigate the impact of intravenous (IV) beta-blocker therapy on short-term mortality and other in-hospital events in patients with ST-segment elevation myocardial infarction (STEMI) treated with dual antiplatelet therapy (DAPT) and primary percutaneous coronary intervention (PCI). METHODS AND RESULTS: Using the nationwide Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies (SWEDEHEART) registry, we identified all patients with STEMI undergoing PCI between 2006 and 2013...
February 28, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28228427/myocardial-infarction-risk-after-discontinuation-of-thienopyridine-therapy-in-the-randomized-dapt-study-dual-antiplatelet-therapy
#12
Ada C Stefanescu Schmidt, Dean J Kereiakes, Donald E Cutlip, Robert W Yeh, Ralph B D'Agostino, Joseph M Massaro, Wen-Hua Hsieh, Laura Mauri
BACKGROUND: Thienopyridine plus aspirin beyond 1 year after coronary stenting reduces myocardial infarction (MI) risk and increases bleeding risk in comparison with aspirin alone. The hazard associated with late thienopyridine discontinuation and risk factors for MI after discontinuation are poorly defined. METHODS: In the DAPT Study (Dual Antiplatelet Therapy), after percutaneous coronary intervention and 12 months of thienopyridine (clopidogrel or prasugrel) plus aspirin, eligible patients remained on aspirin and were randomly assigned to continued thienopyridine versus placebo for 18 months...
May 2, 2017: Circulation
https://www.readbyqxmd.com/read/28211603/impact-of-six-versus-12-months-of-dual-antiplatelet-therapy-in-patients-with-drug-eluting-stent-implantation-after-risk-stratification-with-the-residual-syntax-score-results-from-a-secondary-analysis-of-the-i-love-it-2-trial
#13
RANDOMIZED CONTROLLED TRIAL
Miaohan Qiu, Yi Li, Jing Li, Kai Xu, Quanmin Jing, Shaohong Dong, Zhe Jin, Pitian Zhao, Bo Xu, Yaling Han
BACKGROUND: The optimal duration of dual antiplatelet therapy (DAPT) after drug-eluting stent (DES) implantation remains undetermined, especially for those at high risk of cardiac events postprocedure. OBJECTIVES: This study was aimed to investigate the impact of 6 versus 12 months of DAPT after DES implantation based on risk stratification with the residual SYNTAX score (rSS). METHODS: A total of 2737 patients in the I-LOVE-IT 2 trial were grouped according to rSS status (low rSS [rSS = 0, n = 1474] versus high rSS [rSS > 0, n = 1263]) and DAPT duration (6 months vs...
March 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28179398/medical-therapy-for-secondary-prevention-and-long-term-outcome-in-patients-with-myocardial-infarction-with-nonobstructive-coronary-artery-disease
#14
Bertil Lindahl, Tomasz Baron, David Erlinge, Nermin Hadziosmanovic, Anna Nordenskjöld, Anton Gard, Tomas Jernberg
BACKGROUND: Myocardial infarction with nonobstructive coronary arteries (MINOCA) occurs in 5% to 10% of all patients with myocardial infarction. Clinical trials of secondary prevention treatment in MINOCA patients are lacking. Therefore, the aim of this study was to examine the associations between treatment with statins, renin-angiotensin system blockers, β-blockers, dual antiplatelet therapy, and long-term cardiovascular events. METHODS: This is an observational study of MINOCA patients recorded in the SWEDEHEART registry (the Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapy) between July 2003 and June 2013 and followed until December 2013 for outcome events in the Swedish Cause of Death Register and National Patient Register...
April 18, 2017: Circulation
https://www.readbyqxmd.com/read/28174317/dual-antiplatelet-therapy-and-clinical-outcomes-after-coronary-drug-eluting-stent-implantation-in-patients-on-hemodialysis
#15
Yung-Tai Chen, Hung-Ta Chen, Chien-Yi Hsu, Pei-Wen Chao, Shu-Chen Kuo, Shuo-Ming Ou, Chia-Jen Shih
BACKGROUND AND OBJECTIVES: We aimed to investigate the benefits and risks of dual antiplatelet therapy (DAPT) after coronary drug-eluting stent (DES) implantation in patients undergoing hemodialysis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: A nested case-control analysis of patients on hemodialysis after receipt of DES and DAPT treatment was conducted using data from Taiwan's National Health Insurance Research Database for the period 2007-2011. Cases of myocardial infarction or death within 1 year after DES implantation were matched one-to-one with control patients...
February 7, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28128883/early-canadian-multicenter-experience-with-watchman-for-percutaneous-left-atrial-appendage-closure
#16
Jacqueline Saw, Peter Fahmy, Lorenzo Azzalini, Jean-Francois Marquis, Benjamin Hibbert, Carlos Morillo, Aldo Carrizo, Reda Ibrahim
BACKGROUND: There are limited data with WATCHMAN (Boston Scientific Corporation, Natick, MA, USA) for left atrial appendage (LAA) closure in patients with nonvalvular atrial fibrillation (AF) and contraindications to anticoagulation. The purpose of this study was to evaluate the safety and efficacy of WATCHMAN in our early Canadian experience. METHODS: We report our pooled consecutive series of patients who underwent WATCHMAN implantation at four major Canadian centers...
April 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/27970385/tct-212-application-of-the-dapt-score-to-a-contemporary-percutaneous-coronary-intervention-cohort
#17
Jerrett Lau, Richard Alcock, Jonathan Cherry, Andy Yong, Harry Lowe, Leonard Kritharides, David Brieger, Probal Roy
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27970379/tct-207-extended-validation-of-a-decision-tool-dapt-score-in-patients-randomized-to-6-or-12-months-dual-antiplatelet-therapy-after-percutaneous-coronary-intervention-with-predominantly-second-generation-drug-eluting-stents
#18
Yukinori Harada, Raphaela Lohaus, Katharina Mayer, Roberto Emmer, Jonathan Michel, Roisin Colleran, Daniele Giacoppo, Jens Wiebe, Robert Byrne, Adnan Kastrati, Stefanie Schulz-Schüpke
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27956673/prospective-observational-study-of-the-effect-of-dual-antiplatelet-therapy-with-tranexamic-acid-treatment-on-platelet-function-and-bleeding-after-cardiac-surgery
#19
J Amour, M Garnier, J Szymezak, Y Le Manach, D Helley, S Bertil, A Ouattara, B Riou, P Gaussem
BACKGROUND: The bleeding impact of dual antiplatelet therapy (DAPT), aspirin and clopidogrel, maintained until coronary artery bypass graft surgery (CABG), is still a matter of debate. The lack of preoperative antiplatelet activity measurement and heterogeneity of antifibrinolytic protocols in prior studies make the conclusions questionable. The aim of this prospective study was to determine, after preoperative antiplatelet activity measurement, if the maintenance of DAPT until CABG increases bleeding in patients treated with tranexamic acid (TA)...
December 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27770236/notch-pathway-plays-a-novel-and-critical-role-in-regulating-responses-of-t-and-antigen-presenting-cells-in-agvhd
#20
Xiaodan Luo, Lihua Xu, Yangqiu Li, Huo Tan
Graft-versus-host disease (GVHD) induced by host antigen-presenting cells (APCs) and donor-derived T cells remains the major limitation of allogeneic bone marrow transplantation (allo-BMT). Notch signaling pathway is a highly conserved cell-cell communication that is important in T cell development. Recently, Notch signaling pathway is reported to be involved in regulating GVHD. To investigate the role of Notch inhibition in modulating GVHD, we established MHC-mismatched murine allo-BMT model. We found that inhibition of Notch signaling pathway by γ-secretase inhibitor in vivo could reduce aGVHD, which was shown by the onset time of aGVHD, body weight, clinical aGVHD scores, pathology aGVHD scores, and survival...
April 2017: Cell Biology and Toxicology
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