keyword
Keywords cardiac stents and discontinui...

cardiac stents and discontinuing clopidogrel

https://read.qxmd.com/read/38068419/patient-related-factors-predicting-stent-thrombosis-in-percutaneous-coronary-interventions
#1
REVIEW
Larisa Anghel, Bogdan-Sorin Tudurachi, Andreea Tudurachi, Alexandra Zăvoi, Alexandra Clement, Alexandros Roungos, Laura-Cătălina Benchea, Ioana Mădălina Zota, Cristina Prisacariu, Radu Andy Sascău, Cristian Stătescu
Over the past four decades, percutaneous coronary intervention (PCI) safety and efficacy have significantly improved, particularly with the advent of the drug-eluting stent (DES). First-generation DESs reduced in-stent restenosis rates and targeted lesion revascularization; however, safety issues emerged, due to high incidences of stent thrombosis (ST) linked to death, myocardial infarction, and repeat revascularization. Second-generation DESs were developed to overcome these issues, reducing late-thrombotic-event risk while maintaining anti-restenosis efficacy...
November 28, 2023: Journal of Clinical Medicine
https://read.qxmd.com/read/37802690/dual-antiplatelet-therapy-after-coronary-artery-bypass-grafting-a-survey-of-uk-cardiac-surgeons
#2
JOURNAL ARTICLE
Maria Comanici, Shahzad G Raja
OBJECTIVE: Antiplatelet therapy after coronary artery bypass grafting (CABG) is important in postoperative medical management. Although cardiac surgeons are well-versed in the guidelines regarding discontinuation of dual-antiplatelet therapy (DAPT; aspirin and a P2Y12 antagonist) before CABG to minimize bleeding risk, there is considerable variability in DAPT dosing after CABG. The objective of this study was to explore the current trends in DAPT after CABG in the UK to improve understanding of the existing practice...
December 2023: Journal of Cardiothoracic and Vascular Anesthesia
https://read.qxmd.com/read/35716933/predictors-of-antiplatelet-cessation-in-a-real-world-patient-population-undergoing-non-cardiac-surgery-after-pci
#3
JOURNAL ARTICLE
Anoop N Koshy, Davide Cao, Matthew A Levin, Samantha Sartori, Gennaro Giustino, Htoo Kyaw, Bimmer Claessen, Zhongjie Zhang, Johny Nicolas, Anton Camaj, Anastasios Roumeliotis, Rishi Chandiramani, Rashi Bedekar, Zaha Waseem, Shiv Bagga, Annapoorna Kini, Samin K Sharma, Roxana Mehran
BACKGROUND: The optimal perioperative management of antiplatelet therapy (APT) therapy in patients undergoing noncardiac surgery (NCS) following percutaneous coronary intervention (PCI) is unclear. We sought to identify predictors of APT cessation in a real-world cohort of patients undergoing NCS within 1 year of PCI. METHODS: Consecutive patients undergoing PCI at a tertiary center between 2011 and 2018 were prospectively enrolled. Perioperative interruption of APT was defined as cessation of either aspirin or P2Y12 inhibitor between 1 and 14 days prior to NCS...
October 1, 2022: International Journal of Cardiology
https://read.qxmd.com/read/35450679/dual-antiplatelet-therapy-discontinuation-platelet-reactivity-and%C3%A2-adverse-outcomes-after-successful-percutaneous-coronary-intervention
#4
MULTICENTER STUDY
Björn Redfors, Ajay J Kirtane, Mengdan Liu, Daniel R Musikantow, Bernhard Witzenbichler, Michael J Rinaldi, D Christopher Metzger, Giora Weisz, Thomas D Stuckey, Bruce R Brodie, Ori Ben-Yehuda, Roxana Mehran, Gregg W Stone
OBJECTIVES: The purpose of this study was to assess the extent to which the association between premature dual antiplatelet therapy (DAPT) discontinuation and excess risk of thrombotic events varies according to the reason and timing of DAPT discontinuation and whether high on-treatment platelet reactivity (HPR) influences the risk of thrombotic events after premature DAPT discontinuation. BACKGROUND: DAPT after percutaneous coronary intervention (PCI) suppresses platelet reactivity, and HPR on clopidogrel after PCI is associated with an increased risk of thrombotic events...
April 25, 2022: JACC. Cardiovascular Interventions
https://read.qxmd.com/read/34720158/the-interaction-between-rosuvastatin-and-ticagrelor-leading-to-rhabdomyolysis-a-case-report-and-narrative-review
#5
JOURNAL ARTICLE
Rachel A Sibley, Alyson Katz, John Papadopoulos
Objective: Drug interactions are a common cause of morbidity and mortality and may require prompt discontinuation of therapeutic regimens due to harmful side effects. Patients with acute coronary syndromes are likely to be prescribed multiple medications that are metabolized through the cytochrome P450 system, increasing the probability for drug interaction. Atorvastatin and simvastatin are both well known to interact with the oral P2Y12 agent ticagrelor. The purpose of this paper is to describe the interaction of ticagrelor with rosuvastatin leading to rhabdomyolysis, which is less clearly defined in the literature...
October 2021: Hospital Pharmacy
https://read.qxmd.com/read/33555916/antithrombotic-therapy-in-patients-with-atrial-fibrillation-treated-with-oral-anticoagulation-undergoing-percutaneous-coronary-intervention-a-north-american-perspective-2021-update
#6
REVIEW
Dominick J Angiolillo, Deepak L Bhatt, Christopher P Cannon, John W Eikelboom, C Michael Gibson, Shaun G Goodman, Christopher B Granger, David R Holmes, Renato D Lopes, Roxana Mehran, David J Moliterno, Matthew J Price, Jacqueline Saw, Jean-Francois Tanguay, David P Faxon
A growing number of patients undergoing percutaneous coronary intervention (PCI) with stent implantation also have atrial fibrillation. This poses challenges for their optimal antithrombotic management because patients with atrial fibrillation undergoing PCI require oral anticoagulation for the prevention of cardiac thromboembolism and dual antiplatelet therapy for the prevention of coronary thrombotic complications. The combination of oral anticoagulation and dual antiplatelet therapy substantially increases the risk of bleeding...
February 9, 2021: Circulation
https://read.qxmd.com/read/31658860/early-discontinuation-of-p2y-12-antagonists-and-adverse-clinical-events-post-percutaneous-coronary-intervention-a-hospital-and-primary-care-linked-cohort
#7
JOURNAL ARTICLE
Daniel E Harris, Arron Lacey, Ashley Akbari, Daniel R Obaid, Dave A Smith, Geraint H Jenkins, James P Barry, Mike B Gravenor, Julian P Halcox
Background Early discontinuation of P2Y12 antagonists post-percutaneous coronary intervention may increase risk of stent thrombosis or nonstent recurrent myocardial infarction. Our aims were to (1) analyze the early discontinuation rate of P2Y12 antagonists post-percutaneous coronary intervention, (2) explore factors associated with early discontinuation, and (3) analyze the risk of major adverse cardiovascular events (death, acute coronary syndrome, revascularization, or stroke) associated with discontinuation from a prespecified prescribing instruction of 1 year...
November 5, 2019: Journal of the American Heart Association
https://read.qxmd.com/read/31266007/frequency-and-reasons-of-dual-antiplatelet-therapy-discontinuation-and-switching-of-p2y12-inhibitors-in-patients-with-acute-coronary-syndrome-treated-with-stent-implantation
#8
Georgina Fuertes Ferre, Isabel Caballero Jambrina, Alejandra Ruiz Aranjuelo, Javier Jimeno Sánchez, Jose Gabriel Galache Osuna, Eva María Andrés Esteban, Jose Antonio Casasnovas Lenguas, Jose Antonio Diarte de Miguel
BACKGROUND: Incidence and reasons of dual antiplatelet therapy (DAPT) discontinuation and switching between P2Y12 inhibitors in acute coronary syndrome (ACS) patients treated with a stent have been poorly studied. METHODS AND RESULTS: In a prospective single-center study, 283 consecutive patients presenting with ACS were treated with stent implantation between July 2015 and January 2016. Follow-up was achieved at 12 months in 273 patients using the electronic patient file and telephone interview...
2019: Cardiology
https://read.qxmd.com/read/30891370/ticagrelor-induced-angioedema-after-percutaneous-coronary-intervention-in-a-patient-with-a-history-of-ischemic-stroke-and-low-response-to-clopidogrel-a-rare-dilemma
#9
Paramarajan Piranavan, Nirmal J Kaur, Fady Marmoush, Andrew Burton, Joseph Hannan
Dual antiplatelet therapy (DAPT) is widely recognized as the mainstay of treatment after percutaneous coronary intervention (PCI). Premature discontinuation may pose a risk of in-stent thrombosis, acute myocardial infarction, and death. With the increased usage of antiplatelet agents, increased attention has been drawn to their potential allergic reactions. A 66-year-old male with a history of coronary artery disease and ischemic stroke was admitted with worsening severity angina for cardiac catheterization...
December 11, 2018: Curēus
https://read.qxmd.com/read/30509351/association-of-potent-p2y12-blockers-with-ischemic-and-bleeding-outcomes-in-non-st-segment-elevation-myocardial-infarction
#10
JOURNAL ARTICLE
Doo Sun Sim, Myung Ho Jeong, Hyo Soo Kim, Hyeon Cheol Gwon, Ki Bae Seung, Seung Woon Rha, Shung Chull Chae, Chong Jin Kim, Kwang Soo Cha, Jong Sun Park, Jung Han Yoon, Jei Keon Chae, Seung Jae Joo, Dong Ju Choi, Seung Ho Hur, In Whan Seong, Myeong Chan Cho, Doo Il Kim, Seok Kyu Oh, Tae Hoon Ahn, Jin Yong Hwang
BACKGROUND: Potent P2Y12 blockers are preferred in patients with acute non-ST-segment elevation myocardial infarction (NSTEMI) undergoing percutaneous coronary intervention (PCI). However, the risk of bleeding remains a major concern. We assessed the association of potent P2Y12 blockers with ischemic and bleeding outcomes in patients with NSTEMI. METHODS: From the Korea Acute Myocardial Infarction Registry-National Institute of Health database, 4927 patients with NSTEMI receiving drug-eluting stents (DES) were divided into potent P2Y12 blocker (ticagrelor or prasugrel, n=901) and clopidogrel (n=3180) groups...
February 2019: Journal of Cardiology
https://read.qxmd.com/read/30019463/continuation-versus-discontinuation-of-antiplatelet-therapy-for-bleeding-and-ischaemic-events-in-adults-undergoing-non-cardiac-surgery
#11
REVIEW
Sharon R Lewis, Michael W Pritchard, Oliver J Schofield-Robinson, Phil Alderson, Andrew F Smith
BACKGROUND: Antiplatelet agents are recommended for people with myocardial infarction and acute coronary syndromes, transient ischaemic attack or stroke, and for those in whom coronary stents have been inserted. People who take antiplatelet agents are at increased risk of adverse events when undergoing non-cardiac surgery because of these indications. However, taking antiplatelet therapy also introduces risk to the person undergoing surgery because the likelihood of bleeding is increased...
July 18, 2018: Cochrane Database of Systematic Reviews
https://read.qxmd.com/read/29850285/ticagrelor-as-an-alternative-for-clopidogrel-associated-acute-arthritis
#12
Starr-Mar'ee C Bedy, Jacob P Kesterson, Greg Flaker
A 65-year-old Caucasian man was hospitalized for a non-ST-elevation myocardial infarction. On discharge, the patient was started on multiple new medications, including clopidogrel and atorvastatin. Twenty-six days after discharge, he presented to the Emergency Department (ED) with polyarthralgias. He was instructed to stop atorvastatin and to follow up with rheumatology and cardiology clinic. At cardiology clinic follow-up 43 days after ED discharge, clopidogrel was discontinued and patient was switched to ticagrelor...
2018: Case Reports in Emergency Medicine
https://read.qxmd.com/read/29456058/comparison-of-the-9-month-intra-stent-conditions-and-2-year-clinical-outcomes-after-resolute-zotarolimus-eluting-stent-implantation-between-3-month-and-standard-dual-antiplatelet-therapy
#13
COMPARATIVE STUDY
Wataru Fujimoto, Takahiro Sawada, Takayoshi Toba, Yu Takahashi, Taishi Miyata, Shogo Oishi, Tsuyoshi Osue, Tetsuari Onishi, Tomofumi Takaya, Akira Shimane, Yasuyo Taniguchi, Hiroya Kawai, Yoshinori Yasaka
BACKGROUND: The use of short-duration dual antiplatelet therapy (DAPT) remains controversial. To investigate efficacy and safety of short-duration DAPT, we performed a detailed comparison of intra-stent conditions by optical coherence tomography (OCT) after second-generation drug-eluting stent implantation with short-term and standard DAPT. METHODS AND RESULTS: Eighty-two consecutive patients with stable angina pectoris who received Resolute zotarolimus-eluting stents (R-ZESs; Medtronic Cardiovascular, Santa Rosa, CA, USA) were enrolled...
July 2018: Journal of Cardiology
https://read.qxmd.com/read/29096571/elevated-creatine-kinase-due-to-potential-drug-interaction-with-ticagrelor-and-atorvastatin
#14
JOURNAL ARTICLE
Janna C Beavers
PURPOSE: Ticagrelor and atorvastatin are commonly used medications in the management of acute coronary syndrome and percutaneous intervention. This is a report of a patient case of a potential drug interaction leading to the use of alternative therapy. CASE REPORT: A 58-year-old male presented for cardiac catheterization following an abnormal stress test. He underwent placement of a drug-eluting stent and was started on ticagrelor. Three months later, he was noted to have elevated creatine kinase (CK), thought to be related to a potential drug-drug interaction between ticagrelor and atorvastatin...
January 1, 2017: Journal of Pharmacy Practice
https://read.qxmd.com/read/28838471/risk-of-early-adverse-events-after-clopidogrel-discontinuation-in-patients-undergoing-short-term-dual-antiplatelet-therapy-an-individual-participant-data-analysis
#15
REVIEW
Raffaele Piccolo, Fausto Feres, Alexandre Abizaid, Martine Gilard, Marie-Claude Morice, Myeong-Ki Hong, Hyo-Soo Kim, Antonio Colombo, Deepak L Bhatt, Tullio Palmerini, Gregg W Stone, Stephan Windecker, Marco Valgimigli
OBJECTIVES: The study sought to evaluate the presence of a clinically relevant rebound phenomenon after dual antiplatelet therapy (DAPT) discontinuation in randomized trials. BACKGROUND: It is currently unknown whether clopidogrel discontinuation after short-term DAPT is associated with an early hazard of ischemic events. METHODS: The authors performed an individual participant data analysis and aggregate meta-analysis. The primary outcome was major adverse cardiac and cerebrovascular events (MACCE), defined as the composite of cardiac death, myocardial infarction (MI), or stroke...
August 28, 2017: JACC. Cardiovascular Interventions
https://read.qxmd.com/read/27650638/impact-of-proton-pump-inhibitors-and-dual-antiplatelet-therapy-cessation-on-outcomes-following-percutaneous-coronary-intervention-results-from-the-paris-registry
#16
JOURNAL ARTICLE
Jaya Chandrasekhar, Sameer Bansilal, Usman Baber, Samantha Sartori, Melissa Aquino, Serdar Farhan, Birgit Vogel, Michela Faggioni, Gennaro Giustino, Cono Ariti, Antonio Colombo, Alaide Chieffo, Annapoorna Kini, Richard Saporito, C Michael Gibson, Bernhard Witzenbichler, David Cohen, David Moliterno, Thomas Stuckey, Timothy Henry, Stuart Pocock, George Dangas, P Gabriel Steg, Roxana Mehran
BACKGROUND: Proton pump inhibitors (PPI) may decrease the availability of clopidogrel by competitive antagonism, leading to a potential increase in ischemic events. METHODS: We evaluated patients from the all-comer PARIS registry treated with dual antiplatelet therapy (DAPT) with aspirin and clopidogrel following coronary stenting for outcomes stratified by PPI use. Two-year major adverse cardiovascular events (MACE), composite of cardiac death, myocardial infarction, definite or probable stent thrombosis or target lesion revascularization (TLR), and net adverse cardiac events (NACE), composite of MACE or Bleeding Academic Research consortium (BARC) type 3 or 5 bleeding were assessed...
June 1, 2017: Catheterization and Cardiovascular Interventions
https://read.qxmd.com/read/25661578/simultaneous-carotid-artery-stenting-and-heart-surgery-expanded-experience-of-hybrid-surgical-procedures
#17
JOURNAL ARTICLE
Luigi Chiariello, Paolo Nardi, Antonio Pellegrino, Guglielmo Saitto, Giovanni Alfonso Chiariello, Marco Russo, Jacob Zeitani, Francesco Versaci
BACKGROUND: The aim of this study was to evaluate 10-year results of same-day hybrid revascularization of concomitant carotid artery disease by stenting (CAS) and coronary artery disease by coronary artery bypass grafting (CABG), later also applied to patients requiring CAS and other than coronary open heart cardiac surgery. METHODS: One hundred thirty-two consecutive patients (70 ± 8 years, 102 men) underwent same-day CAS and CABG (group 1, n = 97) or other cardiac surgical procedures (aortic ± mitral valve surgery ± ascending aorta replacement ± CABG; group 2, n = 35)...
April 2015: Annals of Thoracic Surgery
https://read.qxmd.com/read/25634407/a-prospective-multi-centric-observational-registry-to-evaluate-performance-of-excel%C3%A2-des-in-real-world-all-comers-patient-population
#18
JOURNAL ARTICLE
Shirish Hiremath, Praveen Chandra, Devang Desai, R Sivakumar, S Selvamani, Anand Srinivasan, Madhu Paulose, Sajy Jose, B C Kalmath, Vilas P Magarkar, Abhijeet Pathak, Tushar Mhetre
OBJECTIVES: This study aims to assess the safety and efficacy of a biodegradable polymer-coated Rapamycin-Eluting Stent (Excel) used in conjunction with six-month dual antiplatelet therapy in daily practice. BACKGROUND: The polymeric material of cardiac stents has been reported to adversely affect the safety profile of the drug-eluting stents and is also suspected to cause serious long-term complications. It has been proposed that the biodegradable polymer coatings may reduce such late-stage adverse effects...
November 2014: Indian Heart Journal
https://read.qxmd.com/read/25278977/should-antiplatelet-therapy-be-interrupted-in-drug-eluting-stent-recipients-throughout-the-periendoscopic-period-a-very-late-stent-thrombosis-case-report-and-review-of-the-literature
#19
Peng Dong, Xin-Chun Yang, Su-Yan Bian
In-stent thrombosis after cessation of antiplatelet medications in patients with drug-eluting stents (DES) is a significant problem in medical practice, particularly in the perioperative period. We report a case of an 87-year-old man with a medical history of hypertension, coronary artery disease and chronic atrophic gastritis. Very late thrombosis of a sirolimus-eluting stent occurred 1207 days after implantation, seven months after discontinuation of clopidogrel, and the interruption of aspirin 13 days in preparation of an elective endoscopic gastrointestinal procedure presented with acute myocardial infarction...
September 2014: Journal of Geriatric Cardiology: JGC
https://read.qxmd.com/read/25125079/clopidogrel-discontinuation-within-the-first-year-after-coronary-drug-eluting-stent-implantation-an-observational-study
#20
JOURNAL ARTICLE
Troels Thim, Martin Berg Johansen, Gro Egholm Chisholm, Morten Schmidt, Anne Kaltoft, Henrik Toft Sørensen, Leif Thuesen, Steen Dalby Kristensen, Hans Erik Bøtker, Lars Romer Krusell, Jens Flensted Lassen, Per Thayssen, Lisette Okkels Jensen, Hans-Henrik Tilsted, Michael Maeng
BACKGROUND: The impact of adherence to the recommended duration of dual antiplatelet therapy after first generation drug-eluting stent implantation is difficult to assess in real-world settings and limited data are available. METHODS: We followed 4,154 patients treated with coronary drug-eluting stents in Western Denmark for 1 year and obtained data on redeemed clopidogrel prescriptions and major adverse cardiovascular events (MACE, i.e., cardiac death, myocardial infarction, or stent thrombosis) from medical databases...
August 13, 2014: BMC Cardiovascular Disorders
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