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Stopping anti-platelet drugs in drug-eluting cardiac stents: ParuchMD

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5 papers 0 to 25 followers The collective evidence for those pondering discontinuation of anti-platelet drugs in stable patients withdrug-eluting cardiac stents.
By John Paruch Combined training in Internal Medicine-Psychiatry with holistic, evidence-based, preventive approach to implementation and promotion of wellness.
Flavio Airoldi, Antonio Colombo, Nuccia Morici, Azeem Latib, John Cosgrave, Lutz Buellesfeld, Erminio Bonizzoni, Mauro Carlino, Ulrich Gerckens, Cosmo Godino, Gloria Melzi, Iassen Michev, Matteo Montorfano, Giuseppe Massimo Sangiorgi, Asif Qasim, Alaide Chieffo, Carlo Briguori, Eberhard Grube
BACKGROUND: The need for prolonged aspirin and thienopyridine therapy and the risk of stent thrombosis (ST) remain as drawbacks associated with drug-eluting stents. METHODS AND RESULTS: A prospective observational cohort study was conducted between June 2002 and January 2004 on 3021 patients consecutively and successfully treated in 5389 lesions with drug-eluting stents. Detailed patient information was collected on antiplatelet therapy. We analyzed the incidence of ST throughout the 18-month follow-up period and its relationship with thienopyridine therapy...
August 14, 2007: Circulation
John A Spertus, Richard Kettelkamp, Clifton Vance, Carole Decker, Philip G Jones, John S Rumsfeld, John C Messenger, Sanjaya Khanal, Eric D Peterson, Richard G Bach, Harlan M Krumholz, David J Cohen
BACKGROUND: Although drug-eluting stents (DES) significantly reduce restenosis, they require 3 to 6 months of thienopyridine therapy to prevent stent thrombosis. The rate and consequences of prematurely discontinuing thienopyridine therapy after DES placement for acute myocardial infarction (MI) are unknown. METHODS AND RESULTS: We used prospectively collected data from a 19-center study of MI patients to examine the prevalence and predictors of thienopyridine discontinuation 30 days after DES treatment...
June 20, 2006: Circulation
Pramod K Kuchulakanti, William W Chu, Rebecca Torguson, Patrick Ohlmann, Seung-Woon Rha, Leonardo C Clavijo, Sang-Wook Kim, Ahn Bui, Natalie Gevorkian, Zhenyi Xue, Kimberly Smith, Jana Fournadjieva, William O Suddath, Lowell F Satler, Augusto D Pichard, Kenneth M Kent, Ron Waksman
BACKGROUND: Stent thrombosis (ST) is a serious complication of drug-eluting stent (DES) implantation regardless of the timing (acute, subacute, or late). The correlates of ST with DES are not yet completely elucidated. METHODS AND RESULTS: From a total cohort of 2974 consecutive patients treated with DES since April 2003, we identified 38 patients who presented with angiographic evidence of ST (1.27%). The ST occurred acutely in 5 patients, subacutely (< or =30 days) in 25 patients, and late (>30 days) in 8 patients...
February 28, 2006: Circulation
Ioannis Iakovou, Thomas Schmidt, Erminio Bonizzoni, Lei Ge, Giuseppe M Sangiorgi, Goran Stankovic, Flavio Airoldi, Alaide Chieffo, Matteo Montorfano, Mauro Carlino, Iassen Michev, Nicola Corvaja, Carlo Briguori, Ulrich Gerckens, Eberhard Grube, Antonio Colombo
CONTEXT: Traditionally, stent thrombosis has been regarded as a complication of percutaneous coronary interventions during the first 30 postprocedural days. However, delayed endothelialization associated with the implantation of drug-eluting stents may extend the risk of thrombosis beyond 30 days. Data are limited regarding the risks and the impact of this phenomenon outside clinical trials. OBJECTIVE: To evaluate the incidence, predictors, and clinical outcome of stent thrombosis after implantation of sirolimus-eluting and paclitaxel-eluting stents in routine clinical practice...
May 4, 2005: JAMA: the Journal of the American Medical Association
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