TCT: Bivalirudin Cuts Bleeding in PCI

WASHINGTON (MedPage Today) -- A prolonged infusion of bivalirudin (AngioMax) around percutaneous coronary intervention reduced bleeding compared with heparin, with or without glycoprotein IIb/IIIa inhibition, a Chinese trial showed.
Source: MedPage Today Cardiovascular - Category: Cardiology Source Type: news

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Int J Angiol DOI: 10.1055/s-0040-1702208In atrial fibrillation (AF), oral anticoagulant (OAC) therapy with either vitamin K antagonist or non–vitamin K antagonist is used to prevent thromboembolic complications. In patients who presented with acute coronary syndrome (ACS) and treated by percutaneous coronary intervention (PCI), dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 inhibitor reduces major adverse cardiac events (MACEs) and stent thrombosis. Consequently, in patients with AF who presented with ACS and treated by PCI, the combination of OAC and DAPT, the so-called triple antithrombotic therapy (TAT)...
Source: International Journal of Angiology - Category: Cardiology Authors: Tags: Review Article Source Type: research
Conclusion: In adults with AF after PCI, dual therapy reduces risk for bleeding compared with triple therapy, whereas its effects on risks for death and ischemic end points are still unclear. Primary Funding Source: None. PMID: 32176890 [PubMed - as supplied by publisher]
Source: Annals of Internal Medicine - Category: Internal Medicine Authors: Tags: Ann Intern Med Source Type: research
Conclusions: DPI compared with aspirin produced consistent reductions in MACE and mortality but with increased major bleeding with or without prior PCI. Among those with prior PCI one- year and beyond, effects on MACE and mortality were consistent irrespective of time since last PCI. Clinical Trial Registration: URL: www.ClinicalTrials.gov Unique Identifier: NCT01776424. PMID: 32178526 [PubMed - as supplied by publisher]
Source: Circulation - Category: Cardiology Authors: Tags: Circulation Source Type: research
Abstract BACKGROUND: The transradial approach is reportedly associated with reduced bleeding complications and mortality after percutaneous coronary intervention (PCI). It is unknown whether the clinical benefits of transradial vs. transfemoral PCI differ between high bleeding risk (HBR) and non-HBR patients.Methods and Results:After excluding patients with acute myocardial infarction, dialysis, and a transbrachial approach from the 13,087 patients undergoing first PCI in the CREDO-Kyoto Registry Cohort-2, 6,828 patients were eligible for this study. Patients were divided into 2 groups according to bleeding ri...
Source: Circulation Journal - Category: Cardiology Authors: Tags: Circ J Source Type: research
Patients undergoing percutaneous coronary intervention (PCI) often have high-bleeding-risk (HBR) factors. Dual antiplatelet therapy (DAPT) further increases this risk of bleeding. We sought to compare clinical outcomes according to presence or absence of HBR factors in patients with elevated ischemic risk (DAPT score ≥ 2) undergoing PCI. We evaluated all patients undergoing PCI at MedStar Washington Hospital Center (January 2009 to July 2018) with DAPT score ≥2, which is associated with elevated risk of ischemic events.
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
we found of interest the paper by Lu et al. on the outcome after percutaneous coronary intervention in patients with cirrhosis.1 In these patients they observed a much higher frequency of overall adverse events (44.7% vs 17.7%); most importantly, gastrointestinal bleeding was increased more than five times (15.3% vs 2.7%).1 We believe this paper should gain wide diffusion among practicing gastroenterologists, and cardiologists, as acute myocardial infarction is increasing among cirrhosis patients, also in the USA.
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
MONDAY, March 16, 2020 -- For patients with atrial fibrillation (AF) after percutaneous coronary intervention (PCI), dual therapy is associated with a reduced risk for bleeding compared with triple therapy, according to research published online...
Source: Drugs.com - Pharma News - Category: Pharmaceuticals Source Type: news
AbstractPatients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI) have traditionally received triple antithrombotic therapy (TAT) consisting of aspirin and a P2Y12 inhibitor plus an oral anticoagulant (OAC) to reduce atherothrombotic events, even though this strategy is associated with a high risk of severe bleeding. Recent trials have indicated that dual antithrombotic therapy (DAT), consisting of a P2Y12 inhibitor plus an OAC, may be superior to TAT in terms of bleeding risk; however, the  trade-off regarding ischemic complications may be questionable. Patients who have had a myocard...
Source: American Journal of Cardiovascular Drugs - Category: Cardiology Source Type: research
Publication date: Available online 9 March 2020Source: Revista Española de Cardiología (English Edition)Author(s): Juan M. Ruiz-Nodar
Source: Revista Espanola de Cardiologia - Category: Cardiology Source Type: research
Conclusions Neither perioperative aspirin nor clonidine have significant long-term effects after noncardiac surgery. Perioperative aspirin in patients with previous percutaneous coronary intervention showed persistent benefit at 1 yr, a plausible sub-group effect.Editor ’s PerspectiveWhat We Already Know about This TopicThe Perioperative Ischemic Evaluation-2 study (POISE-2) authors previously reported that neither aspirin nor clonidine reduced a 30-day composite of nonfatal myocardial infarction or death. Aspirin caused perioperative bleeding, and clonidine provoked hypotension and bradycardia.In a subgroup analysis...
Source: Anesthesiology - Category: Anesthesiology Source Type: research
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