Diabetes and Outcomes following Guided De-Escalation of Antiplatelet Treatment in Acute Coronary Syndrome Patients Undergoing Percutaneous Coronary Intervention: A Prespecified Analysis from the Randomized TROPICAL-ACS Trial.

CONCLUSIONS: Although diabetic status did not significantly interfere with treatment effects of guided DAPT de-escalation, our results suggest that this approach might be safe and effective in non-diabetic patients, whilst further investigation is definitely warranted in diabetic patients. PMID: 31012853 [PubMed - as supplied by publisher]
Source: EuroIntervention - Category: Cardiovascular & Thoracic Surgery Tags: EuroIntervention Source Type: research

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Publication date: Available online 1 September 2019Source: The LancetAuthor(s): Deepak L Bhatt, Philippe Gabriel Steg, Shamir R Mehta, Lawrence A Leiter, Tabassome Simon, Kim Fox, Claes Held, Marielle Andersson, Anders Himmelmann, Wilhelm Ridderstråle, Jersey Chen, Yang Song, Rafael Diaz, Shinya Goto, Stefan K James, Kausik K Ray, Alexander N Parkhomenko, Mikhail N Kosiborod, Darren K McGuire, Robert A HarringtonSummaryBackgroundPatients with stable coronary artery disease and diabetes with previous percutaneous coronary intervention (PCI), particularly those with previous stenting, are at high risk of ischaemic even...
Source: The Lancet - Category: General Medicine Source Type: research
ConclusionTicagrelor and prasugrel were not associated with significantly different adverse clinical outcomes and bleeding events in these patients with T2DM. Therefore, both antiplatelet agents might safely be used in patients with T2DM following coronary intervention. However, this head-to-head comparison still remains a major challenge which should be resolved in larger clinical trials.
Source: Diabetes Therapy - Category: Endocrinology Source Type: research
Conclusion: In elective PCI, low-dose UFH with sequential enoxaparin has similar effects and safety to the UFH-only method. PMID: 29578118 [PubMed - in process]
Source: Chinese Medical Journal - Category: General Medicine Authors: Tags: Chin Med J (Engl) Source Type: research
Conclusion In ‘real-life’ ACS undergoing PCI, diabetic patients have higher – although not significantly – MACE rate and no difference in bleeding events. This difference in MACE was significant among clopidogrel-treated patients, whereas when newer antiplatelet agents were used the negative impact of DM on ischemic events was eliminated.
Source: Coronary Artery Disease - Category: Cardiology Tags: Original Research Source Type: research
BackgroundMore evidence is needed on the optimal antithrombotic regimen in elderly patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI). HypothesisOctogenarian patients (aged ≥80 years) with AF who underwent PCI have worse 12‐month clinical outcome, compared with younger patients. MethodsWe performed a post‐hoc analysis of data from the prospective, multicenter AFCAS registry, which enrolled consecutive patients with AF who underwent PCI and stenting. Outcome measures included major adverse cardiac/cerebrovascular events (MACCE; all‐cause death, myocardial infarction, repeat r...
Source: Clinical Cardiology - Category: Cardiology Authors: Tags: CLINICAL INVESTIGATIONS Source Type: research
Time limit: 0 Quiz-summary 0 of 20 questions completed Questions: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Information This test series requires login for attempting. You can login easily with your Facebook account (Use the CONNECT WITH icon on the upper part of right sidebar displaying t...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: General Cardiology Source Type: blogs
Background— There is general agreement that the optimal duration of dual antiplatelet therapy (DAPT) in patients treated with drug-eluting stents should be individualized. We hypothesized that the extent of coronary artery disease may affect the clinical outcomes of DAPT. Methods and Results— We pooled patient-level data from 5 large, randomized trials comparing short-term DAPT with prolonged therapy. From the data, we identified 5476 patients who received newer-generation drug-eluting stents. Net adverse clinical event (NACE) was defined as a composite of all-cause mortality, myocardial infarction, stroke, or...
Source: Circulation: Cardiovascular Interventions - Category: Cardiology Authors: Tags: Percutaneous Coronary Intervention, Pharmacology, Stent Source Type: research
Background— As coronary perforation (CP) is a rare but serious complication of percutaneous coronary intervention (PCI) the current evidence base is limited to small series. Using a national PCI database, the incidence, predictors, and outcomes of CP as a complication of PCI were defined. Methods and Results— Data were prospectively collected and retrospectively analyzed from the British Cardiovascular Intervention Society data set on all PCI procedures performed in England and Wales between 2006 and 2013. Multivariate logistic regressions and propensity scores were used to identify predictors of CP and its as...
Source: Circulation: Cardiovascular Interventions - Category: Cardiology Authors: Tags: Percutaneous Coronary Intervention, Revascularization, Stent Coronary Interventions Source Type: research
Abstract BACKGROUND: The population is ageing rapidly and the proportion of patients aged ≥ 80 years undergoing primary percutaneous coronary intervention (PCI) is rising, but clinical trials have primarily been performed in younger patients. METHODS: Patients undergoing primary PCI between 2003 and 2008 were subdivided into 3 groups:
Source: Netherlands Heart Journal - Category: Cardiology Authors: Tags: Neth Heart J Source Type: research
ConclusionsAs compared to men, women undergoing pPCI have more bleedings and strokes, and a worse early, but not mid‐term mortality. These findings may allow a better risk stratification of pPCI patients.
Source: Journal of Interventional Cardiology - Category: Cardiology Authors: Tags: Original Investigation Source Type: research
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