Clinical benefits of prolonged dual antiplatelet therapy following complex percutaneous coronary intervention

Conclusion Prolonged DAPT reduces cardiac mortality and major adverse cardiovascular events in complex PCI. The results would need confirmation in a larger randomized study.
Source: Coronary Artery Disease - Category: Cardiology Tags: Anti-platelet therapy Source Type: research

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Authors: Biondi-Zoccai G, Antonazzo B, Giordano A, Versaci F, Frati G, Ronzoni S, Nudi A, Nudi F Abstract Percutaneous coronary intervention has become a mainstay in the management of coronary artery disease. While initially advanced age was considered a relative contraindication to invasive management of coronary artery disease, current cardiovascular practice stands solidly on an early invasive approach for elderly patients, typically based on radial access and drug-eluting stent implantation. Since the advent of coronary stents, oral antiplatelet therapy has proved crucial to maximize the benefits and minimize t...
Source: Journal of Thoracic Disease - Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research
AbstractCoronary angiography and percutaneous coronary intervention via radial access has been progressively performed over the last three decades and has become standard of care. Even though the radial approach, compared with femoral access, is safe and is also associated with less bleeding in patients with myocardial infarction, it may be problematic in some cases. Here, we describe an 80 ‐year‐old woman with brachial artery dissection due to a twisted diagnostic catheter during transradial coronary angiography, who subsequently underwent surgical retrieval of the catheter.
Source: Journal of Cardiac Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: CASE REPORT Source Type: research
Conclusion: Cardiac catheterization through the distal radial artery in the snuffbox is safe and feasible. The right distal radial artery access can be routinely carried out.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Trial/Experimental Study Source Type: research
Authors: Rashid MK, Singh K, Bernick J, Wells GA, Hibbert B, Russo J, So DY, Le May MR, CAPITAL PCI Group Abstract BACKGROUND: A pharmacoinvasive strategy for ST-segment elevation myocardial infarction (STEMI) management combines the use of fibrinolysis with the routine transfer to coronary angiography, with percutaneous coronary intervention (PCI) if needed. This method reduces the risk of major adverse cardiovascular event (MACE) compared with fibrinolysis alone; however, it is associated with higher bleeding risk. We sought to assess the bivalirudin compared with unfractionated heparin (UFH) used during PCI as p...
Source: The Journal of Invasive Cardiology - Category: Cardiology Tags: J Invasive Cardiol Source Type: research
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
This study compared 9-month angiographic and physiologic results in patients with high bleeding risk and de novo coronary lesions treated with either paclitaxel-coated balloon (PCB) or bare-metal stent (BMS). Patients and methods A total of 40 patients (40 lesions) with high bleeding risk who underwent successful balloon angioplasty with fractional flow reserve (FFR) after balloon angioplasty more than 0.80 were randomized 1: 1 to treatment with PCB versus BMS. Dual antiplatelet therapy was limited to 1 month after the procedure. Results Baseline clinical and lesional characteristics were well balanced between the tw...
Source: Coronary Artery Disease - Category: Cardiology Tags: PCI Source Type: research
, Dangas GD, Pocock S, Mehran R Abstract BACKGROUND:  Data on geographical variations in dual antiplatelet therapy (DAPT) cessation and the impact on outcomes after percutaneous coronary intervention (PCI) are limited. We sought to evaluate geographical patterns of DAPT cessation and associated outcomes in patients undergoing PCI in the United States versus Europe. METHODS:  Analyzing data from the PARIS registry, we studied 3,660 U.S. patients (72.9%) and 1,358 European patients (27.1%) that underwent PCI with stent implantation. DAPT cessation was classified as physician-recommended discontinuation, interruption (
Source: Thrombosis and Haemostasis - Category: Hematology Authors: Tags: Thromb Haemost Source Type: research
This study aimed to evaluate current rates of ad hoc PCI use and associated risks of adverse outcomes in patients with stable coronary artery disease (CAD).MethodsWe identified 550,742 patients with stable CAD who underwent PCI in the National Cardiovascular Data Registry (NCDR) CathPCI Registry from 2009–2017. We compared in-hospital bleeding, acute kidney injury (AKI), and mortality between patients receiving ad hoc vs. non-ad hoc PCI using logistic regression with inverse probability weighted propensity adjustment.ResultsBetween 2009 and 2017, 82.9% of patients underwent ad hoc PCI. Patients who did not undergo ad...
Source: American Heart Journal - Category: Cardiology Source Type: research
ConclusionSchizophrenia and ONOP are the only SMI subtypes associated with adverse clinical outcomes after AMI. However, all patients with SMI were less likely to receive invasive management for AMI, with female gender and schizophrenia diagnosis being the strongest predictors of conservative management. A multidisciplinary approach between psychiatrists and cardiologists could improve the outcomes of this high-risk population.RésuméContexteLe trouble mental grave (TMG) est associé à une augmentation de la mortalité cardiovasculaire. Nous avons étudié la prévalence de...
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
Authors: Hillerson D, Ogunbayo GO, Salih M, Misumida N, Abdel-Latif A, Smyth SS, Messerli AW Abstract OBJECTIVES: Patients with cirrhosis have increased bleeding risk due to coagulopathy and platelet sequestration, as well as inherent cardiovascular risk. We aim to assess the impact of cirrhosis on the revascularization rates and in-hospital outcomes in patients with acute myocardial infarction (AMI). METHODS: We queried the National Inpatient Sample Database from 2010 to 2014 and identified hospitalizations with a primary diagnosis of AMI (n = 612,547); of these, a total of 3135 patients had a concomitant diag...
Source: The Journal of Invasive Cardiology - Category: Cardiology Tags: J Invasive Cardiol Source Type: research
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