Bedside testing of CYP2C19 gene for treatment of patients with PCI with antiplatelet therapy

To mitigate the risk of stent thrombosis, patients treated by percutaneous coronary intervention (PCI) are administered dual anti-platelet therapy comprising aspirin and a platelet P2Y12 receptor inhibitor. Clopi...
Source: BMC Cardiovascular Disorders - Category: Cardiology Authors: Tags: Study protocol Source Type: research

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AbstractBackground and ObjectivesDual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) reduces the incidence of thrombotic events but increases the risk of bleeding, which is associated with a substantial and durable risk of death and could offset the benefits of a reduction in thrombotic events. P2Y12 inhibitor monotherapy after short-term DAPT could be an option to reduce the risk of bleeding. We carried out a meta-analysis comparing P2Y12 inhibitor monotherapy after short-term DAPT with standard-term DAPT in patients undergoing PCI.MethodsWe searched the PubMed and EMBASE databases through 11 A...
Source: Clinical Drug Investigation - Category: Drugs & Pharmacology Source Type: research
VENTRICULAR SEPTAL RUPTURE, resulting in a ventricular septal defect (VSD), is a catastrophic complication after an acute myocardial infarction (MI). Although the incidence of post –myocardial infarction ventricular septal defect (PMI VSD) has decreased dramatically in the thrombolytic and percutaneous coronary intervention era, the perioperative mortality remains elevated.1 Historically, in medically treated patients the mortality rates exceeded 90%, and thus, early surgica l repair first was proposed in the 1980s.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Case Report Source Type: research
In conclusion, the short-term DAPT can reduce the risk of bleeding compared with standard DAPT, without increasing the risk of death or ischemia (Registered by PROSPERO, CRD42020153881). PMID: 32627616 [PubMed - as supplied by publisher]
Source: Platelets - Category: Hematology Tags: Platelets Source Type: research
CONCLUSIONS: Almost one third of OHCA patients undergoing PCI die and more than one third of the fatalities are attributable to cardiovascular causes. The burden of ischemic and bleeding complications was consistently higher and the success rates of PCI lower among OHCA as compared to non-OHCA patients. PMID: 32624462 [PubMed - as supplied by publisher]
Source: EuroIntervention - Category: Cardiovascular & Thoracic Surgery Tags: EuroIntervention Source Type: research
Abstract Antiplatelet therapy is a mainstay preventive strategy for cardiovascular diseases, and dual antiplatelet therapy (DAPT) comprising aspirin and P2Y12 inhibitor is a standard treatment for patients who have received percutaneous coronary intervention (PCI). The Total Thrombus-formation Analysis System (T-TAS®) is a microchip flow chamber system developed to evaluate overall thrombus formation under flow conditions, and is reportedly able to evaluate single and combined antithrombotic therapy. Here, we focus on this new system, T-TAS®, and review together with the conventional systems available to e...
Source: Polish Heart Journal - Category: Cardiology Authors: Tags: Kardiol Pol Source Type: research
This study aimed to evaluate the early vascular response of ultra-thin strut bioresorbable polymer sirolimus-eluting stents (BP SES) using optical frequency domain imaging (OFDI). Ultra-thin strut BP SES have superior outcomes in terms of efficacy and safety endpoints when compared to other thin strut new-generation stents. However, the factors contributing to the superiority of BP SES over other thin strut new-generation stents are unclear. A total of 32 patients with multivessel disease requiring staged procedures at 1  month were enrolled from 3 cardiovascular institutions; of these, 31 were immediately assessed by...
Source: Cardiovascular Intervention and Therapeutics - Category: Cardiology Source Type: research
Recent decades have seen improvements in the prognosis of ST-segment elevation myocardial infarction (STEMI), mainly due to generalization of primary percutaneous coronary intervention (PCI) and organization of STEMI networks to provide rapid and effective care. However, the fate of a significant percentage of patients remains ominous. It is of utmost importance to develop reliable tools to stratify prognosis and identify patients in whom usual care may not be enough to achieve optimal results. In the current issue of the Internal Journal of Cardiology, Leivo et al.
Source: International Journal of Cardiology - Category: Cardiology Authors: Tags: Editorial Source Type: research
AbstractAntithrombotic treatment in patients with atrial fibrillation undergoing percutaneous coronary intervention is still debated. We conducted a meta-analysis of recent randomized controlled trials to evaluate the benefit of different antithrombotic strategies. Data were analyzed between May and September 2019. Efficacy outcomes were trial-defined major adverse cardiovascular events (MACE); its individual components; stent thrombosis. Safety outcomes were trial-defined primary bleeding outcome; TIMI and ISTH major bleeding; clinically relevant non-major bleeding; intracranial hemorrhage. Differences in outcomes among g...
Source: Internal and Emergency Medicine - Category: Emergency Medicine Source Type: research
Abstract PURPOSE: Although current guidelines recommend the administration of dual antiplatelet therapy (DAPT) for up to 12 months after the implantation of a drug-eluting stent (DES), extended DAPT is frequently used in real-world practice. MATERIALS AND METHODS: From the Korean Multicenter Angioplasty Team registry, we identified a total of 1414 patients who used DAPT for>3 years after DES implantation (extended-DAPT group) and conducted a landmark analysis at 36 months after the index procedure. We evaluated the determinants for and long-term outcomes of extended DAPT and compared the occurrence of majo...
Source: Yonsei Medical Journal - Category: Universities & Medical Training Authors: Tags: Yonsei Med J Source Type: research
This study evaluated the benefit of dual therapy in reducing ischemic events in atrial fibrillation (AF) patients presenting with acute coronary syndrome (ACS) or undergoing percutaneous coronary intervention (PCI). We searched PubMed, Cochrane Library, and for randomized controlled trials (RCTs) comparing dual and triple therapies (oral anticoagulation plus aspirin and P2Y12 inhibitor) for AF patients with ACS or those undergoing PCI. The composite primary outcome included all-cause death, myocardial infarction (MI), stent thrombosis (ST), or stroke. Relative risk (RR) and the corresponding 95% confiden...
Source: Aging - Category: Biomedical Science Authors: Tags: Aging (Albany NY) Source Type: research
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