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Outcomes in Patients Undergoing Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction Via Radial Access Anticoagulated With Bivalirudin Versus Heparin: A Report From the National Cardiovascular Data Registry
Conclusions In patients undergoing primary PCI via transradial access anticoagulated with bivalirudin or heparin, there was no difference in the composite endpoint of death, myocardial infarction, or stroke.
Source: Journal of the American College of Cardiology: Cardiovascular Interventions - June 5, 2017 Category: Cardiology Authors: Jovin, I. S., Shah, R. M., Patel, D. B., Rao, S. V., Baklanov, D. V., Moussa, I., Kennedy, K. F., Secemsky, E. A., Yeh, R. W., Kontos, M. C., Vetrovec, G. W. Tags: Coronary Source Type: research

Second-Generation Drug-Eluting Stent Implantation Followed by 6- Versus 12-Month Dual Antiplatelet Therapy The SECURITY Randomized Clinical Trial
BackgroundThe optimal duration of dual antiplatelet therapy (DAPT) following second-generation drug-eluting stent (DES) implantation is still debated.ObjectivesThe aim of this study was to test the noninferiority of 6 versus 12 months of DAPT in patients undergoing percutaneous coronary intervention with second-generation DES.MethodsThe SECURITY (Second Generation Drug-Eluting Stent Implantation Followed by Six- Versus Twelve-Month Dual Antiplatelet Therapy) trial was a 1:1 randomized, multicenter, international, investigator-driven, noninferiority study conducted from July 2009 to June 2014. Patients with a stable or unst...
Source: Journal of the American College of Cardiology: Cardiovascular Interventions - November 10, 2014 Category: Cardiology Source Type: research

Triple Therapy for Atrial Fibrillation and Percutaneous Coronary Intervention A Contemporary Review
Chronic oral anticoagulant therapy is recommended (class I) in patients with mechanical heart valves and in patients with atrial fibrillation with a CHA2DS2-VASc (Congestive heart failure, Hypertension, Age ≥75 years, Diabetes mellitus, prior Stroke or transient ischemic attack or thromboembolism, Vascular disease, Age 65 to 74 years, Sex category) score ≥1. When these patients undergo percutaneous coronary intervention with stenting, treatment with aspirin and a P2Y12 receptor inhibitor also becomes indicated. Before 2014, guidelines recommended the use of triple therapy (vitamin K antagonists, aspirin, and clopidog...
Source: Journal of the American College of Cardiology: Cardiovascular Interventions - September 15, 2014 Category: Cardiology Source Type: research

Triple Therapy With Aspirin, Prasugrel, and Vitamin K Antagonists in Patients With Drug-Eluting Stent Implantation and an Indication for Oral Anticoagulation
This study sought to evaluate whether prasugrel may serve as an alternative to clopidogrel in patients with triple therapy.BackgroundApproximately 10% of patients who receive dual antiplatelet therapy after percutaneous coronary intervention have an indication for oral anticoagulation and are thus treated with triple therapy. The standard adenosine diphosphate receptor blocker in this setting is clopidogrel. Data regarding prasugrel as part of triple therapy are not available.MethodsWe analyzed a consecutive series of 377 patients who underwent drug-eluting stent implantation and had an indication for oral anticoagulation ...
Source: Journal of the American College of Cardiology: Cardiovascular Interventions - May 13, 2013 Category: Cardiology Source Type: research

Primary Percutaneous Coronary Intervention The Deception of Delay ⁎ ⁎
Primary percutaneous coronary intervention (PCI) has become the predominant reperfusion strategy for ST-segment elevation myocardial infarction (STEMI) throughout western healthcare systems. Recent estimates in the United States suggest that primary PCI is used in 85% of all STEMI cases that undergo reperfusion, with thrombolytic agents used in only 9% and the combination of thrombolytic agents with PCI in 6% (1). This dramatic switch from thrombolytic therapy to primary PCI was the result of several studies conducted in the early 1990s that demonstrated the superiority of primary PCI at reducing stroke and reinfarction as...
Source: Journal of the American College of Cardiology: Cardiovascular Interventions - April 15, 2013 Category: Cardiology Source Type: research