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Inadequate response to antiplatelet therapy in patients with peripheral artery disease: a prospective cohort study
CONCLUSIONS: Patients suffering from cardiovascular events and mortality were characterized by prior cardiovascular events as compared to patients who did not experience any events. Antiplatelet therapy was not optimally protective despite high medication adherence, and HTPR was independently associated with the occurrence of events. More research is needed on alternative treatment strategies such as dual antiplatelet therapy or combinations with anticoagulant drugs.TRIAL REGISTRATION: The Medical Ethics Committee (METC) of the MUMC+ approved the study (NL63235.068.17) and the study was registered in the Netherlands Trial ...
Source: Atherosclerosis - January 10, 2023 Category: Cardiology Authors: B M M Kremers J H C Daemen H Ten Cate H M H Spronk B M E Mees A J Ten Cate-Hoek Source Type: research

The WOEST  2 registry : A prospective registry on antithrombotic therapy in atrial fibrillation patients undergoing percutaneous coronary intervention
CONCLUSIONS: Patients on combined oral anticoagulation and antiplatelet therapy undergoing PCI are elderly and have both a high bleeding and ischaemic risk. Over time, a NOAC plus clopidogrel became the preferred treatment. The rate of thrombotic and bleeding events was not significantly different between patients on triple or dual therapy or between those on VKAs versus NOACs.PMID:35230636 | DOI:10.1007/s12471-022-01664-0
Source: Netherlands Heart Journal - March 1, 2022 Category: Cardiology Authors: A J W M de Veer N Bennaghmouch W L Bor J P R Herrman M Vrolix M Meuwissen T Vandendriessche T Adriaenssens B de Bruyne M Magro W J M Dewilde J M Ten Berg Source Type: research

Antithrombotic therapy in high-risk patients  after percutaneous coronary intervention; study design, cohort profile and incidence of adverse events
CONCLUSION: The high risk for both bleeding and ischaemic events in this cohort of patients with multiple clinical risk factors illustrates the challenges that the cardiologist faces to make a balanced decision on the optimal treatment strategy. This cohort will serve to answer several future research questions about the optimal management of these patients on dual/triple antithrombotic therapy, and the possible value of a wide range of laboratory tests to guide these decisions.PMID:34468944 | DOI:10.1007/s12471-021-01606-2
Source: Netherlands Heart Journal - September 1, 2021 Category: Cardiology Authors: R H Olie P E J van der Meijden M J A Vries L Veenstra A W J van 't Hof J M Ten Berg Y M C Henskens H Ten Cate Source Type: research

Optimal antithrombotic treatment of patients with atrial fibrillation undergoing percutaneous coronary intervention: triple therapy is too much!
Abstract Patients with atrial fibrillation who undergo a coronary intervention are eligible for both anticoagulation and (dual) antiplatelet therapy ((D)APT). An optimal balance has to be found to reduce the thromboembolic risk (i.e. stroke, systemic embolism and myocardial infarction) and to minimise the increased risk of bleeding with concomitant use of an anticoagulant and (D)APT. Owing to a lack of evidence, the guideline recommendations are predominantly based on expert opinion. Current evidence indicates that the combination of a non-vitamin K oral anticoagulant (NOAC) and clopidogrel is safer than vitam...
Source: Netherlands Heart Journal - May 8, 2018 Category: Cardiology Authors: Jacobs MS, Tieleman RG Tags: Neth Heart J Source Type: research

Reduced number of cardiovascular events and increased cost-effectiveness by genotype-guided antiplatelet therapy in patients undergoing percutaneous coronary interventions in the Netherlands.
CONCLUSION: This study provides evidence that for CYP2C19-related poor metabolisers prasugrel may be more effective than clopidogrel to prevent major adverse cardiovascular events after PCI and this approach could be cost-effective. PMID: 27573042 [PubMed - as supplied by publisher]
Source: Netherlands Heart Journal - August 28, 2016 Category: Cardiology Authors: Deiman BA, Tonino PA, Kouhestani K, Schrover CE, Scharnhorst V, Dekker LR, Pijls NH Tags: Neth Heart J Source Type: research