Duration of clopidogrel-based dual antiplatelet therapy and clinical outcomes after endeavor sprint zotarolimus-eluting stent implantation in patients presenting with acute coronary syndrome

2015 ◽  
Vol 26 (7) ◽  
pp. 521-527 ◽  
Author(s):  
Pil Sang Song ◽  
Joo-Yong Hahn ◽  
Doo-Il Kim ◽  
Young Bin Song ◽  
Seung-Hyuk Choi ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Clinical Outcomes ◽  
Antiplatelet Therapy ◽  
Stent Implantation ◽  
Dual Antiplatelet Therapy ◽  
Coronary Syndrome

Use of PRECISE-DAPT Score and Admission Platelet Count to Predict Mortality Risk in Patients With Acute Coronary Syndrome

Angiology ◽  
2019 ◽  
Vol 70 (9) ◽  
pp. 867-877 ◽  
Author(s):  
Nuccia Morici ◽  
Giovanni A. Tavecchia ◽  
Laura Antolini ◽  
Maria R. Caporale ◽  
Silvia Cantoni ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Platelet Count ◽  
Antiplatelet Therapy ◽  
Mortality Risk ◽  
Stent Implantation ◽  
Dual Antiplatelet Therapy ◽  
Predictive Accuracy ◽  
Bleeding Complications ◽  
Coronary Syndrome ◽  
Coronary Events

The PREdicting bleeding Complications In patients undergoing Stent implantation and subsEquent Dual Antiplatelet Therapy (PRECISE-DAPT) score has been validated to predict bleeding complications in patients undergoing stent implantation and dual antiplatelet therapy. This score does not include the platelet count (PC), which has been shown to be an independent marker of mortality in patients with acute coronary syndrome (ACS). We assessed the role of the PRECISE-DAPT score calculated on admission for mortality risk prediction and evaluated whether the predictive accuracy of this score improved by adding the PC. In a retrospective cohort study of 1000 patients with ACS, after adjustment for relevant covariates, a PRECISE-DAPT score ≥25 was independently associated with mortality (hazard ratio [HR]: 7.91; 95% confidence interval [CI]: 4.37-14.30). When this score was combined with PC, compared to patients with PRECISE-DAPT <25 and PC ≥150 × 109/L, the adjusted HR was 7.2 (95% CI 2.4-21.6) for those with PRECISE-DAPT <25 and PC <150 × 109/L; 10.7 (95% CI: 5.2-21.9) for those with PRECISE-DAPT ≥25 and PC ≥150 × 109/L; and 17.9 (95% CI 7.0-45.4) for those with PRECISE-DAPT ≥25 and PC <150 × 109/L. Selecting thresholds for high-risk designation, the PRECISE-DAPT score integrated with PC had a higher prediction value, compared to the PRECISE-DAPT and Global Registry of Acute Coronary Events scores.

Frequency and Reasons of Dual Antiplatelet Therapy Discontinuation and Switching of P2Y12 Inhibitors in Patients with Acute Coronary Syndrome Treated with Stent Implantation

Cardiology ◽  
2019 ◽  
Vol 142 (4) ◽  
pp. 203-207
Author(s):  
Georgina Fuertes Ferre ◽  
Isabel Caballero Jambrina ◽  
Alejandra Ruiz Aranjuelo ◽  
Javier Jimeno Sánchez ◽  
Jose Gabriel Galache Osuna ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Antiplatelet Therapy ◽  
Stent Implantation ◽  
Dual Antiplatelet Therapy ◽  
Antiplatelet Agent ◽  
Invasive Procedure ◽  
Medical Decisions ◽  
P2y12 Inhibitors ◽  
Coronary Syndrome

Background: Incidence and reasons of dual antiplatelet therapy (DAPT) discontinuation and switching between P2Y12 inhibitors in acute coronary syndrome (ACS) patients treated with a stent have been poorly studied. Methods and Results: In a prospective single-center study, 283 consecutive patients presenting with ACS were treated with stent implantation between July 2015 and January 2016. Follow-up was achieved at 12 months in 273 patients using the electronic patient file and telephone interview. Switching from clopidogrel to a new antiplatelet agent (ticagrelor or prasugrel) or vice versa occurred in 60 (21.2%) patients. The most frequent reasons for switching were medical decisions not associated with bleeding events and concomitant use of chronic oral anticoagulation. Among the patients with a 1-year follow-up, 42 (15.4%) prematurely discontinued DAPT; 25 of them did so due to the need for an invasive procedure. DAPT premature discontinuation was not significantly associated with an increased 1-year risk of cardiovascular death or serious cardiac ischemic events (HR 2.08 [CI 95%: 0.88–4.94, p = 0.099]). Conclusions: DAPT discontinuation and switching between P2Y12 inhibitors are not uncommon in patients with ACS treated with a stent. The most frequent reasons were the need for an invasive procedure and medical decisions.

scholarly journals Impact of Dual Antiplatelet Therapy with Proton Pump Inhibitors on the Outcome of Patients with Acute Coronary Syndrome Undergoing Drug-Eluting Stent Implantation

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Francesca Macaione ◽  
Carla Montaina ◽  
Salvatore Evola ◽  
Giuseppina Novo ◽  
Salvatore Novo
Keyword(s):  
Acute Coronary Syndrome ◽  
Antiplatelet Therapy ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Stent Implantation ◽  
Dual Antiplatelet Therapy ◽  
Drug Eluting Stent ◽  
Coronary Syndrome ◽  
H2 Antagonist ◽  
Drug Eluting

This study aimed to assess if proton pump inhibitors (PPIs) may reduce the effectiveness of clopidogrel, than H2 antagonist (anti-H2) in order to determine rehospitalization for acute coronary syndrome (re-ACS), target vessel revascularization (TVR) and cardiac death. This case-control study included 176 patients with ACS undergoing angioplasty (PCI) with drug-eluting stent implantation. The population was divided into two groups: PPI group (n=121) consisting of patients receiving at discharge dual antiplatelet therapy (DAT) plus PPI and anti-H2 group (n=55), consisting of patients receiving at discharge DAT + H2 receptor antagonist (H2RA). In a followup of 36 months the prevalence of ACS event (P=0.014), TVR (P=0.031) was higher in the PPI group than in the anti-H2 group; instead there was no statistically significant difference between groups for death. The variables independently associated with ACS were the diabetes, omeprazole, and esomeprazole; instead the variables independently associated with TVR were only omeprazole. Our data shows that the use of omeprazole and esomeprazole, with clopidogrel, is associated with increased risk of adverse outcomes after PCI with drug-eluting stent implantation.

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