scholarly journals PCV26 Budget IMPACT Analysis of Antiplatelet Therapy with Cangrelor in Patients with ACUTE Coronary Artery Disease Undergoing Percutaneous Coronary Intervention in Germany

2020 ◽  
Vol 23 ◽  
pp. S491
Author(s):  
I. Lizano-Díez ◽  
S. Paz ◽  
J. Garcia Cortes
Author(s):  
F. W. A. Verheugt ◽  
P. Damman ◽  
S. A. J. Damen ◽  
J. J. Wykrzykowska ◽  
E. C. I. Woelders ◽  
...  

AbstractFor secondary prevention of coronary artery disease (CAD) antiplatelet therapy is essential. For patients undergoing a percutaneous coronary intervention (PCI) temporary dual antiplatelet platelet therapy (DAPT: aspirin combined with a P2Y12 blocker) is mandatory, but leads to more bleeding than single antiplatelet therapy with aspirin. Therefore, to reduce bleeding after a PCI the duration of DAPT is usually kept as short as clinically acceptable; thereafter aspirin monotherapy is administered. Another option to reduce bleeding is to discontinue aspirin at the time of DAPT cessation and thereafter to administer P2Y12 blocker monotherapy. To date, five randomised trials have been published comparing DAPT with P2Y12 blocker monotherapy in 32,181 stented patients. Also two meta-analyses addressing this novel therapy have been presented. P2Y12 blocker monotherapy showed a 50–60% reduction in major bleeding when compared to DAPT without a significant increase in ischaemic outcomes, including stent thrombosis. This survey reviews the findings in the current literature concerning P2Y12 blocker monotherapy after PCI.


Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 5041-5041
Author(s):  
Peter Xie ◽  
Devin Malik ◽  
Philip Kuriakose

Abstract Background: The incidence of coronary artery disease is increasing in hemophilia patients as their life expectancy improves. However, there are limited evidence-based studies available, and most current guidelines for antiplatelet therapy in patients with hemophilia are largely based on expert opinions. The assessment of benefit and risk of using antiplatelet therapy in these patients remains a clinical challenge. Aim: This study reports our institution's clinical outcome of patients with inherited hemophilia who underwent antiplatelet therapy for percutaneous coronary intervention in the last 10 years. Methods: Retrospective chart review from a single hospital for 10 calendar years of patients with inherited hemophilia A or B and a diagnosis of coronary artery disease who received oral antiplatelet agents. Results: See data Table 1 below. Conclusions: The usage of antiplatelet therapy for coronary artery disease as well as dual-antiplatelet therapy post percutaneous coronary intervention in patients with Hemophilia A or B carries a realistic risk of bleeding. However, outside of one patient with traumatic laceration of the liver, we did not identify any life threatening bleeding events in our patients who were placed on antiplatelet therapy. Since all subjects had no more than mild to moderate factor deficiency, it would be important to see how patients with severe deficiency would do on such therapy. Further studies are needed in the future to provide evidence and clarify the overall risk versus benefit of antiplatelet therapy in hemophilia patients with coronary artery disease. Disclosures No relevant conflicts of interest to declare.


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