225: Impact of platelet function monitoring and optimization of dual antiplatelet therapy in patients with unprotected left main disease treated by percutaneous coronary intervention: The ALMA Registry

Each year, approximately 3 million people with coronary heart disease worldwide undergo percutaneous coronary intervention (PCI). Dual antiplatelet therapy (DAPT) with aspirin and P2Y12 inhibitors became the primary therapy for 6-12 months after PCI. DAPT can be continued > 12 months at a high risk of thrombosis. About 9-10% of patients with dual antiplatelet therapy still experience ischemia. The platelet function examination by thromboelastography (TEG). This research is an analytic observational study using a cross-sectional method. This study was conducted in Saiful Anwar General Hospital. Patients were divided into two groups: (1) on-single antiplatelet therapy; (2) on-dual antiplatelet therapy. The outcome measured result of the platelet function test was divided into standard, low platelet function, and platelet hypercoagulability. An analysis of the differences between single or multiple antiplatelet administration and the platelet function results was performed. There were 52 research subjects, each group of single and multiple antiplatelet therapies as many as 26 people, most of the subjects were male (82.6%) with a mean age of 57. The results of this study showed that there was no significant difference in the results of platelet function examinations between single and multiple antiplatelet therapies after 12 months of dual antiplatelet therapy.

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Dual Antiplatelet Therapy Duration Determines Outcome After 2- But Not 1-Stent Strategy in Left Main Bifurcation Percutaneous Coronary Intervention

JACC Cardiovascular Interventions ◽

10.1016/j.jcin.2018.09.020 ◽

2018 ◽

Vol 11 (24) ◽

pp. 2453-2463 ◽

Cited By ~ 13

Author(s):

Tae-Min Rhee ◽

Kyung Woo Park ◽

Chi-Hoon Kim ◽

Jeehoon Kang ◽

Jung-Kyu Han ◽

...

Keyword(s):

Percutaneous Coronary Intervention ◽

Antiplatelet Therapy ◽

Dual Antiplatelet Therapy ◽

Coronary Intervention ◽

Left Main ◽

Percutaneous Coronary

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AS-079 Predictors For Crossover From Radial To Femoral Approach In Patients Undergoing Percutaneous Coronary Intervention For Unprotected Left Main Disease

The American Journal of Cardiology ◽

10.1016/j.amjcard.2011.02.131 ◽

2011 ◽

Vol 107 (8) ◽

pp. 56A-57A

Author(s):

Young Jin Youn ◽

Junghan Yoon ◽

Jun-Won Lee ◽

Joong Kyung Sung ◽

Woo Taek Kim ◽

...

Keyword(s):

Percutaneous Coronary Intervention ◽

Coronary Intervention ◽

Left Main ◽

Left Main Disease ◽

Femoral Approach ◽

Percutaneous Coronary ◽

Unprotected Left Main Disease

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P1931Effect of de-escalated switching dual antiplatelet therapy after acute myocardial infarction in patients undergoing percutaneous coronary intervention: real-world data from a nationwide cohort study

European Heart Journal ◽

10.1093/eurheartj/ehz748.0678 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

C.-Y Hsu ◽

J.-S Yeh ◽

C.-Y Huang

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Percutaneous Coronary Intervention ◽

Antiplatelet Therapy ◽

Platelet Function ◽

Dual Antiplatelet Therapy ◽

Coronary Intervention ◽

Risk Of Death ◽

Percutaneous Coronary ◽

Function Testing

Abstract Background Recently, both unguided (platelet function testing independent) and guided (platelet function testing dependent) DAPT de-escalation strategies have been investigated in different clinical studies but the data is still limited and conflicting. The aim of this study was to examine the effect of switching dual antiplatelet therapy (DAPT) on the major vascular risk after acute myocardial infarction (AMI) in patients undergoing percutaneous coronary intervention (PCI) by using Taiwan National Health Insurance Research Database. Methods In total, 1,903 and 4,059 patients defined as switched to aspirin and clopidogrel (switched DAPT) and continuation of aspirin and ticagrelor (unswitched DAPT) cohort, respectively who had received PCI during AMI hospitalization, on aspirin and ticagrelor initially and without occurring adverse events at 3 months were evaluated between 2013 and 2015. An inverse probability treatment of weighted approach was adopted to balance the baseline differences between two groups and Cox proportional hazard regression and competing risk regression were used to evaluated the effect of switching DAPT on death, AMI readmission, major bleeding and non-major clinically relevant bleeding. Results The incidence rates (per 100 person-year) of death and AMI readmission were 3.97 (95% confidence interval [CI] = 3.19–4.84) and 3.84 (95% CI = 3.09–4.73) in switched cohort and 1.83 (95% CI = 1.47–2.24) and 2.23 (95% CI = 1.82–2.68) in unswitched cohort, respectively. After adjustment for patients' clinical variables, switched cohort had higher risk of death (adjusted hazard ratio = 2.18, 95% CI = 1.62–2.93, P<0.001), and AMI readmission (adjusted sub-distribution ratio = 1.72, 95% CI = 1.27–2.34, P<0.001) compared to these in unswitched cohort; however, there was no difference in the risk of bleeding. Subgroup analysis showed a similar findings in many specific groups, except the patients who were younger age and had lower comorbidity score. Conclusion Switching DAPT might increase the risk of death and AMI readmission among patients with AMI undergoing PCI.

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