Dual antiplatelet therapy reduced stroke risk in high‐risk patients with transient ischaemic attack assessed by ABCD3‐I score

2018 ◽  
Vol 26 (4) ◽  
pp. 610-616 ◽  
Author(s):  
B. Song ◽  
R. Hu ◽  
L. Pei ◽  
Y. Cao ◽  
P. Chen ◽  
...  
Keyword(s):  
High Risk ◽  
Antiplatelet Therapy ◽  
Transient Ischaemic Attack ◽  
Stroke Risk ◽  
Dual Antiplatelet Therapy ◽  
High Risk Patients ◽  
Risk Patients ◽  
Ischaemic Attack

TWILIGHT: A Randomized Trial of Ticagrelor Monotherapy Versus Ticagrelor Plus Aspirin Beginning at 3 Months in High-risk Patients Undergoing Percutaneous Coronary Intervention

2020 ◽  
Vol 14 ◽  
Author(s):  
Johny Nicolas ◽  
Usman Baber ◽  
Roxana Mehran
Keyword(s):  
Percutaneous Coronary Intervention ◽  
High Risk ◽  
Antiplatelet Therapy ◽  
Dual Antiplatelet Therapy ◽  
Coronary Intervention ◽  
Bleeding Events ◽  
High Risk Patients ◽  
Risk Of Death ◽  
Percutaneous Coronary ◽  
Risk Patients

A P2Y12 inhibitor-based monotherapy after a short period of dual antiplatelet therapy is emerging as a plausible strategy to decrease bleeding events in high-risk patients receiving dual antiplatelet therapy after percutaneous coronary intervention. Ticagrelor With Aspirin or Alone in High-Risk Patients After Coronary Intervention (TWILIGHT), a randomized double-blind trial, tested this approach by dropping aspirin at 3 months and continuing with ticagrelor monotherapy for an additional 12 months. The study enrolled 9,006 patients, of whom 7,119 who tolerated 3 months of dual antiplatelet therapy were randomized after 3 months into two arms: ticagrelor plus placebo and ticagrelor plus aspirin. The primary endpoint of interest, Bleeding Academic Research Consortium type 2, 3, or 5 bleeding, occurred less frequently in the experimental arm (HR 0.56; 95% CI [0.45–0.68]; p<0.001), whereas the secondary endpoint of ischemic events was similar between the two arms (HR 0.99; 95% CI [0.78–1.25]). Transition from dual antiplatelet therapy consisting of ticagrelor plus aspirin to ticagrelor-based monotherapy in high-risk patients at 3 months after percutaneous coronary intervention resulted in a lower risk of bleeding events without an increase in risk of death, MI, or stroke.

T1963 High-Risk Patients for GI Bleeding On Dual Antiplatelet Therapy in Spain Are More Like to Receive PPI Therapy Than Their American Peers

2009 ◽  
Vol 136 (5) ◽  
pp. A-610
Author(s):  
Angel Lanas ◽  
Liz Guastello ◽  
Ruben Casado ◽  
Sameer D. Saini ◽  
Monica Polo-Tomas ◽  
...  
Keyword(s):  
High Risk ◽  
Antiplatelet Therapy ◽  
Dual Antiplatelet Therapy ◽  
Gi Bleeding ◽  
High Risk Patients ◽  
Risk Patients ◽  
To Receive

Management of Atherothrombosis with Clopidogrel in High-Risk Patients with Recent Transient Ischaemic Attack or Ischaemic Stroke (MATCH): Study Design and Baseline Data

2003 ◽  
Vol 17 (2-3) ◽  
pp. 253-261 ◽  
Author(s):  
Hans-Christoph Diener ◽  
Julien Bogousslavsky ◽  
Lawrence M. Brass ◽  
Claudio Cimminiello ◽  
Laszlo Csiba ◽  
...  
Keyword(s):  
High Risk ◽  
Ischaemic Stroke ◽  
Study Design ◽  
Transient Ischaemic Attack ◽  
Baseline Data ◽  
High Risk Patients ◽  
Risk Patients ◽  
Ischaemic Attack

Dual antiplatelet therapy prolongation in high-risk patients with prior myocardial infarction: insights from the post-PCI registry

2020 ◽  
Vol 21 (8) ◽  
pp. 603-609 ◽  
Author(s):  
Marco Ferlini ◽  
Roberta Rossini ◽  
Giuseppe Musumeci ◽  
Stefano Cornara ◽  
Alberto Somaschini ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
High Risk ◽  
Antiplatelet Therapy ◽  
Dual Antiplatelet Therapy ◽  
High Risk Patients ◽  
Prior Myocardial Infarction ◽  
Risk Patients

scholarly journals Dual antiplatelet therapy with aspirin and clopidogrel for acute high risk transient ischaemic attack and minor ischaemic stroke: a clinical practice guideline

BMJ ◽  
2018 ◽  
pp. k5130 ◽  
Author(s):  
Kameshwar Prasad ◽  
Reed Siemieniuk ◽  
Qiukui Hao ◽  
Gordon Guyatt ◽  
Martin O’Donnell ◽  
...  
Keyword(s):  
High Risk ◽  
Ischaemic Stroke ◽  
Antiplatelet Therapy ◽  
Transient Ischaemic Attack ◽  
Dual Antiplatelet Therapy ◽  
Recurrent Stroke ◽  
Minor Stroke ◽  
Strong Recommendation ◽  
Ischaemic Attack

What is the role of dual antiplatelet therapy after high risk transient ischaemic attack or minor stroke? Specifically, does dual antiplatelet therapy with a combination of aspirin and clopidogrel lead to a greater reduction in recurrent stroke and death over the use of aspirin alone when given in the first 24 hours after a high risk transient ischaemic attack or minor ischaemic stroke? An expert panel produced a strong recommendation for initiating dual antiplatelet therapy within 24 hours of the onset of symptoms, and for continuing it for 10-21 days. Current practice is typically to use a single drug

scholarly journals The impact of discontinuation of aspirin within 24 months among the high risk patients who are receiving prolonged dual antiplatelet therapy after implantation of second-generation drug-eluting stents

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S.W Cho ◽  
D.Y Kim ◽  
T.K Park ◽  
J.M Lee ◽  
J.H Yang ◽  
...  
Keyword(s):  
High Risk ◽  
Antiplatelet Therapy ◽  
Second Generation ◽  
Dual Antiplatelet Therapy ◽  
High Risk Patients ◽  
Cerebrovascular Events ◽  
Risk Patients ◽  
Drug Eluting ◽  
The Impact

Abstract Background The clinical impact of discontinuation of aspirin within 24 months after PCI for high risk patients who are receiving prolonged dual antiplatelet therapy (DAPT) is not known. We investigated the long-term outcomes prolonged DAPT among high risk patients after second-generation drug-eluting stent (DES) implantation. Methods and results Of 2082 consecutive patients undergoing PCI using 2nd generation DES, we studied 637 patients at high risk either angiographically or clinically who received clopidogrel longer than 24 months and were event-free at 12 months after index PCI. Patients were divided into 2 groups: the clopidogrel monotherapy group (aspirin discontinued within 24 months) and the prolonged DAPT group. The primary outcome was major adverse cardiac and cerebrovascular events (a composite of all-cause death, non-fatal myocardial infarction, or stroke) between 12 and 36 months after the index procedure. In propensity score-matched population, the risk of major adverse cardiac and cerebrovascular events (4.7%, 12/256 versus 4.3%, 11/256, hazard ratio (HR) 0.95, 95% confidence interval (CI) 0.42–2.16, p=0.91), all-cause mortality (3.1%, 8/256 versus 2.0%, 5/256, HR 0.70, CI 0.23–2.14), cardiovascular death (0.4%, 1/256 versus 0.8%, 2/256, HR 2.34, CI 0.21–25.80, p=0.49), non-fatal myocardial infarct (0.8%, 2/256 versus 0.4%, 1/256, HR 0.57, CI 0.05–6,32, p=0.65), stroke (0.8%, 2/256 versus 0.8%, 2/256, HR 1.09, CI 0.15–7.76, p=0.93) were not significantly different between patients receiving clopidogrel monotherapy and prolonged DAPT. Conclusion Compared to prolonged DAPT, aspirin discontinuation 12–24 months after PCI for high risk patients who received DAPT has similar long-term risk of major adverse cardiac and cerebrovascular events in patients after second-generation DES implantation. Funding Acknowledgement Type of funding source: None

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