scholarly journals Stent Thrombosis Patients with Hyporesponsiveness to Clopidogrel, Prasugrel, and Ticagrelor: A Case Series Using Short Thromboelastography

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Bartosz Olechowski ◽  
Alexander Ashby ◽  
Nalyaka Sambu ◽  
Michael Mahmoudi ◽  
Nick Curzen
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndrome ◽  
Stent Thrombosis ◽  
Stent Implantation ◽  
Case Series ◽  
Coronary Intervention ◽  
Routine Practice ◽  
Coronary Syndrome ◽  
Percutaneous Coronary ◽  
First Time

Patients after percutaneous coronary intervention (PCI) with stent implantation and functional hyporesponsiveness to P2Y12inhibitors are at higher risk of ischaemic events, particularly stent thrombosis (ST). It is currently not routine practice to assess the functional response to these agents. However, concern over functional hyporesponsiveness to clopidogrel has led to widespread uptake of prasugrel and ticagrelor as the default P2Y12inhibitor after stent implantation in patients with acute coronary syndrome. Here we report, for the first time, 3 cases in which patients who have had ST exhibit hyporesponsiveness to clopidogrel, prasugrel, and ticagrelor.

Bleeding with Tirofiban During Percutaneous Coronary Intervention

2021 ◽  
Vol 15 (10) ◽  
pp. 2833-2834
Author(s):  
Muhammad Waqas ◽  
Muhammad Shahzad Azeem ◽  
Muhammad Qasim Khan
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndrome ◽  
Continuous Infusion ◽  
Case Series ◽  
Coronary Intervention ◽  
Male Gender ◽  
Coronary Syndrome ◽  
Percutaneous Coronary ◽  
Modern Era ◽  
Current Guidelines

Objective: To determine the frequency of bleeding with Tirofiban during percutaneous coronary intervention Methodology: In this case series (Descriptive) at Mayo Hospital, Cardiology Deptt. Lahore during the year 2018 and 2019, we enrolled a total of 385 cases of either gender with acute coronary syndrome(ACS) and undergoing percutaneous coronary intervention(PCI)were included. Preloading with aspirin 300 mg and clopidogrel 600 mg was done. Intravenous Tirofiban was given keeping in mind the current guidelines. Tirofiban was given as I/V bolus of 0.25 mcg/kg over 5 minutes during/before the start of PCI. It was followed by a continuous infusion of 0.125 mcg/kg/min for up to eighteen hours. Bleeding during and within 24 hours of percutaneous coronary intervention was noted according to BARC bleeding type Results: Mean age was 50.750± 5.63years. Male gender was dominant i.e. 85.7% as compare to 14.3% females. Bleeding was observed in 3.9% patients Conclusion: In acute coronary syndrome patients undergoing PCI, Tirofiban use was associated with bleeding. In the modern era of PCI, the judicious use of Tirofiban is safe. Keywords: Percutaneous coronary intervention, Tirofiban, Bleeding, Acute coronary syndrome

scholarly journals Primary percutaneous coronary intervention for acute coronary syndrome due to stent thrombosis

2013 ◽  
Vol 34 (suppl 1) ◽  
pp. P1264-P1264
Author(s):  
Z. Mehmedbegovic ◽  
A. Janicijevic ◽  
V. Dedovic ◽  
M. Zivkovic ◽  
D. Milasinovic ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndrome ◽  
Stent Thrombosis ◽  
Primary Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Coronary Syndrome ◽  
Percutaneous Coronary

scholarly journals Independent Predictors of Adverse Cardiovascular Events in Patients With Acute Coronary Syndrome After Percutaneous Coronary Intervention During Hospitalization

Kardiologiia ◽  
2018 ◽  
Vol 58 (12) ◽  
pp. 22-29 ◽  
Author(s):  
J. A. Mansurova ◽  
L. K. Karazhanova
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndrome ◽  
Regression Analysis ◽  
Stent Thrombosis ◽  
Cardiovascular Events ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Coronary Syndrome ◽  
Percutaneous Coronary

Purpose: to elucidate independent clinical and laboratory predictors of adverse cardiovascular events (ACVE) in patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI) with stenting in early inhospital period.Materials and methods. We included in this prospective single center study 130 patients with ACS who underwent PCI with stenting. All patients prior to and after PCI received dual antiplatelet therapy with acetylsalicylic acid and clopidogrel. In 12–48 hours after PCI we measured residual platelet reactivity (RPR) using light aggregometry. In 57 patients simultaneously we performed genotyping of CYP2C19*2 polymorphisms. The following ACVE were used as end­points and were registered during inhospital observation (mean duration 9.7±3.2 days): sudden death, stent thrombosis, arterial thrombosis of other localization, recurrent angina, cardiac rhythm disturbances requiring special therapy.Results. Repetitive ACVE were observed in 32 patients. According to unifactorial regression analysis risk factors of their development were, ADP F­induced RPR (р<0.001), levels of creatinine (р<0.001), hemoglobin (р<0.001), and glucose (р=0.026), age (р=0.01), iron­deficiency anemia (р=0.01), left ventricular ejection fraction (р=0.004), number of stents (р=0.015). According to results of multifactorial regression analysis independent predictors of ACVE were: ADP­induced RPR >76 % (р=0.003), levels of creatinine >189 µmol / L (р=0.003), and hemoglobin <114 g / L (р=0.004). Significant effect of homozygous carriage of CYP2C19*2 (G681A) (А / А) on development of stent thrombosis was also detected (р=0.028).Conclusion. ADP­induced RPR, levels of creatinine and hemoglobin were found to be independent predictors of inhospital ACVE after myocardial revascularization with stenting in patients with ACS.

scholarly journals The Clinical and Angiographic Outcomes of Postdilation after Percutaneous Coronary Intervention in Patients with Acute Coronary Syndrome: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Yan Li ◽  
Xiying Liang ◽  
Wenjiao Zhang ◽  
Xuan Qiao ◽  
Zhilu Wang
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndrome ◽  
Stent Thrombosis ◽  
Meta Analysis ◽  
Coronary Intervention ◽  
Target Vessel ◽  
Target Vessel Revascularization ◽  
Coronary Syndrome ◽  
Percutaneous Coronary

Objective. The effect of postdilation in patients with acute coronary syndrome is still controversial. This meta-analysis aims to analyze the clinical and angiographic outcomes of postdilation after percutaneous coronary intervention in patients with acute coronary syndrome. Methods. PubMed, Embase, the Cochrane Library, Web of Science, CNKI, and Wangfang databases were searched from inception to August 30, 2020. Eligible studies from acute coronary syndrome patients treated with postdilation were included. The primary clinical outcome was major adverse cardiovascular events (MACE), the secondary clinical outcomes comprised all-cause death, stent thrombosis, myocardial infarction, and target vessel revascularization, and the angiographic outcomes were no reflow and slow reflow. Results. 11 studies met inclusion criteria. In clinical outcomes, our pooled analysis demonstrated that the postdilation had a tendency of decreasing MACE (OR = 0.67, 95% CI 0.45–1.00; P  = 0.05) but significantly increased all-cause death (OR = 1.49, 95% CI 1.05–2.12; P  = 0.03). No significant difference existed in stent thrombosis (OR = 0.71, 95% CI 0.40–1.26; P  = 0.24), myocardial infarction (OR = 1.40, 95% CI 0.51–3.83; P  = 0.51), and target vessel revascularization (OR = 0.61, 95% CI 0.21–1.80; P  = 0.37) between postdilation and non-postdilation groups. In angiographic outcomes, there were no significant differences in no reflow (OR = 1.19, 95% CI 0.54–2.65; P  = 0.66) and slow reflow (OR = 1.12, 95% CI 0.93–1.35; P  = 0.24) between two groups. Conclusions. The postdilation tends to reduce the risk of MACE but significantly increases all-cause death, without significantly affecting stent thrombosis, myocardial infarction, target vessel revascularization, and coronary TIMI flow grade. However, more randomized controlled trials are required for investigating the effect of postdilation for patients with acute coronary syndrome (registered by PROSPERO, CRD42020160748).

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