scholarly journals Evolving Concepts in Post-PCI Antiplatelets Therapy

2020 ◽  
Vol 1 (3-4) ◽  
pp. 186-194
Author(s):  
Kartik Pandurang Jadhav ◽  
Pankaj V. Jariwala

The standard duration dual antiplatelet therapy (DAPT) is considered as gold standard for post percutaneous coronary intervention (PCI) medical therapy, as mentioned in American College of Cardiology/American Heart Association 2016 and European Society of Cardiology 2017 guidelines. Recently it has been challenged, in terms of duration and composition of this therapy. Many newer regimens and therapeutic drugs are being tried in large randomized clinical trial studies and found to be as effective as DAPT if not superior. There is general trend to introduce better antiplatelets like P2Y12 inhibitor (prasugrel and ticagrelor) as monotherapy for longer duration and restricting use of aspirin beyond 3 months. This review article helps us in understanding the evolution of DAPT therapy, formation of guidelines, and what are the new and evolving concepts in post-PCI medical therapy.

2016 ◽  
Vol 2 (11) ◽  
Author(s):  
John Ambrose

<p>Acute myocardial infarction (AMI) and sudden cardiac death (SCD) contribute to the leading cause of mortality for adults in the United States – cardiovascular disease.  Over the last 3 decades, there have been tremendous improvements in our ability to: rapidly detect (eg. Troponin utilization) and treat acute coronary syndromes (eg.new medications, percutaneous coronary intervention), lower cardiovascular risk (eg. statins) and standardize cardiovascular care through widely available guideline-directed medical therapies.  Nevertheless, according to the American Heart Association, in 2010 there were still an estimated 915,000 new or recurrent AMIs and 278,000 SCD events.<sup>1</sup>So this begs the question, what more can we do to prevent devastating future acute coronary events?</p>


2001 ◽  
Vol 37 (8) ◽  
pp. 2215-2238 ◽  
Author(s):  
Sidney C Smith ◽  
James T Dove ◽  
Alice K Jacobs ◽  
J Ward Kennedy ◽  
Dean Kereiakes ◽  
...  

2020 ◽  
Vol 49 (03) ◽  
pp. 57-61
Author(s):  
Christoph B. Olivier ◽  
Christoph Bode ◽  
Daniel Dürschmied

ZUSAMMENFASSUNGDieser Artikel soll einen Überblick über klinische Studien des Jahres 2019 zur antithrombotischen Therapie kardiovaskulärer Erkrankungen geben. Im Jahr 2019 wurden auf den jährlichen Hauptkongressen der 3 international führenden kardiovaskulären Gesellschaften (American College of Cardiology, European Society of Cardiology und American Heart Association) 15 Studien zur antithrombotischen Therapie kardiovaskulärer Erkrankungen vorgestellt und in einer der führenden Fachzeitschriften veröffentlicht. Der Trend geht zu einer personalisierten antithrombotischen Therapie. Während eine verkürzte Dauer der Thrombozytenaggregationshemmung nach perkutaner Koronarintervention eher sicher erscheint, profitieren Patienten mit hohem individuellem ischämischen Risiko möglicherweise von einer verlängerten intensivierten antithrombotischen Therapie. Die Standardtherapie für Patienten mit Vorhofflimmern nach perkutaner Koronarintervention besteht aus einem Nicht-Vitamin-K-Antagonist oralen Antikoagulanz und einem P2Y12-Inhibitor. Nach 12 Monaten ohne neues Ereignis reicht bei den meisten dieser Patienten eine orale Antikoagulation ohne zusätzliche Thrombozytenaggregationshemmung aus. Nach Katheter-gestütztem Aortenklappenersatz kann für Patienten ohne Indikation für eine orale Antikoagulation eine Therapie mit 10 mg Rivaroxaban nicht empfohlen werden.


Circulation ◽  
2021 ◽  
Author(s):  
Jennifer S. Lawton ◽  
Jacqueline E. Tamis-Holland ◽  
Sripal Bangalore ◽  
Eric R. Bates ◽  
Theresa M. Beckie ◽  
...  

Aim: The executive summary of the American College of Cardiology/American Heart Association/Society for Cardiovascular Angiography and Interventions coronary artery revascularization guideline provides the top 10 items readers should know about the guideline. In the full guideline, the recommendations replace the 2011 coronary artery bypass graft surgery guideline and the 2011 and 2015 percutaneous coronary intervention guidelines. This summary offers a patient-centric approach to guide clinicians in the treatment of patients with significant coronary artery disease undergoing coronary revascularization, as well as the supporting documentation to encourage their use. Methods: A comprehensive literature search was conducted from May 2019 to September 2019, encompassing studies, reviews, and other evidence conducted on human subjects that were published in English from PubMed, EMBASE, the Cochrane Collaboration, CINHL Complete, and other relevant databases. Additional relevant studies, published through May 2021, were also considered. Structure: Recommendations from the earlier percutaneous coronary intervention and coronary artery bypass graft surgery guidelines have been updated with new evidence to guide clinicians in caring for patients undergoing coronary revascularization. This summary includes recommendations, tables, and figures from the full guideline that relate to the top 10 take-home messages. The reader is referred to the full guideline for graphical flow charts, supportive text, and tables with additional details about the rationale for and implementation of each recommendation, and the evidence tables detailing the data considered in the development of this guideline.


scholarly journals ACC/AHA guidelines for percutaneous coronary intervention (revision of the 1993 PTCA guidelines)31This document was approved by the American College of Cardiology Board of Trustees in April 2001 and by the American Heart Association Science Advisory and Coordinating Committee in March 2001.32When citing this document, the American College of Cardiology and the American Heart Association would appreciate the following citation format: Smith SC, Jr, Dove JT, Jacobs AK, Kennedy JW, Kereiakes D, Kern MJ, Kuntz RE, Popma JJ, Schaff HV, Williams DO. ACC/AHA guidelines for percutaneous coronary intervention: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1993 Guidelines for Percutaneous Transluminal Coronary Angioplasty). J Am Coll Cardiol 2001;37:2239i–lxvi.33This document is available on the ACC Web site at www.acc.organd the AHA Web site at www.americanheart.org(ask for reprint no. 71-0206). To obtain a reprint of the shorter version (executive summary and summary of recommendations) to be published in the June 15, 2001 issue of the Journal of the American College of Cardiology and the June 19, 2001 issue of Circulation for $5 each, call 800-253-4636 (US only) or write the American College of Cardiology, Educational Services, 9111 Old Georgetown Road, Bethesda, MD 20814-1699. To purchase additional reprints up to 999 copies, call 800-611-6083 (US only) or fax 413-665-2671; 1,000 or more copies, call 214-706-1466, fax 214-691-6342, or E-mail: [email protected](ask for reprint no. 71-0205).

2001 ◽  
Vol 37 (8) ◽  
pp. 2239 ◽  
Author(s):  
Sidney C. Smith ◽  
James T. Dove ◽  
Alice K. Jacobs ◽  
J. Ward Kennedy ◽  
Dean Kereiakes ◽  
...  

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