scholarly journals A case of primary lung cancer treated without interruption of aspirin monotherapy after dual antiplatelet therapy following myocardial infarction

2020 ◽  
Vol 34 (5) ◽  
pp. 358-363
Author(s):  
Akihiro Yonei ◽  
Hirokazu Moriyama
Keyword(s):  
Myocardial Infarction ◽  
Lung Cancer ◽  
Antiplatelet Therapy ◽  
Dual Antiplatelet Therapy ◽  
Primary Lung Cancer

Abstract 9634: As Compared With Cardiac Magnetic Resonance Imaging, Transthoracic Echocardiography Has an Excellent Accuracy in Diagnosing a Left Ventricular Thrombus After an Anterior Myocardial Infarction Complicated With Left Ventricular Dysfunction: Results of a Prospective Multicentric Study

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Philippe Meurin ◽  
Virginie Brandao Carreira ◽  
Raphaelle D Dumaine ◽  
Alain Shqueir ◽  
Olivier Milleron ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Myocardial Infarction ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Cardiac Magnetic Resonance Imaging ◽  
Antiplatelet Therapy ◽  
Transthoracic Echocardiography ◽  
Dual Antiplatelet Therapy ◽  
Left Ventricular ◽  
Resonance Imaging

Introduction: The generalization of reperfusion techniques to treat acute myocardial infarction (MI) has allowed for markedly reduced incidence in left ventricular (LV) thrombi because of the reduced myocardial damage. LV thrombi are estimated to complicate 5% to 10% of unselected anterior-wall MI (Ant-MI). However, the incidence and evolution of LV thrombi in high-risk patients with Ant-MI complicated by LV systolic dysfunction is not well known. Cardiac magnetic resonance imaging with contrast delayed enhancement (CMR-DE) is the gold standard in assessing LV thrombus, but comparisons of transthoracic echocardiography (TTE) and CMR-DE are scarce. Hypothesis: We assessed whether LV thrombi are still frequent after major Ant-MI, despite systematic dual antiplatelet therapy, and whether focused TTE has a good accuracy for detection as compared with CMR-DE. Methods: From 2011 to 2013, from 7 centers, we prospectively included patients with LV ejection fraction (LVEF) < 45% at a first TTE performed < 7 days after Ant-MI. A second evaluation including TTE and CMR-DE (analyzed by blinded examiners) was performed at 30 days. A third TTE and assessment of clinical status and adverse events were performed between months 6 and 12. Results: We included 100 consecutive patients (71% males; mean age 59.1 ± 12.1 years; LVEF 33.5 ± 6.0%) at a mean of 4.8 ± 1.9 days after Ant-MI; 88% had undergone primary coronary angioplasty. In total, 26 patients had LV thrombi detected at a mean of 23.2 ± 34.8 days after MI (6 during the first week after the MI, 16 from days 8 to 30, 4 after day 30). As compared with CMR-DE, TTE sensitivity and specificity were 94.7% and 98.5%, respectively. For 24 patients (92.3%), the LV thrombi disappeared with triple antithrombotic therapy including dual antiplatelet therapy and a vitamin K antagonist. One patient died from a recurrent subdural haematoma and another had a peripheral embolism. Conclusions: In this prospective multicenter study, LV thrombus occurred in 26% of patients after Ant-MI complicated by LV dysfunction. Focused TTE has a high accuracy for detection. CMR-DE should be performed only when the apex is not clearly seen.

scholarly journals COST-EFFECTIVENESS OF SHORTER DURATIONS OF TICAGRELOR-BASED DUAL ANTIPLATELET THERAPY FOLLOWING MYOCARDIAL INFARCTION

2019 ◽  
Vol 35 (10) ◽  
pp. S39-S40
Author(s):  
D. Dinea ◽  
A. Matteau ◽  
D. Mitchell ◽  
M. Durand ◽  
S. Mansour ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cost Effectiveness ◽  
Antiplatelet Therapy ◽  
Dual Antiplatelet Therapy

scholarly journals Myocardial Metastasis from Primary Lung Cancer: Myocardial Infarction-like ECG Changes and Pathologic Findings.

1991 ◽  
Vol 30 (3) ◽  
pp. 213-218 ◽  
Author(s):  
Shosaku ABE ◽  
Naomi WATANABE ◽  
Shigeaki OGURA ◽  
Hiroshi KUNIKANE ◽  
Hiroshi ISOBE ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Lung Cancer ◽  
Primary Lung Cancer ◽  
Ecg Changes ◽  
Pathologic Findings ◽  
Myocardial Metastasis

scholarly journals Six months versus 12 months dual antiplatelet therapy after drug-eluting stent implantation in ST-elevation myocardial infarction (DAPT-STEMI): randomised, multicentre, non-inferiority trial

BMJ ◽  
2018 ◽  
pp. k3793 ◽  
Author(s):  
Elvin Kedhi ◽  
Enrico Fabris ◽  
Martin van der Ent ◽  
Pawel Buszman ◽  
Clemens von Birgelen ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Confidence Interval ◽  
Antiplatelet Therapy ◽  
Primary Endpoint ◽  
Second Generation ◽  
Dual Antiplatelet Therapy ◽  
Drug Eluting Stents ◽  
Primary Pci ◽  
Drug Eluting ◽  
St Elevation

Abstract Objective To show that limiting dual antiplatelet therapy (DAPT) to six months in patients with event-free ST-elevation myocardial infarction (STEMI) results in a non-inferior clinical outcome versus DAPT for 12 months. Design Prospective, randomised, multicentre, non-inferiority trial. Setting Patients with STEMI treated with primary percutaneous coronary intervention (PCI) and second generation zotarolimus-eluting stent. Participants Patients with STEMI aged 18 to 85 that underwent a primary PCI with the implantation of second generation drug-eluting stents were enrolled in the trial. Patients that were event-free at six months after primary PCI were randomised at this time point. Interventions Patients that were taking DAPT and were event-free at six months were randomised 1:1 to single antiplatelet therapy (SAPT) (ie, aspirin only) or to DAPT for an additional six months. All patients that were randomised were then followed for another 18 months (ie, 24 months after the primary PCI). Main outcome measures The primary endpoint was a composite of all cause mortality, any myocardial infarction, any revascularisation, stroke, and thrombolysis in myocardial infarction major bleeding at 18 months after randomisation. Results A total of 1100 patients were enrolled in the trial between 19 December 2011 and 30 June 2015. 870 were randomised: 432 to SAPT versus 438 to DAPT. The primary endpoint occurred in 4.8% of patients receiving SAPT versus 6.6% of patients receiving DAPT (hazard ratio 0.73, 95% confidence interval 0.41 to 1.27, P=0.26). Non-inferiority was met (P=0.004 for non-inferiority), as the upper 95% confidence interval of 1.27 was smaller than the prespecified non-inferiority margin of 1.66. Conclusions DAPT to six months was non-inferior to DAPT for 12 months in patients with event-free STEMI at six months after primary PCI with second generation drug-eluting stents. Trial registration Clinicaltrials.gov NCT01459627 .

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