Download or read book Dual pathway Antithrombotic Therapy in Patients with Atrial Fibrillation After Percutaneous Coronary Intervention in Stable Coronary Artery Disease a Single center Single operator Retrospective Cohort Study written by Lukas Andreas Heger and published by . This book was released on 2020 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Antithrombotic Therapy written by Richard C. Becker and published by Professional Communications. This book was released on 2010-12-31 with total page 466 pages. Available in PDF, EPUB and Kindle. Book excerpt: Clinical application of antithrombotic therapy in both arterial disease (acute coronary syndromes, acute MI, peripheral arterial disease, valvular heart disease, atrial fibrillation) and venous disease, (venous thromboembolic disease and pulmonary embolism). Results of major clinical trials and their implications for clinical practice.

Download or read book Atrial Fibrillation and Percutaneous Coronary Intervention written by Andrea Rubboli and published by Springer. This book was released on 2016-11-30 with total page 217 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book considers paradigmatic clinical cases in order to cast light on key issues relating to elective or emergency stent implantation and the use of oral anticoagulation (OAC) in patients with atrial fibrillation. The topics addressed include the optimal periprocedural antithrombotic treatment (uninterrupted vs interrupted OAC, intraprocedural use of heparin and glycoprotein IIb/IIIa inhibitors, etc.), the most appropriate type of stent (bare metal vs drug eluting vs “bioactive”), the optimal regimen (e.g., triple therapy of OAC, aspirin, and clopidogrel vs the combination of OAC and a single antiplatelet agent), and the most suitable duration of the antithrombotic treatment prescribed at discharge (1 vs 6–12 months). The case-based management recommendations will be of wide practical value in the current health care context, where percutaneous coronary intervention is available even to patients with relevant co-morbidities, such as those warranting long-term OAC, and the indications for OAC are much broader than in the past. The book will appeal especially to clinical and interventional cardiologists, internal medicine specialists, hematologists, and family physicians and will also be of interest to cardiology and internal medicine residents and fellows.

Download or read book Dual Antiplatelet Therapy for Coronary and Peripheral Arterial Disease written by Sorin Brener and published by Academic Press. This book was released on 2021-01-09 with total page 222 pages. Available in PDF, EPUB and Kindle. Book excerpt: Dual Antiplatelet Therapy for Coronary and Peripheral Arterial Disease is a complete reference containing updated information on the advantages and disadvantages of dual antiplatelet therapy, its duration, composition and anticipated changes. The basis for DAPT in arterial disease is discussed, allowing readers to understand platelet physiology and its relevance to ischemic events. Data on shorter than usual duration of DAPT, and on extended therapy beyond the recommendation of current guidelines is presented in great detail, summarizing a large body of evidence into concrete, relevant recommendation that is readily adaptable by practicing clinicians. A clinically relevant and updated compendium of data pertaining to this field is also presented, as well as the anticipated trends and innovations likely to occur in the next 3-5 years. Summarizes a large body of evidence into concrete, relevant recommendations that is readily adapted by practicing clinicians Explores the current status of DAPT, controversial topics, and future developments and trends in this field Edited and contributed by renowned cardiologists in the field

Download or read book Antiplatelet and Anticoagulation Therapy In PCI An Issue of Interventional Cardiology Clinics E Book written by Dominick J. Angiolillo and published by Elsevier Health Sciences. This book was released on 2016-11-26 with total page 185 pages. Available in PDF, EPUB and Kindle. Book excerpt: This issue of Interventional Cardiology Clinics, edited by Drs. Dominick Angiolillo and Matthew Price, will focus on Antiplatelet and Anticoagulation Therapy in PCI. The topics covered in this volume will span across pretreatment with antiplatelet agents; optimal duration of antiplatelet therapy after PCI; Cangrelor and its role in percutaneous coronary intervention; Ticagrelor and its effects beyond the P2Y12 receptor; dyspnea and Reversibly-binding P2Y12 antagonists; PAR receptor inhibition post-PCI; switching P2Y12 receptor inhibiting therapies; antiplatelet and antithrombotic therapy in patients with atrial fibrillation undergoing coronary stenting; antithrombotic therapy to reduce ischemic events in ACS patients undergoing PCI; and the current role of platelet function testing in PCI and CABG, among other topics.

Download or read book Antiplatelet Therapy in ACS and A Fib written by Victor L. Serebruany and published by Karger Medical and Scientific Publishers. This book was released on 2012 with total page 177 pages. Available in PDF, EPUB and Kindle. Book excerpt: Written by top experts in the field Platelets play a critical role in the pathophysiology of acute coronary syndromes (ACS) and thromboembolic complications associated with atrial fibrillation. Anticoagulant and antiplatelet therapies are central to the treatment of ACS and atrial fibrillation. Over the last several decades, a better understanding of the pathogenesis of coronary heart disease and atrial fibrillation has led to refinements in antithrombotic strategies and clinical outcomes. With this in mind, some of the issues outlined in this book are new insights in genetic testing and modification of individualized antiplatelet therapy based on rapid bedside platelet analyzers. Most importantly, the current update of pros and cons of novel antiplatelet agents such as prasugrel and ticagrelor are provided in detail. Conventional antiplatelet strategies with aspirin and clopidogrel are also discussed. Special attention is devoted to experimental antiplatelet agents like PAR-1 thrombin receptor antagonists or aptamers. The ability to focus on different diseases beyond ACS, including heart failure and atrial fibrillation, distinguishes this publication. Each chapter was written by top experts in the field and scientists with the utmost authority and expertise to provide cardiologists, internists, and clinical pharmacologists with the latest updates.

Download or read book Dual Antiplatelet Therapy Following Percutaneous Coronary Intervention written by and published by . This book was released on 2019 with total page 24 pages. Available in PDF, EPUB and Kindle. Book excerpt: Dual antiplatelet therapy (DAPT; combination of a P2Y12 inhibitor with ASA is generally given for six to 12 months following percutaneous coronary intervention (PCI) with stenting, with the aim of preventing stent thrombosis and major adverse cardiac and cerebrovascular events (MACCEs). However, debate is ongoing about the optimal duration of DAPT. Of note, patient characteristics may be an important factor in treatment duration decisions. In some settings, DAPT for less than six months may be appropriate (e.g., patients with high risk of bleeding), while other patients may derive greater benefit from extended DAPT, i.e., duration beyond 12 months (e.g., high risk of stent thrombosis and low risk of bleeding). Current guidelines recommend tailoring the length of DAPT depending on patient characteristics. The American College of Cardiology/American Heart Association (ACC/AHA) guidelines recommend DAPT for six months following PCI for patients with stable coronary artery disease and for 12 months in patients with acute coronary syndrome (ACS), with the consideration of extended DAPT beyond 12 months if potential thrombotic risk is high and bleeding risk is deemed low. Particularly, the use of the DAPT score as a potential means of identifying high-risk patients was emphasized. Similarly, the European Society of Cardiology (ESC) updated guidelines in 20173 also support a one-year minimum duration of DAPT for patients with ACS. Recent Canadian guidelines support an individualized approach to selecting DAPT duration, with different recommendations for patients with ACS or non-ACS indications at the time of PCI. Given the risk of developing stent thrombosis and de-novo recurrent ischemic events, evidence assessing the impact of extending the duration of DAPT beyond 12 months has been increasing during the last few years. Clinicians need to consider the potential benefits of extended DAPT alongside the associated bleeding risk to identify patients who are most likely to benefit. Also, in some jurisdictions, reimbursement of P2Y12 inhibitors after coronary stenting may be limited to 12 months, particularly reimbursement of prasugrel and ticagrelor. Accordingly, in 2018, CADTH undertook a systematic review of relevant randomized clinical trials (RCTs); a cost-utility analysis was also conducted to complement that work. Results from both assessments are available in a science report. Findings from this work were considered by the CADTH Canadian Drug Expert Committee (CDEC) to develop the recommendations that follow.

Download or read book Atrial Fibrillation written by National Collaborating Centre for Chronic Conditions (Great Britain) and published by Royal College of Physicians. This book was released on 2006 with total page 172 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Antiplatelet and Anticoagulant Therapy in Patients with Acute Coronary Syndromes and Atrial Fibrillation written by Aimee Fake and published by . This book was released on 2018 with total page 408 pages. Available in PDF, EPUB and Kindle. Book excerpt: Dual antiplatelet therapy (DAPT), consisting of aspirin and a P2Y12 receptor antagonist, is the standard of care following an acute coronary syndrome (ACS) presentation, and oral anticoagulation (OAC) is standard of care for stroke prevention in atrial fibrillation (AF) patients. In patients with AF who present with an ACS, it is not clear whether the combination of DAPT and OAC, known as triple therapy (TT), should be the preferred treatment strategy, or whether DAPT alone is optimal.The first two studies in this thesis examined contemporary antiplatelet/anticoagulant management in New Zealand. The first study examined management of 93 ACS patients with AF from a single-centre. We found DAPT was the preferred treatment regimen, and no TT use was observed. Decisions regarding therapy did not appear to be based on assessments of stroke or bleeding risk. In the second study, we utilised the national ANZACS-QI registry, and examined pharmacy prescription data for 610 ACS patients who underwent percutaneous coronary intervention (PCI) with a history of AF. In this cohort DAPT was again the most common discharge regimen followed by TT, and their use was not driven by stroke risk (CHA2DS2VASc scores). Rates of DAPT and TT declined markedly over the 12 months following the ACS event. On the basis of these two studies we concluded that no consistent treatment strategy was evident for the management of ACS patients with AF.A systematic literature review was then undertaken to identify optimal therapy. We selected papers describing treatment regimens and one-year outcomes for patients with AF and either ACS or PCI. The inclusion of stable PCI patients was necessary as the majority of literature featured mixed cohorts of ACS or stable coronary disease undergoing PCI. The identified literature was entirely observational in nature and the overall quality was poor. The largest studies reported that TT offered significant reductions in stroke over DAPT, and a consistent increase in bleeding associated with TT was reported.On the basis that the available literature did not offer clear guidance on when the benefits associated with stroke reduction with TT would be greater than the harm associated with excess bleeding, we constructed a decision analysis model. This model addressed likely thresholds at which TT stroke reduction may exceed harm from bleeding. Under most modelled scenarios TT was not preferred above DAPT at CHA2DS2VASc 2, and only outperformed DAPT when stroke risk was high in the CHA2DS2VASc 3-5 range.Given the importance of bleeding in determining the net clinical benefit of DAPT versus TT we examined how accurately bleeding events could be predicted in a cohort of 1000 acute myocardial infarction patients. We examined the ACS bleeding scores CRUSADE and ACTION as well as low platelet reactivity (LPR) to predict one-year TIMI major and minor bleeding. We found that neither score nor LPR accurately predicted one-year bleeding events.The clinical problem of optimal antiplatelet/anticoagulant therapy in ACS patients with AF remains significant. Our data suggests that at low stroke risks DAPT is probably the treatment of choice, with TT becoming more acceptable at higher stroke risk. Accurate classification of bleeding risk in this population is needed to minimise potential harms associated with TT.

Download or read book Treatment Related Stroke written by Alexander Tsiskaridze and published by Cambridge University Press. This book was released on 2016-12 with total page 289 pages. Available in PDF, EPUB and Kindle. Book excerpt: This major new book examines all causes of treatment-related stroke, highlighting therapeutic approaches.

Download or read book Ventricular Arrhythmias written by John M. Miller and published by . This book was released on 2008 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Ventricular arrhythmias cause most cases of sudden cardiac death, which is the leading cause of death in the US. This issue reviews the causes of arrhythmias and the promising new drugs and devices to treat arrhythmias.

Download or read book The ESC Textbook of Cardiovascular Medicine written by A. John Camm and published by . This book was released on 2019 with total page 3198 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Primary Angioplasty written by Timothy J Watson and published by Springer. This book was released on 2018-07-13 with total page 338 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book is open access under a CC BY 4.0 license. This quick-reference handbook offers a concise and practical review of key aspects of the treatment of ST-segment elevation myocardial infarction (STEMI) in the era of primary percutaneous coronary intervention (PPCI). In the context of STEMI, PPCI is the preferred mode of emergency revascularization. Access to PPCI is rapidly increasing and is now routinely practiced in both general and specialist hospitals and there has been a recent emphasis on developing STEMI networks to enhance and expedite the referral pathway. This coupled with concurrent developments to enhance the safety and efficacy of the PPCI procedure has heralded an era where STEMI interventions are increasingly considered an important subspecialty within interventional cardiology. Written by leading cardiologists who have been instrumental in the adoption of PPCI in their respective institutions, the book provides junior and senior cardiologists alike with insightful and thought-provoking tips and tricks to enhance the success of PPCI procedures, which may in turn translate into direct improvements in outcomes. The book is also relevant for healthcare providers and emergency department physicians.

Download or read book Percutaneous Revascularization Techniques written by Manuel Maynar-Moliner and published by Georg Thieme Verlag. This book was released on 1993 with total page 360 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Pharmacological Treatment of Chronic Stable Angina Pectoris written by Pablo Avanzas and published by Springer. This book was released on 2015-06-02 with total page 290 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book is intended for general cardiologists and other physicians involved in the care of patients with chronic stable angina (CSA). The goal of this book is to update clinicians on recent data on the medical management of patients with CSA. Ischemic heart disease remains a major public health problem. Chronic stable angina is the initial manifestation of ischemic heart disease in approximately one half of patients. Stable coronary artery disease is generally characterized by episodes of reversible myocardial demand/supply mismatch, related to ischaemia or hypoxia, which are usually inducible by exercise, emotion or other stress and reproducible—but, which may also be occurring spontaneously. Such episodes of ischaemia/hypoxia are commonly associated with transient chest discomfort (angina pectoris). The aim of the management of CSA is to reduce symptoms and improve prognosis. The management of these patients encompasses lifestyle modification, control of coronary artery disease risk factors, evidence-based pharmacological therapy and patient education. All patients with stable angina should be offered optimal medical treatment, defined as one or two anti-anginal drugs as necessary, plus drugs for secondary prevention of cardiovascular disease. Regarding the role of revascularization, randomised trials provide compelling evidence that myocardial revascularisation by coronary artery bypass grafting or by percutaneous coronary intervention improves symptoms of angina relative to continued medical treatment.

Download or read book Developing a Protocol for Observational Comparative Effectiveness Research A User s Guide written by Agency for Health Care Research and Quality (U.S.) and published by Government Printing Office. This book was released on 2013-02-21 with total page 236 pages. Available in PDF, EPUB and Kindle. Book excerpt: This User’s Guide is a resource for investigators and stakeholders who develop and review observational comparative effectiveness research protocols. It explains how to (1) identify key considerations and best practices for research design; (2) build a protocol based on these standards and best practices; and (3) judge the adequacy and completeness of a protocol. Eleven chapters cover all aspects of research design, including: developing study objectives, defining and refining study questions, addressing the heterogeneity of treatment effect, characterizing exposure, selecting a comparator, defining and measuring outcomes, and identifying optimal data sources. Checklists of guidance and key considerations for protocols are provided at the end of each chapter. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews. More more information, please consult the Agency website: www.effectivehealthcare.ahrq.gov)

Download or read book Cardiac Arrhythmias written by Ambrose S. Kibos and published by Springer Science & Business Media. This book was released on 2013-12-13 with total page 678 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book covers all the major aspects associated with pathophysiological development of cardiac arrhythmias (covering enhanced or suppressed automaticity, triggered activity, or re-entry), from basic concepts through disease association, limitations of current pharmacotherapy and implant therapies and on-going trials and analysis of new biomarkers based on current knowledge of cellular interaction and signalling. The book describes novel and state-of-the-art methods for differentiating between the major types of arrhythmia, structural abnormalities and current practice guidelines and determination of risk stratification associated with sudden cardiac death. A particular focus is on arrhythmias associated with atrial fibrillation and includes details of associations with cardiac disease, current detection, analysis and imaging and future perspectives.​