Consensus Document ANMCO/ANCE/ARCA/GICR-IACPR/GISE/SICOA: Long-term Antiplatelet Therapy in Patients with Coronary Artery Disease

Gulizia, Michele Massimo; Colivicchi, Furio; Abrignani, Maurizio Giuseppe; Ambrosetti, Marco; Aspromonte, Nadia; Barile, Gabriella; Caporale, Roberto; Casolo, Giancarlo; Chiuini, Emilia; Lenarda, Andrea Di; Faggiano, Pompilio; Gabrielli, Domenico; Geraci, Giovanna; Manna, A.; Maggioni, Aldo P.; Marchese, Alfredo; Massari, Ferdinando; Mureddu, Gian Francesco; Musumeci, Giuseppe; Nardi, Federico; Panno, Antonio Vittorio; Pedretti, Roberto F.E.; Piredda, Massimo; Pusineri, Enrico; Riccio, Carmine; Rossini, Roberta; Uccio, Fortunato Scotto di; Urbinati, Stefano; Varbella, Ferdinando; Zito, Giovanni; Luca, Leonardo De

doi:10.1093/eurheartj/suy019

Cited by 32 publications

(20 citation statements)

References 380 publications

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“…As is the case with percutaneous coronary intervention, the use of anticoagulants (warfarin sodium) or dual antiplatelet therapy (aspirin and clopidogrel) should be considered to prevent early stent occlusion. 11 However, those therapies were not initiated in our case because of risk of rebleeding during further endoscopic procedure. Therefore, aspirin alone was used as antiplatelet therapy in our case.…”

Section: Discussionmentioning

confidence: 90%

Stent-graft placement for treatment of massive hemobilia caused by porto-biliary fistula

Takahashi

Sato

Hara

et al. 2019

Int J Gastrointest Interv

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Proton beam therapy is a type of radiation therapy and a promising modality for cancer management because it involves few adverse effects and high therapeutic efficacy. However, there are reports of acute and late complications because of normal tissue damage. Hemobilia, known as bleeding from the biliary tree, is observed in various conditions, and it can also be of iatrogenic origin such as due to percutaneous hepatobiliary interventions. In most cases, it can be managed conservatively without significant hemorrhage. However, in a few cases with massive hemobilia, further intervention is necessary. We report the successful use of a stent-graft in the portal vein to treat massive hemobilia with porto-biliary fistula that was caused by previous proton beam therapy.

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Section: Discussionmentioning

confidence: 90%

Stent-graft placement for treatment of massive hemobilia caused by porto-biliary fistula

Takahashi

Sato

Hara

et al. 2019

Int J Gastrointest Interv

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“…The major limitation of the study is that patients put on 325 mg/day aspirin for 2 days and then switched to 100 mg aspirin q.d. The dose of 100 mg/day spirin is a low dose to observe angiotensin-converting enzyme inhibitor–aspirin interaction, 5 but the safest dose for long-term use is ⩽100 mg. 15 , 16 In addition, this was a retrospective study, and there was no control group. The study was performed for just 1 year, while the results of the SMILE study were evaluated after 5 years of follow-up.…”

Section: Discussionmentioning

confidence: 99%

Zofenopril versus ramipril in the early phase of acute myocardial infarction with systolic dysfunction: A retrospective study

Liu

Chu

et al. 2020

J Renin Angiotensin Aldosterone Syst

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Introduction: Prognostic benefits of zofenopril over ramipril in the early phase of acute myocardial infarction have been reported by the SMILE study, but these benefits have not been tested in clinical practice in the Chinese population. The objective of this study was to compare the effectiveness and safety of zofenopril plus aspirin against ramipril plus aspirin in patients with acute myocardial infarction. Methods: Patients in the early phase of acute myocardial infarction received 30 mg zofenopril (ZF cohort, N=191) or 5 mg ramipril (RP cohort, N=256) b.i.d. plus 100 mg aspirin/day. Data regarding hospitalisation for cardiovascular disease, non-cardiovascular events and mortality were collected and analysed. Results: During 1 year of treatment, 47 (25%) patients in the ZF cohort and 97 (40%) patients in the RP cohort were hospitalised due to cardiovascular disease ( p=0.002), and three (2%) patients in the ZF cohort and 14 (6%) patients in the RP cohort died ( p=0.043). Lower incidences of dry cough ( p=0.001) and anaemia ( p=0.049) were reported in the ZF cohort. Conclusions: The study recommends zofenopril with 100 mg aspirin for a longer period in patients with acute myocardial infarction with systolic dysfunction.

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“…Thus, ADP is the P2Y12 receptor agonist, while adenosine triphosphate (ATP) is the receptor antagonist that increases the production of cAMP and therefore reduces platelet aggregation. (Gulizia et al 2018) Clopidogrel has been widely studied and shown to reduce cardiovascular events among patients with atherosclerotic disease. Among high-risk patients with ischemic stroke, MI, or established PAD, clopidogrel monotherapy was associated with a 7.9% relative risk reduction in MI, ischemic stroke, vascular death, or rehospitalization compared with aspirin.…”

Section: Clopidogrelmentioning

confidence: 99%

Antithrombotic regimens in patients after coronary artery bypass grafting and coronary endarterectomy

Kyuchukov¹,

Zheleva-Kyuchukova²,

G³

2020

PHAR

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Background: Coronary artery bypass grafting (CABG) remains the gold standard in the treatment of complex chronic forms of coronary heart disease (CHD). Coronary endarterectomy (CEAE) is a useful adjunctive technique to CABG in patients with diffuse coronary artery disease. In order to maintain the patency of the coronary arteries and graft conduits, various antithrombotic protocols have been introduced over the years, combining various antiplatelet and anticoagulant drugs, but still there is no consensus. Aim: The aim of the study is to compare results between two antithrombotic regimens after CEAE. The first one is a combination of acenocoumarol combined with acetylsalicylic acid (ASA), the second regimen is a dual antiplatelet therapy (DAPT) of clopidogrel combined with ASA. Material and methods: We retrospectively reviewed 56 consecutive patients (60 ± 8.2 years) undergoing isolated CABG in association with CEAE between January 2018 and December 2019. In the postoperative period, patients were divided into two groups according to the antithrombotic regimens described above. Twenty-four were in the ASA and acenocoumarol group (AA) and 32 were in the ASA and clopidogrel group (AC). Patients were followed up to 30 days after the operation and we access the mortality rate, new ECG changes, levels of myocardial fraction of creatinine phosphokinase (CPK-MB), left ventricular systolic function, pericardial or pleural effusions requiring drainage or revision for bleeding. Results: Operative mortality was 3,6 %. No differences in the antithrombotic efficacy of the two regimens. A significantly higher level of hemorrhagic complications was observed in the ASA + acenocoumarol treatment group. Conclusion: Dual antiplatelet therapy (DAPT) after CABG and coronary endarterectomy is an effective pharmacological regimen in regard to 30-day postoperative outcomes and is considerably safety in terms of bleeding complications.

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Consensus Document ANMCO/ANCE/ARCA/GICR-IACPR/GISE/SICOA: Long-term Antiplatelet Therapy in Patients with Coronary Artery Disease

Cited by 32 publications

References 380 publications

Stent-graft placement for treatment of massive hemobilia caused by porto-biliary fistula

Stent-graft placement for treatment of massive hemobilia caused by porto-biliary fistula

Zofenopril versus ramipril in the early phase of acute myocardial infarction with systolic dysfunction: A retrospective study

Antithrombotic regimens in patients after coronary artery bypass grafting and coronary endarterectomy

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