Dual Antiplatelet Therapy

Ziada, Khaled M.; Moliterno, David J.

doi:10.1001/jama.2019.7025

Cited by 9 publications

(2 citation statements)

References 22 publications

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“…To do so, it is necessary to identify the subjects most at risk and to evaluate all relevant therapeutic optimizations, including the duration of dual antiplatelet therapy (DAPT) with aspirin and a P2Y 12 inhibitor in subsets of patients at high ischemic risk in the absence of a concomitant high hemorrhagic risk [6][7][8]. Both the American College of Cardiology/American Heart Association (ACC/AHA) and the ESC GLs recommend treatment with DAPT based on acetylsalicylic acid (ASA, aspirin) and an oral platelet adenosine diphosphate receptor (P2Y 12 ) inhibitor) for 12 months after the acute event, unless a high 2 of 16 hemorrhagic risk is present or unless there is a need for surgery that cannot be deferred within this time [9,10].…”

Section: Introductionmentioning

confidence: 99%

A Therapeutic Pathway in Patients with Chronic Coronary Syndromes: Proposal for Optimization

Caterina

Calabrò

Campo

et al. 2022

JCM

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There is uncertainty in cardiologists’ attitudes for prolonging dual antiplatelet therapy (DAPT) with ticagrelor 60 mg beyond 12 months in post-myocardial infarction (MI) patients. We aimed at characterizing the Italian cardiologists’ perceptions and needs in the management of such patients. Two consecutive questionnaires were proposed between June and November 2021, and compiled by 122 and 87 Cardiologists, respectively. Agreement among cardiologists was defined as either a >70% frequency of concordant responses relative to total respondents or following the Delphi method as developed by the RAND Corporation. An agreement was reached on the indication of ticagrelor as the first choice P2Y12 inhibitor in MI patients, irrespective of the presentation [ST elevation MI (STEMI), 72%, vs. non-ST elevation MI (NSTEMI), 71%] or the management [invasive vs. conservative (75%)]. A consensus was also achieved on the possibility to consider a patient suitable for long-term DAPT with ticagrelor 60 mg even in case of another P2Y12 inhibitor used in the first year after the acute event (74, 85%). To define ischemic and bleeding risks, a consensus was reached on the utilization of one or more scores (87, 71%).

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Section: Introductionmentioning

confidence: 99%

A Therapeutic Pathway in Patients with Chronic Coronary Syndromes: Proposal for Optimization

Caterina

Calabrò

Campo

et al. 2022

JCM

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“…2,3 The recognition of the higher risk of stent thrombosis following PCI led to the recommendation of the use of dual antiplatelet therapy (DAPT), a combination of aspirin and antagonists of the platelet ADP receptor P2Y12. 4 Clopidogrel is a common component of DAPT that exhibited high efficacy in prevention stent thrombosis when administrated for 12 months after PCI. 5 Nevertheless, the current body of published literature demonstrated that poor response to DAPT, usually indicated by platelet function tests, is associated with a significant increase in the risk of stent thrombosis.…”

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confidence: 99%

Clopidogrel Responsiveness in Patients Undergoing Percutaneous Coronary Intervention using Multiplate Analyzer: Frequency and Outcomes

Khadim,

Farhan,

et al. 2023

IJDDT

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Objectives: Over and under response to dual antiplatelet therapy (DAPT) can lead to bleeding and thrombotic events in patients undergoing coronary stent placement. The present study aimed to assess the platelet response to clopidogrel in patient undergoing percutaneous coronary intervention (PCI) using Multiplate Analyzer. The primary outcome in the present study was the short-term incidence of stent thrombosis and bleeding events. Background: Multiple electrode aggregometry is a rapid and standardized tool to for diagnosis of platelet defects and monitoring response to DAPT. Methods: A hospital-based, prospective study was conducted on 431 patients who underwent PCI from September 2016 to November 2017 and received clopidogrel therapy. The platelet aggregometry was done using a Multiplate analyzer (Dynabyte, Munich, Germany). Patients were followed for 30 days to assess the incidence of stent thrombosis and bleeding. Results: The patients’ mean age was 58 ± 6.7 years. A total of 40% of the patients were diabetic and 7.7% had chronic renal failure. The rate of clopidogrel non-responders was 10.7%, while clopidogrel over-responders were 18.3%. Patients with diabetes and chronic renal failure had significantly lower platelet responsiveness (40.1% with p < 0.05 and 7.7% with p <0.005, respectively). Smoking was significantly associated with platelet over-responsiveness (39.4%, p < 0.001). Patients with low platelet responsiveness to clopidogrel were associated with an increased risk of definite stent thrombosis (p < 0.005), while increasing bleeding risk was significantly associated with over-responsiveness to patients to clopidogrel (p <0.001). Conclusions: Antiplatelet responsiveness showing individual variability with increased risk of stent thrombosis among the cases with no response to the effect of clopidogrel and high risk of bleeding with the over-responsiveness group.

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Short-term dual antiplatelet therapy (DAPT) followed by P2Y12 monotherapy versus traditional DAPT in patients undergoing percutaneous coronary intervention: meta-analysis and viewpoint

Wernly

Rezar

Gurbel³

et al. 2019

J Thromb Thrombolysis

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Dual Antiplatelet Therapy

Cited by 9 publications

References 22 publications

A Therapeutic Pathway in Patients with Chronic Coronary Syndromes: Proposal for Optimization

A Therapeutic Pathway in Patients with Chronic Coronary Syndromes: Proposal for Optimization

Clopidogrel Responsiveness in Patients Undergoing Percutaneous Coronary Intervention using Multiplate Analyzer: Frequency and Outcomes

Short-term dual antiplatelet therapy (DAPT) followed by P2Y12 monotherapy versus traditional DAPT in patients undergoing percutaneous coronary intervention: meta-analysis and viewpoint

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