By Andrea Rubboli, Gregory Y. H. Lip
This booklet considers paradigmatic scientific circumstances to be able to solid gentle on key concerns on the subject of non-obligatory or emergency stent implantation and using oral anticoagulation (OAC) in sufferers with atrial traumatic inflammation. the themes addressed contain the optimum periprocedural antithrombotic therapy (uninterrupted vs interrupted OAC, intraprocedural use of heparin and glycoprotein IIb/IIIa inhibitors, etc.), the main acceptable kind of stent (bare steel vs drug eluting vs “bioactive”), the optimum routine (e.g., triple treatment of OAC, aspirin, and clopidogrel vs the mix of OAC and a unmarried antiplatelet agent), and the main appropriate length of the antithrombotic remedy prescribed at discharge (1 vs 6–12 months).
The case-based administration suggestions should be of large functional worth within the present wellbeing and fitness care context, the place percutaneous coronary intervention is accessible even to sufferers with proper co-morbidities, comparable to these warranting long term OAC, and the indicators for OAC are a lot broader than long ago. The e-book will allure in particular to scientific and interventional cardiologists, inner medication experts, hematologists, and kin physicians and also will be of curiosity to cardiology and inner medication citizens and fellows.
Read or Download Atrial Fibrillation and Percutaneous Coronary Intervention: A Case-based Guide to Oral Anticoagulation, Antiplatelet Therapy and Stenting PDF
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Extra resources for Atrial Fibrillation and Percutaneous Coronary Intervention: A Case-based Guide to Oral Anticoagulation, Antiplatelet Therapy and Stenting
Gao XF, Chen Y, Fan ZG, Jiang XM, Wang ZM, Li B, Mao WX, Zhang JJ, Chen SL. Antithrombotic regimens for patients taking oral anticoagulation after coronary intervention: a meta-analysis of 16 clinical trials and 9185 patients. Clin Cardiol. 2015;38:499–509. 26. Dans AL, Connolly SJ, Wallentin L, Yang S, Nakamya J, Brueckmann M, Ezekowitz M, Oldgren J, Eikelboom JW, Reilly PA, Yusuf S. Concomitant use of antiplatelet therapy with dabigatran or warfarin in the Randomized Evaluation of Long-Term Anticoagulation Therapy (RE-LY) trial.
Douketis JD, Spyropoulos AC, Kaatz S, Becker RC, Caprini JA, Dunn AS, Garcia DA, Jacobson A, Jaffer AK, Kong DF, Schulman S, Turpie AG, Hasselblad V, Ortel TL, BRIDGE Investigators. Perioperative bridging anticoagulation in patients with atrial fibrillation. N Engl J Med. 2015;373:823–33. 10. Windecker S, Kolh P, Alfonso F, Collet JP, Cremer J, Falk V, Filippatos G, Hamm C, Head SJ, Jüni P, Kappetein AP, Kastrati A, Knuuti J, Landmesser U, Laufer G, Neumann FJ, Richter DJ, Schauerte P, Sousa Uva M, Stefanini GG, Taggart DP, Torracca L, Valgimigli M, Wijns W, Witkowski A.
0) OAC with warfarin. 1 Periprocedural Management • Coronary angiography was scheduled 48 h after the last intake of dabigatran 150 mg. • No periprocedural LMWH bridging anticoagulation was arranged after dabigatran interruption. 24 P. Vranckx et al. • Front-loading with 600 mg of clopidogrel orally was performed the evening before the procedure. • Ongoing aspirin treatment was continued at the dose of 100 mg once daily. • Right radial access site was selected. 000 IU (about 50 IU/kg) of UFH was given through the arterial sheath at the beginning of procedure to prevent radial artery occlusion.