By Andrea Rubboli, Gregory Y. H. Lip
This ebook considers paradigmatic scientific situations with the intention to forged mild on key concerns with regards to optional or emergency stent implantation and using oral anticoagulation (OAC) in sufferers with atrial traumatic inflammation. the themes addressed contain the optimum periprocedural antithrombotic remedy (uninterrupted vs interrupted OAC, intraprocedural use of heparin and glycoprotein IIb/IIIa inhibitors, etc.), the main acceptable form of stent (bare steel vs drug eluting vs “bioactive”), the optimum routine (e.g., triple remedy of OAC, aspirin, and clopidogrel vs the combo of OAC and a unmarried antiplatelet agent), and the main compatible period of the antithrombotic remedy prescribed at discharge (1 vs 6–12 months).
The case-based administration innovations might be of huge sensible worth within the present future health care context, the place percutaneous coronary intervention is on the market even to sufferers with suitable co-morbidities, akin to these warranting long term OAC, and the symptoms for OAC are a lot broader than long ago. The e-book will charm in particular to medical and interventional cardiologists, inner drugs experts, hematologists, and family members physicians and also will be of curiosity to cardiology and inner medication citizens and fellows.
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Extra info for Atrial Fibrillation and Percutaneous Coronary Intervention: A Case-based Guide to Oral Anticoagulation, Antiplatelet Therapy and Stenting
Thromb Haemost. 2011;106:571–84. 24. Dewilde WJ, Oirbans T, Verheugt FW, Kelder JC, De Smet BJ, Herrman JP, Adriaenssens T, Vrolix M, Heestermans AA, Vis MM, Tijsen JG, van’t Hof AW, ten Berg JM, WOEST study investigators. Use of clopidogrel with or without aspirin in patients taking oral anticoagulant therapy and undergoing percutaneous coronary intervention: an open-label, randomised, controlled trial. Lancet. 2013;381:1107–15. 25. Gao XF, Chen Y, Fan ZG, Jiang XM, Wang ZM, Li B, Mao WX, Zhang JJ, Chen SL.
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Albeit in the different contexts of patients with no indication for OAC, long-term combination therapy of OAC and single antiplatelet appears, however, associated with a relevant incidence of bleeding, without apparent benefit on MACEs  and therefore should not be considered routinely [1–3]. 12) [1–3]. 1 Long-Term Management • Upon completion of the 1-year combined therapy of OAC and DAPT or single antiplatelet therapy, ongoing clopidogrel 75 m once daily was discontinued and dabigatran, after increasing of the dose to the initial 150 mg twice daily (given that conditions mandating the use of low dose, including age ≥80 years and/or concomitant use of P-glycoprotein inhibitors, like verapamil, amiodarone, or quinidine, were not present), prescribed lifelong.
Atrial Fibrillation and Percutaneous Coronary Intervention: A Case-based Guide to Oral Anticoagulation, Antiplatelet Therapy and Stenting by Andrea Rubboli, Gregory Y. H. Lip