2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention: Executive Summary

Levine, Glenn N.; Bates, Eric R.; Blankenship, James C.; Bailey, Steven R.; Bittl, John A.; Cercek, Bojan; Chambers, Charles E.; Ellis, Stephen G.; Guyton, Robert A.; Hollenberg, Steven M.; Khot, Umesh N.; Lange, Richard A.; Mauri, Laura; Mehran, Roxana; Moussa, Issam; Mukherjee, Debabrata; Nallamothu, Brahmajee K.; Ting, Henry H.

doi:10.1016/j.jacc.2011.08.006

Cited by 117 publications

(27 citation statements)

References 439 publications

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“…Coronary heart disease affects 30% to 60% of patients with end‐stage renal disease (ESRD) on dialysis, and the number of percutaneous coronary interventions (PCI) in these patients has increased by nearly 50% over the past decade . After PCI with stent placement, clinical practice guidelines recommend dual antiplatelet therapy with aspirin and either a thienopyridine (clopidogrel, ticlopidine, or prasugrel) or ticagrelor for at least 1 month and up to 12 months after receipt of bare‐metal stents (BMS), and for at least 12 months following insertion of drug‐eluting stents (DES) to prevent stent thrombosis, provided that the patient is not at increased risk for bleeding . These guidelines were based on studies conducted in patients without significant kidney disease.…”

Section: Introductionmentioning

confidence: 99%

Thienopyridine Use After Coronary Stenting in Low Income Patients Enrolled in Medicare Part D Receiving Maintenance Dialysis

Chang

Montez‐Rath

Shen

et al. 2014

JAHA

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BackgroundCoronary stenting in patients on dialysis has increased by nearly 50% over the past decade, despite heightened risks of associated stent thrombosis and bleeding relative to the general population. We examined clopidogrel, prasugrel or ticlopidine use after percutaneous coronary intervention (PCI) with stenting in patients on dialysis. We conducted 3‐, 6‐, and 12‐month landmark analyses to test the hypothesis that thienopyridine discontinuation prior to those time points would be associated with higher risks of death, myocardial infarction, or repeat revascularization, and a lower risk of major bleeding episodes compared with continued thienopyridine use.Methods and ResultsUsing the US Renal Data System, we identified 8458 patients on dialysis with Medicare Parts A+B+D undergoing PCI with stenting between July 2007 and December 2010. Ninety‐nine percent of all thienopyridine prescriptions were for clopidogrel. At 3 months, 82% of patients who received drug‐eluting stents (DES) had evidence of thienopyridine use. These proportions fell to 62% and 40% at 6 and 12 months, respectively. In patients who received a bare‐metal stent (BMS), 70%, 34%, and 26% of patients had evidence of thienopyridine use at 3, 6, and 12 months, respectively. In patients who received a DES, there was a suggestion of higher risks of death or myocardial infarction associated with thienopyridine discontinuation in the 3‐, 6‐, and 12‐months landmark analyses, but no higher risk of major bleeding episodes. In patients who received a BMS, there were no differences in death or cardiovascular events, and possibly lower risk of major bleeding with thienopyridine discontinuation in the 3‐ and 6‐month landmark analyses.ConclusionsThe majority of patients on dialysis who undergo PCI discontinue thienopyridines before 1 year regardless of stent type. While not definitive, these data suggest that longer‐term thienopyridine use may be of benefit to patients on dialysis who undergo PCI with DES.

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Section: Introductionmentioning

confidence: 99%

Thienopyridine Use After Coronary Stenting in Low Income Patients Enrolled in Medicare Part D Receiving Maintenance Dialysis

Chang

Montez‐Rath

Shen

et al. 2014

JAHA

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“…One of the tenets of the conservative management of non-CLs is the concern over unnecessary risk involved with an extended index procedure at the time of acute STEMI revascularization. [11][12][13] Placing multiple stents requires a longer procedure increasing risks associated with both contrast load and fluoroscopic time.…”

Section: The Risk Of Non-cardiac Side Effectsmentioning

confidence: 99%

“…[11][12][13] Functional flow resistance (FFR) studies are now emerging which suggest that the functional stenosis of non-CLs are indeed often over estimated on angiogram after acute STEMI. 28 The concept of preventative PCI introduced by PRAMI implies that non-CLs will develop into more serious disease at a later date.…”

Section: Future Development Of This Researchmentioning

confidence: 99%

“…[11][12][13][14] Currently there is debate regarding management strategy for angiographically significant coronary artery lesions neighboring the CL but not implicated in the infarct i.e. a non-culprit lesion (non-CL).…”

Section: Introductionmentioning

confidence: 99%

“…Practice guidelines from both the European Society of Cardiology (ESC) and the American Heart Association (AHA) do not endorse reperfusion of significant non-CLs except in the circumstance of cardiogenic shock and persistent ischemia after PCI (ESC), or hemodynamic compromise (AHA). [11][12][13][14] There is a suggestion that in the current era of drug eluting stents, the current guidelines espousing conservative management of non-CLs is outdated. This refers to the argument that modern drug-eluting stents make the risk of avoiding in-stent restenosis obsolete.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Management and outcomes of significant non-culprit coronary artery lesions in STEMI: a retrospective cohort study

Weitemeyer¹,

Murphy²,

Gillen³

et al. 2015

ICFJ

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BackgroundIn the setting of ST-elevation myocardial infarction (STEMI) and multi-vessel disease (MVD), guidelines recommend revascularization of the culprit lesion (CL) only, due to poor evidence supporting intervention in non-culprit lesions (non-CLs) during the same index procedure. Debate over management for significant non-CLs is of interest i.e. medical management vs. percutaneous revascularization. We describe a cohort of patients with STEMI and MVD and compare the occurrence of major adverse cardiac events (MACE) by therapeutic strategies for non-CLs with regard to follow-up outcomes.

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Percutaneous Coronary Interventions and Complications, Intra‐Aortic Balloon Pump, Ventricular Assist Devices, and Fractional Flow Reserve

2017

Practical Cardiovascular Medicine

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2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention: Executive Summary

Cited by 117 publications

References 439 publications

Thienopyridine Use After Coronary Stenting in Low Income Patients Enrolled in Medicare Part D Receiving Maintenance Dialysis

Thienopyridine Use After Coronary Stenting in Low Income Patients Enrolled in Medicare Part D Receiving Maintenance Dialysis

Management and outcomes of significant non-culprit coronary artery lesions in STEMI: a retrospective cohort study

Percutaneous Coronary Interventions and Complications, Intra‐Aortic Balloon Pump, Ventricular Assist Devices, and Fractional Flow Reserve

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