Dual Antiplatelet Therapy for 6 Months vs 12 Months After New-generation Drug-eluting Stent Implantation: Matched Analysis of ESTROFA-DAPT and ESTROFA-2

Oteo-Domínguez, Juan Francisco; Hernández, Felipe; Camarero, Tamara García; Altisent, Omar Abdul‐Jawad; Crespo, Fernando Rivero; Cascon, Jose D.; Zavala, German; Gimeno, Federico; Moreno, Antonio L. Arrebola; Andraka, Leire; Menchero, Antonio Gómez; Bosa, Francisco; Carrillo, Xavier; Recalde, Ángel Sánchez; Alfonso, Fernándo; Prado, Armando Pérez de; Palop, Ramón Lopéz; Sanchis, Juan; Miguel, José Antonio Diarte de; Jiménez-Navarro, Manuel F.; Muñoz, Luz; Moreno, Antonio Ramírez; Marcos, Helena Tizón

doi:10.1016/j.rec.2015.01.008

Cited by 5 publications

(3 citation statements)

References 26 publications

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“…The observed low event rates in this acute MI population were mainly attributable to the DES used and not to the concomitant pharmacological therapy, which was quite traditional. 28 In addition, we observed no significant between-stent differences in clinical outcome among patients with STEMI and NSTEMI. The DUTCH PEERS trial enrolled a high proportion (45.1%) of patients with acute MI at presentation.…”

Section: Discussionmentioning

confidence: 54%

Resultados de los stents Resolute Integrity y Promus Element en el infarto de miocardio: análisis del ensayo aleatorizado DUTCH PEERS (TWENTE II )

Houwelingen

Lam

Löwik

et al. 2016

Revista Española de Cardiología

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Section: Discussionmentioning

confidence: 54%

Resultados de los stents Resolute Integrity y Promus Element en el infarto de miocardio: análisis del ensayo aleatorizado DUTCH PEERS (TWENTE II )

Houwelingen

Lam

Löwik

et al. 2016

Revista Española de Cardiología

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“…If the DAPT was discontinued after 90 d, it was safer[49]. A large multicenter study determined that the safety and efficacy of a 6-mo DAPT post implantation of new-generation DES was noninferior to that of a 12-mo DAPT[50]. …”

Section: Antiplatelet Medicationmentioning

confidence: 99%

Organ transplantation and drug eluting stents: Perioperative challenges

Dalal¹

2016

WJT

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Patients listed for organ transplant frequently have severe coronary artery disease (CAD), which may be treated with drug eluting stents (DES). Everolimus and zotarolimus eluting stents are commonly used. Newer generation biolimus and novolimus eluting biodegradable stents are becoming increasingly popular. Patients undergoing transplant surgery soon after the placement of DES are at increased risk of stent thrombosis (ST) in the perioperative period. Dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 inhibitor such as clopidogrel, prasugrel and ticagrelor is instated post stenting to decrease the incident of ST. Cangrelor has recently been approved by Food and Drug Administration and can be used as a bridging antiplatelet drug. The risk of ischemia vs bleeding must be considered when discontinuing or continuing DAPT for surgery. Though living donor transplant surgery is an elective procedure and can be optimally timed, cadaveric organ availability is unpredictable, therefore, discontinuation of antiplatelet medication cannot be optimally timed. The type of stent and timing of transplant surgery can be of utmost importance. Many platelet function point of care tests such as Light Transmittance Aggregrometry, Thromboelastography Platelet Mapping, VerifyNow, Multiple Electrode Aggregrometry are used to assess bleeding risk and guide perioperative platelet transfusion. Response to allogenic platelet transfusion to control severe intraoperative bleeding may differ with the antiplatelet drug. In stent thrombosis is an emergency where management with either a drug eluting balloon or a DES has shown superior outcomes. Post-transplant complications often involved stenosis of an important vessel that may need revascularization. DES are now used for endovascular interventions for transplant orthotropic heart CAD, hepatic artery stenosis post liver transplantation, transplant renal artery stenosis following kidney transplantation, etc. Several antiproliferative drugs used in the DES are inhibitors of mammalian target of rapamycin. Thus they are used for post-transplant immunosuppression to prevent acute rejection in recipients with heart, liver, lung and kidney transplantation. This article describes in detail the various perioperative challenges encountered in organ transplantation surgery and patients with drug eluting stents.

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“…[1,2] Unfortunately, this treatment regimen still fails to produce good antiplatelet effects in some patients, leading to further ischemic complications such as stent thrombosis, cardiovascular death, nonfatal myocardial infarction, and strokes. [3,4] Research has shown that these inconsistencies in complications, although using the same treatment regimen, could be partially linked to toxicities that arise in different individuals’ response to drugs. [5] Thus far, the exact mechanism of the interindividual variability has not yet been fully elucidated.…”

Section: Introductionmentioning

confidence: 99%

PIK3CG single nucleotide polymorphisms are associated with poor responsiveness to clopidogrel and increased risk of ischemia in patients with coronary heart disease

Zhuge

2017

Medicine

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show abstract

Dual Antiplatelet Therapy for 6 Months vs 12 Months After New-generation Drug-eluting Stent Implantation: Matched Analysis of ESTROFA-DAPT and ESTROFA-2

Cited by 5 publications

References 26 publications

Resultados de los stents Resolute Integrity y Promus Element en el infarto de miocardio: análisis del ensayo aleatorizado DUTCH PEERS (TWENTE II )

Resultados de los stents Resolute Integrity y Promus Element en el infarto de miocardio: análisis del ensayo aleatorizado DUTCH PEERS (TWENTE II )

Organ transplantation and drug eluting stents: Perioperative challenges

PIK3CG single nucleotide polymorphisms are associated with poor responsiveness to clopidogrel and increased risk of ischemia in patients with coronary heart disease

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