JCS 2020 Guideline Focused Update on Antithrombotic Therapy in Patients With Coronary Artery Disease

Nakamura, Masato; Kimura, Kazuo; Kimura, Takeshi; Ishihara, Masaharu; Otsuka, Fumiyuki; Kozuma, Ken; Kosuge, Masami; Shinke, Toshiro; Nakagawa, Yoshihisa; Natsuaki, Masahiro; Yasuda, Satoshi; Akasaka, Takashi; Kohsaka, Shun; Haze, Kazuo; Hirayama, Atsushi

doi:10.1253/circj.cj-19-1109

Cited by 244 publications

(239 citation statements)

References 195 publications

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“…such national society to do so. 18 The present study has several novel aspects. First, the ARC-HBR criteria, originally developed to assess bleeding risk in patients after elective PCI, were applied to STEMI patients.…”

Section: Discussionmentioning

confidence: 90%

Predictive Ability of Academic Research Consortium for High Bleeding Risk Criteria in ST-Elevation Myocardial Infarction Patients Undergoing Primary Coronary Intervention

Fujii

Ikari

2021

Circ J

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Section: Discussionmentioning

confidence: 90%

Predictive Ability of Academic Research Consortium for High Bleeding Risk Criteria in ST-Elevation Myocardial Infarction Patients Undergoing Primary Coronary Intervention

Fujii

Ikari

2021

Circ J

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“…The clinically important factors were selected with reference to the Japanese guideline. 23 The software used for the statistical analysis was SAS Release 9.4 (SAS Institute, Cary, NC, USA). the dose can be increased up to 300 mg once daily; prasugrel 20 mg administered once as a loading dose, followed by 3.75 mg once daily as the maintenance dose.…”

Section: Discussionmentioning

confidence: 99%

“…DAPT for HBR patients, the present findings suggest that P2Y12 monotherapy with prasugrel after short-term DAPT may be a suitable treatment option. 23 Multivariate analysis revealed that the ARC-HBR score was an independent risk factor for CRB even in patients who received P2Y12 inhibitor monotherapy. The Kaplan-Meier curve revealed that among patients who were unsuitable for long-term DAPT therapy, those with ARC-HBR had a higher risk of CRB ( Supplementary Figure).…”

Section: Advance Publicationmentioning

confidence: 95%

Monotherapy With Prasugrel After Dual-Antiplatelet Therapy for Japanese Percutaneous Coronary Intervention Patients With High Bleeding Risk　― A Prospective Cohort Study (PENDULUM mono Study) ―

Nakamura

Morino

Kakuta

et al. 2020

Circ J

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medical therapy; however, a recent study suggested that bleeding complications worsen prognosis leading to subsequent fatal events. 2 Bleeding management is essential to improve the prognosis after PCI, especially with the introduction of potent antiplatelet drugs and a new generation I n patients who undergo percutaneous coronary intervention (PCI), treatment strategies that favor optimal medical therapy have been shown to be comparable to treatment strategies that favor revascularization. 1 Antiplatelet therapy is one of the key treatments for optimal

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“…Fourth, medication side effects during clinical follow-up were not evaluated. Finally, patients usually receive DAPT for at least 12 months after PCI, but the duration of DAPT for patients with SCAD became shorter in recent ESC, AHA, and JCS guidelines [42][43][44] . Thus, shorter duration of DAPT may change our results.…”

Section: Safety Endpointsmentioning

confidence: 99%

Efficacy and Safety of Ticagrelor and Clopidogrel in Patients with Stable Coronary Artery Disease Undergoing Percutaneous Coronary Intervention

Qiu

et al. 2021

JAT

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The efficacy and safety of ticagrelor and clopidogrel in patients with stable coronary artery disease (SCAD) undergoing percutaneous coronary intervention (PCI) remain uncertain. Thus, this study aimed to compare the efficacy and safety of ticagrelor and clopidogrel in patients with SCAD treated with PCI. Methods: A total of 9,379 patients with SCAD undergoing PCI who received dual antiplatelet therapy (DAPT) were consecutively enrolled in two groups, namely, ticagrelor (n 1,081) and clopidogrel (n 8,298) groups. Major adverse cardiovascular and cerebrovascular events (MACCEs) and bleeding events according to ticagrelor or clopidogrel use were compared. Results: After propensity matching (n 1,081 in each group), ticagrelor was associated with fewer MACCEs compared with clopidogrel (3.6% vs. 5.7%, hazard ratio [HR] 0.62, 95% confidence interval [CI] 0.41-0.93, p 0.019), and the difference between ticagrelor and clopidogrel for bleeding events was nonsignificant (1.7% vs. 1.2%, HR 1.39, 95% CI 0.68-2.85, p 0.366). On the other hand, the difference between ticagrelor and clopidogrel for net adverse clinical events was significant (4.1% vs. 6.0%, HR 0.67, 95% CI 0.46-0.98, p 0.039). In a multivariate analysis, the use of ticagrelor, number of stents, previous history of diabetes, previous history of smoking, and ACC/AHA type B2 or C lesions were considered independent predictors of MACCEs, while radial artery access, previous history of stroke, and weight 60kg were independent predictors of bleeding events. Conclusions: Ticagrelor was associated with a lower incidence of MACCEs without an increased risk of bleeding events in patients with SCAD receiving PCI. Thus, to overcome the shortcomings of clopidogrel, a new generation of antiplatelet drugs, namely, prasugrel and ticagrelor, has been developed 6). Ticagrelor is a reversible, nonthienopyridine, P2Y12 oral inhibitor that has a faster onset and offset of action and a higher inhibitory effect on platelet aggregation compared with clopidogrel 7) , which requires metabolic activation through a multistep process involving multiple cytochrome P450 isoenzymes 8). Ticagrelor can bind directly to the P2Y12 receptor and inhibit platelet aggregation induced by Copyright©2020 Japan Atherosclerosis Society This article is distributed under the terms of the latest version of CC BY-NC-SA defined by the Creative Commons Attribution License.

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JCS 2020 Guideline Focused Update on Antithrombotic Therapy in Patients With Coronary Artery Disease

Cited by 244 publications

References 195 publications

Predictive Ability of Academic Research Consortium for High Bleeding Risk Criteria in ST-Elevation Myocardial Infarction Patients Undergoing Primary Coronary Intervention

Predictive Ability of Academic Research Consortium for High Bleeding Risk Criteria in ST-Elevation Myocardial Infarction Patients Undergoing Primary Coronary Intervention

Monotherapy With Prasugrel After Dual-Antiplatelet Therapy for Japanese Percutaneous Coronary Intervention Patients With High Bleeding Risk　― A Prospective Cohort Study (PENDULUM mono Study) ―

Efficacy and Safety of Ticagrelor and Clopidogrel in Patients with Stable Coronary Artery Disease Undergoing Percutaneous Coronary Intervention

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JCS 2020 Guideline Focused Update on Antithrombotic Therapy in Patients With Coronary Artery Disease

Cited by 244 publications

References 195 publications

Predictive Ability of Academic Research Consortium for High Bleeding Risk Criteria in ST-Elevation Myocardial Infarction Patients Undergoing Primary Coronary Intervention

Predictive Ability of Academic Research Consortium for High Bleeding Risk Criteria in ST-Elevation Myocardial Infarction Patients Undergoing Primary Coronary Intervention

Monotherapy With Prasugrel After Dual-Antiplatelet Therapy for Japanese Percutaneous Coronary Intervention Patients With High Bleeding Risk ― A Prospective Cohort Study (PENDULUM mono Study) ―

Efficacy and Safety of Ticagrelor and Clopidogrel in Patients with Stable Coronary Artery Disease Undergoing Percutaneous Coronary Intervention

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Monotherapy With Prasugrel After Dual-Antiplatelet Therapy for Japanese Percutaneous Coronary Intervention Patients With High Bleeding Risk　― A Prospective Cohort Study (PENDULUM mono Study) ―