Optimal Antiplatelet Therapy During Percutaneous Coronary Interventions Includes Glycoprotein IIb/IIIa Inhibitors

Mahmud, Ehtisham; Prasad, Anand

doi:10.1016/j.jacc.2008.12.004

Cited by 3 publications

(2 citation statements)

References 21 publications

(13 reference statements)

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“…Intravenous infusion of eptifibatide (2 μ g/kg/min) was added to aspirin [12]. Moreover, anticoagulation was started, initially with enoxaparin (100 UI/Kg twice daily) and then with oral anticoagulants (dicumarol, titrated to obtain an International Normalised Ratio of 2-3).…”

Section: Case Reportmentioning

confidence: 99%

Clopidogrel-Induced Neutropenia after Coronary Stenting: Is Cilostazol a Good Alternative?

Montalto

Porto

Gallo

et al. 2011

International Journal of Vascular Medicine

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Dual antiplatelet therapy with aspirin plus thienopyridines has become the standard treatment of patients undergoing coronary stenting. Clopidogrel has mostly replaced the use of ticlopidine due to its more favourable adverse event profile. However, also the use of clopidogrel is not without side effects. Clopidogrel major adverse events are represented by marrow suppression, manifesting with aplastic anaemia, thrombocytopenia and neutropenia. When clopidogrel toxicity occurs, there are few and unsubstantiated alternative treatments and thus, in these cases, medical decisions may be very difficult. We report a case of clopidogrel-induced bone marrow toxicity manifesting with severe neutropenia in a patient treated with multiple coronary stents and provide suggestions for an alternative treatment.

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Section: Case Reportmentioning

confidence: 99%

Clopidogrel-Induced Neutropenia after Coronary Stenting: Is Cilostazol a Good Alternative?

Montalto

Porto

Gallo

et al. 2011

International Journal of Vascular Medicine

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“…Moreover, major bleeding has been shown to be the strongest predictor of 30-day mortality in PCI treated patients with acute coronary syndromes, even stronger than periprocedural myocardial infarction. 38 Despite the increased bleeding complications with heparin plus GP IIb/IIIa inhibitors, this combination still have potential advantages in patients with high clinical risk but low bleeding risk. Blood transfusions are associated to significantly increased morbidity and mortality, increased infections, and increased hospital stay and costs.…”

Section: Comparison Of Bivalirudin With Heparin In the Presence Or Abmentioning

confidence: 99%

Bivalirudin in Contemporary Percutaneous Coronary Intervention for Non-ST-Segment Elevation Acute Coronary Syndromes

Centurión¹

2011

Critical Pathways in Cardiology: A Journal of Evidence-Based Medicine

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Currently, the wide variety of antithrombotic agents as adjunctive pharmacological therapy for non-ST-segment elevation acute coronary syndromes (ACS) in the setting of contemporary percutaneous coronary intervention (PCI) available for clinical use has made choosing the optimal drug therapy a complex and difficult task. In the stent era, bivalirudin, a semisynthetic direct thrombin inhibitor, has recently been shown to provide similar efficacy with less bleeding compared with unfractionated heparin plus platelet glycoprotein IIb/IIIa inhibitors in ACS patients treated with PCI. Although there are some controversial results and limitations in the studies with bivalirudin, this drug certainly is a plausible option in the treatment of ACS. With current findings in contemporary PCI, there may be a steady increase in the utilization of bivalirudin. On the other hand, in the real world, there may be reinforcement in the sole use of unfractionated heparin confining glycoprotein IIb/IIIa inhibitors and other intravenous antithrombotics to bailout therapy for periprocedural PCI complications in ACS patients.

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Percutaneous Interventions

O'Loughlin¹,

Yeung²

2011

A Practical Approach to Cardiovascular Medicine

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Optimal Antiplatelet Therapy During Percutaneous Coronary Interventions Includes Glycoprotein IIb/IIIa Inhibitors

Cited by 3 publications

References 21 publications

Clopidogrel-Induced Neutropenia after Coronary Stenting: Is Cilostazol a Good Alternative?

Clopidogrel-Induced Neutropenia after Coronary Stenting: Is Cilostazol a Good Alternative?

Bivalirudin in Contemporary Percutaneous Coronary Intervention for Non-ST-Segment Elevation Acute Coronary Syndromes

Percutaneous Interventions

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