Uninterrupted Oral Anticoagulant Therapy in Patients Undergoing Unplanned Percutaneous Coronary Intervention

Venetsanos, Dimitrios; Skibniewski, Mikolaj; Janzon, Magnus; Lawesson, Sofia Sederholm; Charitakis, Emmanouil; Böhm, Felix; Henareh, Loghman; Andell, Pontus; Karlson, L; Simonsson, Moa; Völz, Sebastian; Erlinge, David; Ömerovic, Elmir; Alfredsson, Joakim

doi:10.1016/j.jcin.2021.01.022

Cited by 7 publications

(1 citation statement)

References 23 publications

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“…In the present study under an effective anticoagulatory dose of dabigatran, and the treatment with aspirin and clopidogrel one pig suffered from access site hematoma with a hemoglobin drop of 4.4 g/dL considering it a major bleeding event. Interestingly, an uninterrupted oral anticoagulation therapy in patients undergoing unplanned percutaneous coronary intervention was associated with shorter length of hospitalization and equivalent risk for MACCE and bleeding complications as compared to interrupted oral anticoagulation therapy (33). Taking this data in consideration, the additional information on faster endothelialization and enhanced endothelium-dependent vasodilation is of interest.…”

Section: Discussionmentioning

confidence: 99%

Peri-interventional Triple Therapy With Dabigatran Improves Vasomotion and Promotes Endothelialization in Porcine Coronary Stenting Model

Hemetsberger

Farhan

Lukovic

et al. 2021

Front. Cardiovasc. Med.

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Objective: We evaluated the short and long-term effect of peri-interventional dabigatran therapy on vasomotion, endothelialization, and neointimal formation in a porcine coronary artery stenting model.Background: Stenting of coronary arteries induces local inflammation, impairs vasomotion and delays endothelialization.Methods: Twenty-eight animals underwent percutaneous coronary intervention (PCI) with drug eluting stents. Sixteen pigs started dabigatran therapy 4 days prior to PCI and continued for 4 days post-stenting, while 12 animals served as controls. Post-stenting dual antiplatelet therapy (75 mg clopidogrel and 100 mg aspirin) was continued in both groups until termination. Immediately post-stenting and at day 3 optical coherence tomography (OCT) was performed in all animals, followed by euthanasia of 8 dabigatran and 4 control animals. The remaining pigs (8 of each group) were followed up for 1 month, with control angiography and OCT. Tissue burden (degree of peri-strut structure—thrombus and/or fibrin) was evaluated. After euthanasia coronary arteries were harvested for in-vitro myometry and histology.Results: Thrombin generation was lower (p < 0.001) and tissue burden (0.83 ± 0.98 vs. 3.0 ± 2.45; p = 0.031) was significantly decreased in dabigatran treated animals. After 3 days post-PCI endothelium-dependent vasodilation was significantly improved (77 ± 40% vs. 41 ± 31%, p = 0.02) in dabigatran animals. Neither quantitative angiography nor histomorphometry showed differences between the groups. Endothelialization was faster in the dabigatran group as compared with controls (p = 0.045).Conclusion: Short-term peri-interventional triple therapy with dabigatran, aspirin, and clopidogrel led to an enhanced endothelium dependent vasodilation and faster endothelialization. However, neointimal formation 1-month after stent implantation was comparable between groups.

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Section: Discussionmentioning

confidence: 99%