By Andrea Rubboli, Gregory Y. H. Lip
This e-book considers paradigmatic scientific circumstances in an effort to solid gentle on key matters in terms of optional or emergency stent implantation and using oral anticoagulation (OAC) in sufferers with atrial traumatic inflammation. the themes addressed comprise the optimum periprocedural antithrombotic remedy (uninterrupted vs interrupted OAC, intraprocedural use of heparin and glycoprotein IIb/IIIa inhibitors, etc.), the main applicable kind of stent (bare steel vs drug eluting vs “bioactive”), the optimum routine (e.g., triple remedy of OAC, aspirin, and clopidogrel vs the combo of OAC and a unmarried antiplatelet agent), and the main appropriate length of the antithrombotic therapy prescribed at discharge (1 vs 6–12 months).
The case-based administration options should be of vast sensible worth within the present wellbeing and fitness care context, the place percutaneous coronary intervention is out there even to sufferers with appropriate co-morbidities, similar to these warranting long term OAC, and the symptoms for OAC are a lot broader than some time past. The e-book will allure particularly to scientific and interventional cardiologists, inner drugs experts, hematologists, and kin physicians and also will be of curiosity to cardiology and inner medication citizens and fellows.
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Extra resources for Atrial Fibrillation and Percutaneous Coronary Intervention: A Case-based Guide to Oral Anticoagulation, Antiplatelet Therapy and Stenting
Current status of bioresorbable scaffolds in the treatment of coronary artery disease. J Am Coll Cardiol. 2014;64:2541–51. Kleber FX, Rittger H, Bonaventura K, Zeymer U, Wöhrle J, Jeger R, Levenson B, MöbiusWinkler S, Bruch L, Fischer D, Hengstenberg C, Pörner T, Mathey D, Scheller B. Drug-coated balloons for treatment of coronary artery disease: updated recommendations from a consensus group. Clin Res Cardiol. 2013;102:785–97. Camm AJ, Kirchhof P, Lip GY, Schotten U, Savelieva I, Ernst S, Van Gelder IC, Al-Attar N, Hindricks G, Prendergast B, Heidbuchel H, Alfieri O, Angelini A, Atar D, Colonna P, De Caterina R, De Sutter J, Goette A, Gorenek B, Heldal M, Hohloser SH, Kolh P, Le Heuzey JY, Ponikowski P, Rutten FH.
Such condition, in fact, likely increases the risk of in-hospital bleeding complications, which in turn are associated with increased mortality, especially in the event that invasive evaluation/treatment is carried out. 3) . Nonetheless, application of the CRUSADE score may be of value also in patients on OAC to identify, and potentially correct, established factors for increased 42 K. 2 GRACE score calculation  Background 1. Age (years) Points ≤29 30–39 40–49 50–59 60–69 70–79 80–89 ≥90 0 0 18 36 55 73 91 100 2.
Vranckx et al. 5) [1, 2]. 3) . The dose of dabigatran (and other NOACs) should generally be reduced to the lower tested in clinical trials [1–3]. 10) [27–30]. 2) [1–3]. Both data from clinical trials comparing clopidogrel to newer agents prasugrel and ticagrelor, albeit in the specific context of acute coronary syndrome [36, 37], and small data from a single-center cohort where prasugrel was used instead of clopidogrel in combination with OAC with VKA and aspirin show that the risk of bleeding may largely be increased.
Atrial Fibrillation and Percutaneous Coronary Intervention: A Case-based Guide to Oral Anticoagulation, Antiplatelet Therapy and Stenting by Andrea Rubboli, Gregory Y. H. Lip