By Andrea Rubboli, Gregory Y. H. Lip
This booklet considers paradigmatic scientific circumstances which will forged mild on key concerns on the subject of optional or emergency stent implantation and using oral anticoagulation (OAC) in sufferers with atrial traumatic inflammation. the subjects addressed contain 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 treatment of OAC, aspirin, and clopidogrel vs the mix of OAC and a unmarried antiplatelet agent), and the main appropriate period of the antithrombotic therapy prescribed at discharge (1 vs 6–12 months).
The case-based administration ideas may be of vast functional price within the present well-being care context, the place percutaneous coronary intervention is out there even to sufferers with proper co-morbidities, similar to these warranting long term OAC, and the indicators for OAC are a lot broader than some time past. The publication will charm particularly to medical and interventional cardiologists, inner medication experts, hematologists, and family members physicians and also will be of curiosity to cardiology and inner drugs 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
Urban P, Meredith IT, Abizaid A, Pocock SJ, Carriè D, Naber C, Lipiecki J, Richardt G, Iñiguez A, Brunel P, Valdes-Chavarri M, Garot P, Talwar S, Berland J, Abdellaoui M, Eberli F, Odroyd K, Zambahari R, Gregson J, Greene S, Stoll HP, Morice MC, LEADERS FREE Investigators. Polymer-free drug-coated coronary stents in patients at high bleeding risk. N Engl J Med. 2015;373:2038–47. Wiebe J, Nef HM, Hamm CW. Current status of bioresorbable scaffolds in the treatment of coronary artery disease. J Am Coll Cardiol.
2). No significant lesions were detected in the left coronary system. Fig. 2 Diagnostic angiography of right coronary artery (RCA) (LAO view). 3 Procedural Issues To prevent thrombosis at the PCI hardware and/or at the atherosclerotic plaque disrupted by balloon traumatism, effective anticoagulation is required throughout elective PCI. 5) [1–3]. Therefore, a standard IV bolus of UFH at the dose of 70–100 IU/ kg should be given upon the start of procedure . , high thrombus burden or acute stent/vessel occlusion) [1–3].
2014;64:1430–6. 1 Baseline Characteristics • • • • • Gender: male. Age: 79 years. CV risk factors: hypertension. Associated diseases: chronic gastritis. Previous history: approximately 10 years earlier, transient ischemic attack (TIA) with no permanent sequelae during a first episode of paroxysmal atrial fibrillation (AF). 0 was initiated. Since then, occasional, brief episodes of paroxysmal AF recurred for which however no antiarrhythmic therapy was prescribed. • Current history: in the absence of previous symptoms, precordial chest pain, with radiation to the jaw, developed at rest and lasted approximately 30 min.