Dual antiplatelet therapy (DAPT) in the era of Novel Oral Anticoagulants (NOACs) SACIS 2015
|
|
- Garry Charles
- 5 years ago
- Views:
Transcription
1 Dual antiplatelet therapy (DAPT) in the era of Novel Oral Anticoagulants (NOACs) SACIS 2015 Wesam A Alhejily MD FRCPC FACP FACC FSCAI Assistant Professor of Medicine Chief Of Adult Cardiology Consultant Cardiovascular Medicine and interventional Cardiology King Abdulaziz University Jeddah, Kingdom Of Saudi Arabia
2 Non Disclosures
3 Outlines Real Time Case Study Introduction to NOAC and NEW DAPT Review ACS trials of NOACS Recommendations for patients requiring OAC for Stroke prevention in afib (SPAF) and DAPT for acute coronary syndrome (ACS). Review evidence related to triple oral antithrombotic therapy (TOAT) Back to the case Summary and conclusion.
4 Mr WH 67 year old male ER visit May 2014 with worsening SOBOE x 2 weeks No chest pain, palpitations, syncope Presenting symptoms consistent with exacerbation of heart failure Cardiac risk factors: HTN, diabetes, dyslipidemia
5 Mr WH Past medical history HTN DM AVR 2009 (bioprosthetic) IHD PCI to LAD 2004 AV block Pacemaker 2013 OSA/ CPAP Atrial fibrillation Ablation 2008 Carotid endarterectomy Cancer Colon/ resected 2009 Medications prior to admission Dabigatran 110 mg BID Metoprolol 25 mg BID Atorvastatin 40 mg daily Amlodipine 7.5 mg daily Furosemide 60 mg daily NPH 60 units am and hs Aspart units ac meals
6 Mr WH Course in hospital HF symptoms improved on IV furosemide ECHO FunctioningAortic valve, mild gradient LV function normal except septal/apical akinesis Angiogram RCA 99% (chronic) LAD (mid-third) 90% (de Novo) Cx 50% PCI culprit vessel (LAD) on May 22,2014, Eeverolomus (DES) stents
7 Question (s)? What should be done with anti platelet therapy and oral anticoagulation? Choices: ASA, clopidogrel, warfarin (Stop Dabigatran) Clopidogrel plus warfarin Dabigatran, clopidogrel, ASA For How long? Any other consideration?
8 Dual Antiplatelet therapy (DAPT)
9 NEW DAPT
10 Prasugrel
11 Ticagrelor
12
13 DAPT in ACS
14 DAPT post Stenting
15
16
17 NOVEL ORAL ANTICOAGULANTS
18 Why NOACs?
19 Mechanism Of Action
20 Metabolism
21 INDICATIONS
22 In non-valvular Afib
23 In DVT and PE
24 Other NOACS
25 Patients Follow up
26 Bleeding and need for reversal
27 Antidotes
28 NOAC(s) in ACUTE CORONARY SYNDROME
29 NOACS in ACS
30
31
32 NNT= 56 over 2 year
33
34
35
36
37 What did we learn from this Important observations from APPRAISE-2, ATLAS ACS-TIMI 46, and RUBY-1 suggest that in patients with a recent acute coronary syndrome, very low doses of an oral anticoagulant (Rivaroxiban) appear to be favorable.
38 Guidelines
39 Triple Therapy DAPT in addition to (N)OACs (Triple therapy)
40
41 Risk Assessment Ischemic Risk GRACE risk < 118 Low/moderate atherothrombotic risk GRACE risk >118 High residual atherothrombotic risk Stroke Risk CHADS VASC Bleeding HASBLED 3 Elevated bleed risk
42
43
44 HAS BLED SCORE
45 DUAL VERSUS TRIPLE
46 Pre NOAC (s)
47
48
49 Other questions? BMS VS DES, Shorter Duration of TT, GI protection
50 What about Triple Therapy (DAPT)+NOACS NO Study yet!
51 What s in the pipe?
52
53 As we Stand, NOAC and DAPT Efficacy evidence is lacking Bleeding risk is high!!! Definitions differ than that of SPAF Cannot compare ACS trials to SPAF Patient characteristics differ!! Doses in ACS trials differ from SPAF trials?
54 Back To Mr WH Triple therapy prescribed on discharge No dabigatran Warfarin, clopidogrel, ASA until August 2014 Target INR Add PPI for GI protection. Warfarin plus ASA until May 2015 Resume dabigatran 150 mg bid (patient Preference) after one year.
55 In summary - Ideal combination of antiplatelet therapy and anticoagulants does not exist in patients with atrial fibrillation and a recent ACS. Needs to be individualized based on risks OAC plus clopidogrel? Risk Stratification is helpful!
56 Limit duration of TOAT to reduce risk of Bleeding Educate your patients on risks/benefits Provide GI protection May consider using bare metal stent over drug eluting stents.
57 REFERENCES 1)Asencio LA et al. Combining antiplatelet and antithrombotic therapy: what are the risks and benefits. American Journal of Medicine(article in press) ) Moser M et al. Triple antithrombotic therapy in cardiac patients:more questions than answers. European Heart Journal (2014) 35, ) Mega JL et al. Rivaroxaban in Patients with a Recent Acute Coronary Syndrome. N Engl J Med 2012;366:9-19 4) Alexander JH et al. Apixaban with Antiplatelet Therapy after Acute Coronary Syndrome. N Engl J Med 2011;365: ) Tsu LE., Dager WE. Safety of New Oral Anticoagulants with Dual Antiplatelet Therapy in Patients with Acute Coronary Syndromes. Ann Pharmacother 2013;47:573-7 lation. Europace (2013) 15,
58 References 6) Dewilde WJ et al. Use of clopidogrel with or without aspirin in patients taking oral anticoagulant therapy and undergoing percutaneous coronary intervention: an open-label, randomised, controlled trial. Published Online February 13, ) Cairns JA et al. Oral Antithrombotic Therapy in Atrial Fibrillation Associated With Acute or Chronic Coronary Artery Disease. Canadian Journal of Cardiology 29 (2013) S60-S70 8) Reed GW, Cannon CP Triple Oral Antithrombotic Therapy in Atrial Fibrillation and Coronary Artery Stenting. Clin. Cardiol. 36, 10, (2013) 9) Menozzi M et al. Triple antithrombotic therapy in patients with atrial fibrillation undergoing coronary artery stenting: hovering among bleeding risk, thromboembolic events, and stent thrombosis. Thrombosis Journal 2012, 10:22 10) Heidbuchel H et al. European Heart Rhythm Association Practical Guide on the use of new oral anticoagulants in patients with non-valvular atrial fibril
59 Thanks
TRIPLE THERAPY, NOACs with concurrent indication for DAPT. Paul Wright Lead Cardiac Pharmacist The Heart, UCLH NHS Foundation Trust
TRIPLE THERAPY, NOACs with concurrent indication for DAPT Paul Wright Lead Cardiac Pharmacist The Heart, UCLH NHS Foundation Trust Content Why consider triple therapy What we know of triple therapy Current
More information3/23/2017. Angelika Cyganska, PharmD Austin T. Wilson, MS, PharmD Candidate Europace Oct;14(10): Epub 2012 Aug 24.
Angelika Cyganska, PharmD Austin T. Wilson, MS, PharmD Candidate 2017 Explain the efficacy and safety of triple therapy, in regards to thromboembolic and bleeding risk Summarize the guideline recommendations
More informationAngelika Cyganska, PharmD Austin T. Wilson, MS, PharmD Candidate 2017
Angelika Cyganska, PharmD Austin T. Wilson, MS, PharmD Candidate 2017 Explain the efficacy and safety of triple therapy, in regards to thromboembolic and bleeding risk Summarize the guideline recommendations
More informationAsif Serajian DO FACC FSCAI
Anticoagulation and Antiplatelet update: A case based approach Asif Serajian DO FACC FSCAI No disclosures relevant to this talk Objectives 1. Discuss the indication for antiplatelet therapy for cardiac
More informationWhen and how to combine antiplatelet agents and anticoagulant?
When and how to combine antiplatelet agents and anticoagulant? Christophe Beauloye, MD, PhD Head, Division of Cardiology Cliniques Universitaires Saint-Luc Brussels, Belgium Introduction Anticoagulation
More informationPCI in Patients with AF Optimizing Oral Anticoagulation Regimen
PCI in Patients with AF Optimizing Oral Anticoagulation Regimen Walid I. Saliba, MD Director, Atrial Fibrillation Center Heart and Vascular Institute Cleveland Clinic 1 Epidemiology and AF and PCI AF and
More informationThe Challenge. Warfarin or Novel Oral Anti-Coagulants in the PCI patient? Anticoagulation/Stroke
Anticoagulation/Stroke Warfarin v new oral anticoagulants post PCI Warfarin or Novel Oral Anti-Coagulants in the PCI patient? Gerry Devlin Chairs: Phillip Matsis & Tony Scott Gerry Devlin Honorary Associate
More informationNAVIGATING THROMBOSIS AND BLEEDING AT THE INTERSECTION OF ATRIAL FIBRILLATION AND CORONARY STENTING
NAVIGATING THROMBOSIS AND BLEEDING AT THE INTERSECTION OF ATRIAL FIBRILLATION AND CORONARY STENTING Snehal H. Bhatt, Pharm.D., BCPS-AQ Cardiology, FASHP, AACC Associate Professor of Pharmacy Practice MCPHS
More informationDr Αντώνιος Στ. Ντάτσιος MSc, MRCP(UK), FESC. Επεμβατικός Καρδιολόγος Επιμελητής Β Γ. Ν. Θ. Παπαγεωργίου
Dr Αντώνιος Στ. Ντάτσιος MSc, MRCP(UK), FESC. Επεμβατικός Καρδιολόγος Επιμελητής Β Γ. Ν. Θ. Παπαγεωργίου Θεσσαλονίκη, 9/2/2018 Disclosures: None Primary efficacy outcome* (%/year) Antiplatelet Therapy
More informationBleeding Management Strategies. Aiming for the best Outcomes August 27, Amit Gupta, MD FACC FSCAI Interventional Cardiologist CANM
Bleeding Management Strategies Aiming for the best Outcomes August 27, 2016 Amit Gupta, MD FACC FSCAI Interventional Cardiologist CANM Learning Objectives Review the use of anti-coagulants in patients
More informationManagement of Patients with Atrial Fibrillation and Stents: Is Three Drugs Too Many?
Management of Patients with Atrial Fibrillation and Stents: Is Three Drugs Too Many? Neal S. Kleiman, MD Houston Methodist DeBakey Heart and Vascular Center, Houston, TX Some Things Are Really Clear 2013
More informationHEART OF THE MATTER: cardiac issues in safe endoscopy & sedation
HEART OF THE MATTER: cardiac issues in safe endoscopy & sedation YUVAL KONSTANTINO M.D. CARDIOLOGY DEPARTMENT, ELECTROPHYSIOLOGY UNIT, SOROKA MEDICAL CENTER, BEN-GURION UNIVERSITY OUTLINE 1 2 3 Anticoagulation
More informationDual Antiplatelet Therapy Made Practical
Dual Antiplatelet Therapy Made Practical David Parra, Pharm.D., FCCP, BCPS Clinical Pharmacy Program Manager in Cardiology/Anticoagulation VISN 8 Pharmacy Benefits Management Clinical Associate Professor
More informationStudy design: multicenter, randomized, open-label trial following a PROBE design
Subgroup Analysis from the RE-DUAL PCI Trial Dual Antithrombotic Therapy with in Patients with Atrial Fibrillation Undergoing Percutaneous Coronary Intervention Jonas Oldgren, Philippe Gabriel Steg, Stefan
More informationGRAND ROUNDS - DILEMMAS IN ANTICOAGULATION AND ANTIPLATELET THERAPY. Nick Collins February 2017
GRAND ROUNDS - DILEMMAS IN ANTICOAGULATION AND ANTIPLATELET THERAPY Nick Collins February 2017 DISCLOSURES Before I commence Acknowledge.. Interventional Cardiologist Perception evolved. Interventional
More informationAntiplatelet and Anti-Thrombotic Therapy. Ivan Anderson, MD RIHVH Cardiology
Antiplatelet and Anti-Thrombotic Therapy Ivan Anderson, MD RIHVH Cardiology Outline Anti-thrombotic therapy Risk stratification of stroke with atrial fibrillation DVT and PE treatment Pharmacology Anti-platelet
More informationStable CAD, Elective Stenting and AFib
Stable CAD, Elective Stenting and AFib Kurt Huber, MD, FESC, FACC, FAHA 3 rd Medical Department Cardiology & Intensive Care Medicine Wilhelminenhospital & Sigmund Freud Private University, Medical School
More informationNovel Anticoagulants PHYSICIANS UPDATE 2014
Novel Anticoagulants PHYSICIANS UPDATE 2014 Farouk Mookadam MD FRCPC FACC MSc Professor College of Medicine Mayo Consultant Cardiovascular Diseases Medical Director Anticoagulation Clinic Assoc Programme
More informationDIRECT ORAL ANTICOAGULANTS
2017 Cardiovascular Symposium DIRECT ORAL ANTICOAGULANTS ERNESTO UMAÑA, MD, FACC ORAL ANTICOAGULANTS Vitamin K Antagonists (VKAs): Warfarin Non Vitamin K Antagonists Direct oral anticoagulants Novel Oral
More informationManagement of Patients with Atrial Fibrillation Undergoing Coronary Artery Stenting 경북대의전원내과조용근
Management of Patients with Atrial Fibrillation Undergoing Coronary Artery Stenting 경북대의전원내과조용근 Case (2011, 5) 74-years old gentleman Exertional chest pain Warfarin with good INR control Ex-smoker, social(?)
More informationThe Poor Long-Term Candidate for Warfarin: NOAC or Left Atrial Appendage Closure?
The Poor Long-Term Candidate for Warfarin: NOAC or Left Atrial Appendage Closure? Suneet Mittal, MD, FACC, FHRS Director, Electrophysiology Laboratory Valley Health System Ridgewood, NJ and New York, NY
More informationWhich drug do you prefer for stable CAD? - P2Y12 inhibitor
Which drug do you prefer for stable CAD? - P2Y12 inhibitor Jung Rae Cho, MD, PhD Cardiovascular Division, Department of Internal Medicine Kangnam Sacred Heart Hospital, Hallym University Medical Center,
More informationByeong-Keuk Kim, M.D. Ph D. Division of Cardiology, Severance Cardiovascular Hospital Yonsei University College of Medicine, Seoul, Korea
Byeong-Keuk Kim, M.D. Ph D Division of Cardiology, Severance Cardiovascular Hospital Yonsei University College of Medicine, Seoul, Korea CASE, M/64 C.C; Recently aggravated chest discomfort for 3 days
More informationClinical and Economic Value of Rivaroxaban in Coronary Artery Disease
CHRISTOPHER B. GRANGER, MD Professor of Medicine Division of Cardiology, Department of Medicine; Director, Cardiac Care Unit Duke University Medical Center, Durham, NC Clinical and Economic Value of Rivaroxaban
More informationIndications of Anticoagulants; Which Agent to Use for Your Patient? Marc Carrier MD MSc FRCPC Thrombosis Program Ottawa Hospital Research Institute
Indications of Anticoagulants; Which Agent to Use for Your Patient? Marc Carrier MD MSc FRCPC Thrombosis Program Ottawa Hospital Research Institute Disclosures Research Support/P.I. Employee Leo Pharma
More informationTriple Therapy: A review of the evidence in acute coronary syndrome. Stephanie Kling, PharmD, BCPS Sanford Health
Triple Therapy: A review of the evidence in acute coronary syndrome Stephanie Kling, PharmD, BCPS Sanford Health Objectives 1. Describe how the presented topic impacts patient outcomes. 2. Review evidence
More informationAnticoagulants and antiplatelet therapy in the older patient: Choosing wisely
Anticoagulants and antiplatelet therapy in the older patient: Choosing wisely Rajiv Gulati, MD PhD Advances in Cardiac Arrhythmias & Great Innovations in Cardiology Torino, October 2015 2015 MFMER 3477310-1
More informationRobert C. Welsh, MD, FRCPC Professor of Medicine, University of Alberta Zone Clinical Department Head, Cardiac Sciences
Managing Atrial Fibrillation and ACS/PCI Applying New Evidence to Clinical Practice Dual Anti-Thrombotic Therapy in Acute Coronary Syndromes (ACS) and Afib + PCI/ACS Patients Robert C. Welsh, MD, FRCPC
More informationATRIAL FIBRILLATION: REVISITING CONTROVERSIES IN AN ERA OF INNOVATION
ATRIAL FIBRILLATION: REVISITING CONTROVERSIES IN AN ERA OF INNOVATION Frederick Schaller, DO, MACOI,FACP Adjunct Clinical Professor Touro University Nevada DISCLOSURES I have no financial relationships
More informationΣτεφανιαίος ασθενής με μη βαλβιδική Κολπική Μαρμαρυγή - Νέες στρατηγικές
4 ο ΠΑΝΕΛΛΗΝΙΟ ΑΡΡΥΘΜΙΟΛΟΓΙΚΟ ΣΥΝΕΔΡΙΟ 21-22 ΣΕΠΤΕΜΒΡΙΟΥ 2018 HILTON, ΑΘΗΝΑ Στεφανιαίος ασθενής με μη βαλβιδική Κολπική Μαρμαρυγή - Νέες στρατηγικές Ι. Κανακάκης MD, PhD Διευθυντής Αιμοδυναμικού Τμήματος
More informationA Patient with Chest Pain and Atrial Fibrillation
A Patient with Chest Pain and Atrial Fibrillation Kurt Huber, Vienna, Austria Declaration of Interest Lecturing & Consulting Activities: AstraZeneca, Boehringer-Ingelheim, Bristol-Myers Squibb, Daiichi
More informationEliquis and plavix combination therapy
Eliquis and plavix combination therapy ELIQUIS Dosing for Patients With NVAF. patients treated with aspirin or the combination of bleeding or completion of a course of therapy,. 9-11-2011 Thrombosis is
More informationSpecial Conditions of NOAC PCI 가톨릭의대 순환기내과 장성원
Special Conditions of NOAC PCI 가톨릭의대 순환기내과 장성원 Issues on Patients with NOAC PCI Peri-procedural management CKD or dialysis Cardioversion Neurological situations Dual Antiplatelet Therapy with Oral Anticoagulants
More informationUPDATES FROM THE 2018 ANTIPLATELET GUIDELINES
UPDATES FROM THE 2018 ANTIPLATELET GUIDELINES Claudia Bucci BScPhm, PharmD Clinical Coordinator, Cardiovascular Diseases Sunnybrook Health Sciences Centre 21st Annual Contemporary Therapeutic Issues in
More informationMODULE 1: Stroke Prevention in Atrial Fibrillation Benjamin Bell, MD, FRCPC
MODULE 1: Stroke Prevention in Atrial Fibrillation Benjamin Bell, MD, FRCPC Specialty: General Internal Medicine Lecturer, Department of Medicine University of Toronto Staff Physician, General Internal
More informationFred Kusumoto Professor of Medicine
Fred Kusumoto Professor of Medicine Faculty photo will be placed here Kusumoto.Fred@mayo.edu 2015 MFMER 3543652-1 Atrial Fibrillation Presentation Subtitle Here Mayo School of Continuous Professional Development
More informationThe Korean Society of Cardiology COI Disclosure
The Korean Society of Cardiology COI Disclosure Name of First Author: Yongwhi Park The authors have no financial conflicts of interest to disclose concerning the presentation 2017 Annual Spring Scientific
More informationLow Dose Rivaroxaban Versus Aspirin, in Addition to P2Y12 Inhibition, in Acute Coronary Syndromes (GEMINI-ACS-1)
Low Dose Rivaroxaban Versus Aspirin, in Addition to P2Y12 Inhibition, in Acute Coronary Syndromes (GEMINI-ACS-1) Caitlin C. Akerman, PharmD PGY2 Cardiology Resident WakeMed Health & Hospitals Raleigh,
More informationLet s Gi e The So ethi g To Clot About: Controversies in Anticoagulation
Let s Gi e The So ethi g To Clot About: Controversies in Anticoagulation Janna Beavers, MS, PharmD, BCPS Cardiology Clinical Pharmacy Specialist WakeMed Health & Hospitals Raleigh, NC March 13, 2018 Pharmacist
More informationWhat oral antiplatelet therapy would you choose? a) ASA alone b) ASA + Clopidogrel c) ASA + Prasugrel d) ASA + Ticagrelor
76 year old female Prior Hypertension, Hyperlipidemia, Smoking On Hydrochlorothiazide, Atorvastatin New onset chest discomfort; 2 episodes in past 24 hours Heart rate 122/min; BP 170/92 mm Hg, Killip Class
More informationAnticoagulation Management Around Endoscopy: GI Perspective. Nathan Landesman, DO FACOI Flint Gastroenterology Associates October 11, 2017
Anticoagulation Management Around Endoscopy: GI Perspective Nathan Landesman, DO FACOI Flint Gastroenterology Associates October 11, 2017 EDUCATIONAL OBJECTIVES Understand risks of holding anticoagulation
More information6 th ACC-SHA Joint Meeting Jeddah, Saudi Arabia
6 th ACC-SHA Joint Meeting Jeddah, Saudi Arabia October 31 st - November 1 st, 2015 NOACS vs. Coumadin in Atrial Fibrillation: Is It Worth to Switch? Raed Sweidan, MD, FACC Consultant and Head of Cardiac
More informationNorth Wales Cardiac Network Guidelines on oral antiplatelet therapy in cardiovascular disease
Guidelines on oral antiplatelet therapy in cardiovascular disease This guidance should be considered as one part of the wider therapeutic management of patients. The indication for antiplatelet therapy
More informationOUTPATIENT ANTITHROMBOTIC MANAGEMENT POST NON-ST ELEVATION ACUTE CORONARY SYNDROME. TARGET AUDIENCE: All Canadian health care professionals.
OUTPATIENT ANTITHROMBOTIC MANAGEMENT POST NON-ST ELEVATION ACUTE CORONARY SYNDROME TARGET AUDIENCE: All Canadian health care professionals. OBJECTIVE: To review the use of antiplatelet agents and oral
More informationManagement and Investigation of Ischemic Stroke By Etiology
Management and Investigation of Ischemic Stroke By Etiology Andrew M. Demchuk MD FRCPC Director, Calgary Stroke Program Deputy Dept Head, Clinical Neurosciences Heart and Stroke Foundation Chair in Stroke
More informationINR as a Biomarker: Anticoagulation in Atrial Fib, Heart Failure, and Cardiovascular Disease Daniel Blanchard, MD, FACC, FAHA
INR as a Biomarker: Anticoagulation in Atrial Fib, Heart Failure, and Cardiovascular Disease Daniel Blanchard, MD, FACC, FAHA Professor of Medicine Director, Cardiology Fellowship Program Sulpizio Cardiovascular
More informationThe Role of Oral Anticoagulants in Atrial Fibrillation: What You Need to Know Now. Bradley A. Hardin, MD Richard F.
The Role of Oral Anticoagulants in Atrial Fibrillation: What You Need to Know Now Bradley A. Hardin, MD Richard F. Otten, MD, FACC Outline Atrial Fibrillation Overview Overview of New Oral Anticoagulants
More information4/25/2017. Atrial Fibrillation Review. John Evans, D.O. April 29 th, No disclosures
Atrial Fibrillation Review John Evans, D.O. April 29 th, 2017 No disclosures 1 Atrial Fibrillation Review: Learning Goals Stroke Prevention Rate Control Rhythm Control Drugs Ablation Cardioversion Atrial
More informationDisclosures. Theodore A. Bass MD, FSCAI. The following relationships exist related to this presentation. None
SCAI Fellows Course December 10, 2013 Disclosures Theodore A. Bass MD, FSCAI The following relationships exist related to this presentation None Current Controversies on DAPT in PCI Which drug? When to
More informationAntithrombotic therapy in the ACS patient with atrial fibrillation
Antithrombotic therapy in the ACS patient with atrial fibrillation Kurt Huber, MD, FESC, FACC, FAHA 3 rd Medical Department Cardiology & Emergency Medicine Wilhelminenhospital Vienna, Austria Great Minds,
More informationNews Release. For UK Media
News Release For UK Media Bayer plc 400 South Oak Way Reading RG2 6AD www.bayer.co.uk Bayer s Xarelto (rivaroxaban) in combination with single antiplatelet therapy receives positive CHMP opinion for treatment
More informationHoly Crap! Why is a Cardiologist Speaking at a GI Meeting? Jonathan A. Rapp, MD, FACC, FSCAI Cardiologist, Mercy Heart Institute Cincinnati, OH
Holy Crap! Why is a Cardiologist Speaking at a GI Meeting? Jonathan A. Rapp, MD, FACC, FSCAI Cardiologist, Mercy Heart Institute Cincinnati, OH Goals and Objectives Discuss cardiac considerations for patients
More informationAcute coronary syndromes A European viewpoint. Felicita Andreotti, MD PhD FESC Catholic University Hospital Cardiovascular Diseases - Rome, IT
Acute coronary syndromes A European viewpoint Felicita Andreotti, MD PhD FESC Catholic University Hospital Cardiovascular Diseases - Rome, IT Potential conflicts of interest In the past 2 years Felicita
More informationFACTOR Xa AND PAR-1 BLOCKER : ATLAS-2, APPRAISE-2 & TRACER TRIALS
New Horizons In Atherothrombosis Treatment 2012 순환기춘계학술대회 FACTOR Xa AND PAR-1 BLOCKER : ATLAS-2, APPRAISE-2 & TRACER TRIALS Division of Cardiology, Jeonbuk National University Medical School Jei Keon Chae,
More informationANTI-THROMBOTIC THERAPY in NON-VALVULAR ATRIAL FIBRILLATION
ANTI-THROMBOTIC THERAPY in NON-VALVULAR ATRIAL FIBRILLATION Colin Edwards Auckland Heart Group Waitemata Health June 2015 PFIZER Lecture series Disclosures EPIDEMIOLOGY Atrial fibrillation is the most
More informationUpdates in Stroke Management. Jessica A Starr, PharmD, FCCP, BCPS Associate Clinical Professor Auburn University Harrison School of Pharmacy
Updates in Stroke Management Jessica A Starr, PharmD, FCCP, BCPS Associate Clinical Professor Auburn University Harrison School of Pharmacy Disclosure I have no actual or potential conflict of interest
More informationUpdate on the NOAC s: 2018 Daniel Blanchard, MD, FACC, FAHA
Update on the NOAC s: 2018 Daniel Blanchard, MD, FACC, FAHA Professor of Medicine Director, Cardiology Fellowship Program Sulpizio Cardiovascular Center UC San Diego The NOACS, chronologically Dabigatran:
More informationΔΙΑΧΕΙΡΙΣΗ ΑΣΘΕΝΩΝ ΜΕ ΣΤΕΦΑΝΙΑΙΑ ΚΑΡΔΙΟΠΑΘΕΙΑ ΚΑΙ ΚΟΛΠΙΚΗ ΜΑΡΜΑΡΥΓΗ:ΚΙΝΔΥΝΟΙ ΚΑΙ ΟΦΕΛΗ ΔΙΠΛΗΣ ΚΑΙ ΤΡΙΠΛΗΣ ΘΕΡΑΠΕΙΑΣ
ΔΙΑΧΕΙΡΙΣΗ ΑΣΘΕΝΩΝ ΜΕ ΣΤΕΦΑΝΙΑΙΑ ΚΑΡΔΙΟΠΑΘΕΙΑ ΚΑΙ ΚΟΛΠΙΚΗ ΜΑΡΜΑΡΥΓΗ:ΚΙΝΔΥΝΟΙ ΚΑΙ ΟΦΕΛΗ ΔΙΠΛΗΣ ΚΑΙ ΤΡΙΠΛΗΣ ΘΕΡΑΠΕΙΑΣ Χρήστος Δ.Καλλιάνος Α Καρδιολογικό τμήμα και Ηλεκτροφυσιολογικό Εργαστήριο ΓΝΑ «Ο Ευαγγελισμός»
More informationDisclosure Slide. Controversies in Anticoagulation. Presenter Disclosure Information. Challenges in Anticoagulation
1:15 2:15 PM Challenges in Anticoagulation SPEAKER Nasser Lakkis, MD, FACC, FSCAI Presenter Disclosure Information The following relationships exist related to this presentation: Nasser Lakkis, MD, FACC,
More informationPatient with high risk for bleeding
Will Apixaban change practice in atrial fibrillation Luncheon Satellite Sponsored by Pfizer Patient with high risk for bleeding Prof. Amos Katz M.D August 2012: patient background 67-year-old woman History
More informationNOACs in AF. Dr Colin Edwards Auckland Heart Group and Waitemata DHB. Dr Fiona Stewart Auckland Heart Group and Auckland DHB
NOACs in AF Dr Colin Edwards Auckland Heart Group and Waitemata DHB Dr Fiona Stewart Auckland Heart Group and Auckland DHB Conflict of Interest Dr Fiona Stewart received funding from Pfizer to attend the
More informationTriple Therapy After PCI in AF: A Quagmire Soon to be Drained
Triple Therapy After PCI in AF: A Quagmire Soon to be Drained Freek W.A. Verheugt Department of Cardiology, Onze Lieve Vrouwe Gasthuis (OLVG) Amsterdam, Netherlands DISCLOSURES FOR FREEK W. A. VERHEUGT
More information8th Emirates Cardiac Society Congress in collaboration with ACC Middle East Conference Dubai: October Acute Coronary Syndromes
8th Emirates Cardiac Society Congress in collaboration with ACC Middle East Conference 2017 Dubai: 19-21 October 2017 Acute Coronary Syndromes Antonio Colombo Centro Cuore Columbus and S. Raffaele Scientific
More informationPaolo Gresele Dipartimento di Medicina Sezione di Medicina Interna e Cardiovascolare Università di Perugia
Anticoagulanti e mono-antiaggregazione: a chi, quali e per quanto tempo Paolo Gresele Dipartimento di Medicina Sezione di Medicina Interna e Cardiovascolare Università di Perugia Anticoagulazione: Bologna,
More informationPerioperative Anticoagulation Management
Perioperative Anticoagulation Management ACP Delaware Chapter Scientific Meeting Feb 9, 2019 Andrew Dunn, MD, MPH, MACP Chief, Division of Hospital Medicine Mount Sinai Health System, NY DISCLOSURES Desai
More informationDISCLOSURE. What I am Talking About. Rational Use of Antiplatelet Agents. Aspirin. Tom DeLoughery, MD MACP FAWM
Rational Use of Antiplatelet Agents DISCLOSURE Relevant Financial Relationship(s) Speaker Bureau None Tom DeLoughery, MD MACP FAWM Oregon Health and Sciences University What I am Talking About 1. Current
More informationProstate Biopsy Alerts
Prostate Biopsy Alerts Saskatchewan Prostate Assessment Pathway Guidelines for the Primary Care Provider for Patient Preparation and the Management of Medications and Complications September 2016 Table
More informationNew Study Presented at American Heart Association (AHA) Scientific Sessions 2016:
Investor News Not intended for U.S. and UK Media Bayer AG Investor Relations 51368 Leverkusen Germany www.investor.bayer.com New Study Presented at American Heart Association (AHA) Scientific Sessions
More informationIndividual Therapeutic Selection Of Anti-coagulants And Periprocedural. Miguel Valderrábano, MD
Individual Therapeutic Selection Of Anti-coagulants And Periprocedural Management Miguel Valderrábano, MD Outline Does the patient need anticoagulation? Review of clinical evidence for each anticoagulant
More informationANTIPLATELET THERAPY ANTIPLATELET THERAPY ANTIPLATELET THERAPY
ANTIPLATELET THERAPY 2018 UPDATE ANTIPLATELET THERAPY ANTIPLATELET THERAPY About this Pocket Guide This pocket guide is a quick-reference tool that features diagnostic and management recommendations based
More informationDisclosures. Updates in Acute Coronary Syndromes 10/21/17. No Conflicts of Interest. Updates in Acute Coronary Syndromes. Krishan Soni, MD, MBA, FACC
Disclosures Updates in Acute Coronary Syndromes No Conflicts of Interest Krishan Soni, MD, MBA, FACC Assistant Professor of Medicine Division of Cardiology Krishan.soni@ucsf.edu Updates in Acute Coronary
More informationTriple Therapy Post-Percutaneous Coronary Intervention (PCI) and/or Acute Coronary Syndrome (ACS): How and When to Ditch the Third Wheel
Triple Therapy Post-Percutaneous Coronary Intervention (PCI) and/or Acute Coronary Syndrome (ACS): How and When to Ditch the Third Wheel Elaine Lum (PharmD) Vancouver General Hospital April 19, 2018 1
More informationState of the Art in the ACS Atrial Fibrillation Overlap Syndrome
State of the Art in the ACS Atrial Fibrillation Overlap Syndrome C. Michael Gibson, M.S., M.D. Professor of Medicine, Harvard Medical School Chief, Clinical Research, Beth Israel Deaconess CV Division
More informationAntiplatelet Therapy: Current Recommendations for Choice of Agent and Concurrent Therapy with Warfarin and Novel Oral Anticoagulants
Antiplatelet Therapy: Current Recommendations for Choice of Agent and Concurrent Therapy with Warfarin and Novel Oral Anticoagulants S. Hinan Ahmed, MD Anti-platelet Therapy: Simple Answer Bare metal stent
More informationFølgende dias er fremlagt ved DCS / DTS Fællesmøde 13. januar 2011 og alle rettigheder tilhører foredragsholderen. Gengivelse må kun foretages ved
. Følgende dias er fremlagt ved DCS / DTS Fællesmøde 13. januar 2011 og alle rettigheder tilhører foredragsholderen. Gengivelse må kun foretages ved tilladelse Antithrombotic therapy in Atrial Fibrillation
More informationAfib, Stroke, and DOAC. Albert Luo, MD. Cardiology Lindsey Frischmann, DO. Neurology Xiao Cai, MD. HBS
Afib, Stroke, and DOAC Albert Luo, MD. Cardiology Lindsey Frischmann, DO. Neurology Xiao Cai, MD. HBS Disclosure of Relevant Financial Relationships I have no relevant financial relationships with commercial
More informationDays
Post ACS Care 2013 Clinical dilemmas Christopher Granger, MD Professor of Medicine Disclosure Research contracts: AstraZeneca, GSK, Merck, Sanofi- Aventis, BMS, Pfizer, The Medicines Company, Medtronic
More informationApixaban for Atrial Fibrillation in Patients with End-Stage Renal Disease on Dialysis
Apixaban for Atrial Fibrillation in Patients with End-Stage Renal Disease on Dialysis Caitlin Reedholm, PharmD PGY1 Pharmacy Resident St. David s South Austin Medical Center November 2, 2018 Abbreviations
More informationPrimary Care Atrial Fibrillation Update: Anticoagulation and Left Atrial Appendage Occlusion. Greg Francisco, MD, FACC
Primary Care Atrial Fibrillation Update: Anticoagulation and Left Atrial Appendage Occlusion Greg Francisco, MD, FACC DISCLOSURES None to declare Estimated 33.5million have AF worldwide (6-7million in
More informationAntithrombotics in Stroke management
Antithrombotics in Stroke management Faculty: Robert Beveridge Relationships with commercial interests: Grants/Research Support: N/A Speakers Bureau/Honoraria: Astra Zeneca, Bayer, Boerhinger Ingelheim,
More informationThrombin Receptor Antagonists and Other New Oral Antiplatelets Drugs
Thrombin Receptor Antagonists and Other New Oral Antiplatelets Drugs David J. Moliterno, MD Professor and Chairman Department of Internal Medicine The University of Kentucky Linda and Jack Gill Heart Institute
More informationAntiplatelet Therapy in Patients on Anticoagulation
Antiplatelet Therapy in Patients on Anticoagulation Ziad A Ali MD DPhil Cardiovascular Research Foundation Columbia University New York, Medical NY Center Cardiovascular Research Foundation Disclosure
More informationNew options in Stroke Prevention in AF Paul Dorian University of Toronto St Michael s Hospital
New options in Stroke Prevention in AF Paul Dorian University of Toronto St Michael s Hospital Disclosures: Honoraria, research support, and consulting f Sanofi, Boehringer-Ingleheim, Portola, BMS, Bayer,
More informationComplicated issues in GI bleeding for internists? Nonthalee Pausawasdi, M.D. Faculty of Medicine Siriraj Hospital
Complicated issues in GI bleeding for internists? Nonthalee Pausawasdi, M.D. Faculty of Medicine Siriraj Hospital Complicated issues in GI bleeding; Survey results from internists Optimal resuscitation
More informationOral anti-thrombotic therapy-management in patients requiring endoscopy
Oral anti-thrombotic therapy-management in patients requiring endoscopy Management of anti-thrombotic therapy in patients requiring endoscopy This guideline suggests appropriate management of patients
More informationcontroversies in anticoagulation: optimizing outcome for atrial fibrillation
controversies in anticoagulation: optimizing outcome for atrial fibrillation SUNDAY, NOVEMBER 13, 2016 WESTIN HOTEL NEW ORLEANS CANAL PLACE COLLABORATE INVESTIGATE EDUCATE PROVIDING PERSPECTIVE: CURRENT
More informationDAPT in CAD, Acute & Chronic CAD, antiplatelet therapy non-responders
DAPT in CAD, Acute & Chronic CAD, antiplatelet therapy non-responders Annual Ohio ACC Conference October 14, 2017 Ernest L. Mazzaferri Jr, MD, FACC, FSCAI Disclosures No financial disclosures related to
More informationOptimal lenght of DAPT in different clinical scenarios
Optimal lenght of DAPT in different clinical scenarios After PCI with DES in the light of recent and ongoing studies Dr Grégoire Rangé / CH Chartres / France DAPT duration depend on the evolution of risk
More informationClinical Practice Guideline for Anticoagulation Management
Clinical Practice Guideline for Anticoagulation Management This guideline is to inform practitioners of the Standard of Care for providing safe and effective anticoagulation management for ambulatory patients.
More informationJoshua D. Lenchus, DO, RPh, FACP, SFHM Associate Professor of Medicine and Anesthesiology University of Miami Miller School of Medicine
Joshua D. Lenchus, DO, RPh, FACP, SFHM Associate Professor of Medicine and Anesthesiology University of Miami Miller School of Medicine Antithrombotics Antiplatelets Aspirin Ticlopidine Prasugrel Dipyridamole
More information2018 CCS/CAIC Focused Update of the Guidelines for the Use of Antiplatelet Therapy Disclaimer
Disclaimer The Canadian Cardiovascular Society (CCS) welcomes reuse of our educational slide deck for medical institution internal education or training (i.e. grand rounds, medical college/classroom education,
More informationNovel Anticoagulants: Emerging Evidence
18/10/2016 Topics: Novel Anticoagulants: Emerging Evidence Dr Matthew Swale Electrophysiologist Genesis Care NOAC Novel Oral Anti Coagulant Now Non-Vit K Oral Anti Coagulant DOAC Direct Oral Anti Coagulant
More informationAtrial Fibrillation. Alan Bell, MD, CCFP. Staff Physician, Humber River Regional Hospital. University of Toronto
Pearls in Thrombosis 1 Atrial Fibrillation Alan Bell, MD, CCFP Staff Physician, Humber River Regional Hospital Assistant tprofessor, Department tof Family and Community Mdii Medicine University of Toronto
More information12/20/2018. Disclosures Coagulation Conundrums: The Challenge of Managing Multiple Antithrombotics. Talk Objectives. Epidemiologic Perspectives
Disclosures Coagulation Conundrums: The Challenge of Managing Multiple Antithrombotics Keith E Swanson MD FACP FSVM RPVI ND Family Medicine Conference, Big Sky MT January, 2019 Speaker s Bureau: Bristol
More informationSecondary Stroke Prevention: A Precautionary Tale
Secondary Stroke Prevention: A Precautionary Tale Kirsten George-Phillips, BSP Clinical Practice Leader, AHS Clinical Pharmacist, AHS Owen Stroke Prevention Clinic Learning Objectives! Examine literature
More informationCases & Panel Discussion
TSOACs What s the difference anyway? Controversies in selection and complications Augustus Hough, PharmD, BCPS (AQ-Cardiology) Clinical Pharmacy Specialist West Palm Beach VA Medical Center Larry Lopez
More informationA New Era for NOACs: What Does the Future Hold? CME
This article is a CME certified activity. To earn credit for this activity visit: http://www.medscape.org/viewarticle/884772 www.medscape.org A New Era for NOACs: What Does the Future Hold? CME Manesh
More information2017 Bryan Health Primary Care Conference. Dale Hansen MD Bryan Heart 5/20/17
2017 Bryan Health Primary Care Conference Dale Hansen MD Bryan Heart 5/20/17 I have no financial disclosures or conflicts of interest Bridging Anticoagulation Primum Non Nocere 67 y.o. male with mechanical
More informationShow Me the Outcomes!
Show Me the Outcomes! Real-World Safety Data on Oral Anticoagulants in Nonvalvular Atrial Fibrillation Gabby Anderson, PharmD PGY1 Pharmacy Resident anderson.gabrielle@mayo.edu Pharmacy Grand Rounds October
More informationUsing DOACs in CAD Patients in Sinus Ryhthm Results of the ATLAS ACS 2, COMPASS and COMMANDER-HF Trials
Using DOACs in CAD Patients in Sinus Ryhthm Results of the ATLAS ACS 2, COMPASS and COMMANDER-HF Trials 19 th Annual San Diego Heart Failure Symposium for Primary Care Physicians January 11-12, 2019 La
More information