Medical Therapy for Peripheral Artery Disease
|
|
- Tyler Myron Hood
- 5 years ago
- Views:
Transcription
1 Medical Therapy for Peripheral Artery Disease Beau M. Hawkins, MD, FSCAI University of Oklahoma Health Sciences Center, Oklahoma City, OK Sahil A. Parikh, MD, FSCAI Columbia University Medical Center, New York, NY
2 Medical Therapy in PAD- The Problem Medical therapy is underprescribed despite the excess cardiovascular risk associated with PAD Under-utilization is greater in the PAD population than it is in other forms of cardiovascular disease Aspirin Use in Incident PAD Population Subherwal et al. Circulation 2012;126:
3 Guideline-Directed Medical Therapy (GDMT) Antiplatelets Antithrombotics Statins GDMT Exercise Program Nicotine Cessation Comorbidity Treatment
4 Antiplatelets Aspirin reduces cardiovascular events in patients with coronary and cerebrovascular disease The benefits of antiplatelets in patients with PAD are less well established Monotherapy with aspirin or clopidogrel is a guideline recommendation Symptomatic patients- Class I, LOE A Asymptomatic patients- Class IIa, LOE C-EO Gerhard-Herman et al. Circulation 2017;135:e
5 Risk Reduction with Aspirin in PAD Meta-analysis of 18 randomized trials involving 5,269 patients with PAD Non-significant decrease in events with aspirin compared to placebo (8.9 vs. 11.0%, P=NS) Aspirin significantly reduced stroke risk Endpoint Composite of mortality, MI, or stroke Event rate (CI), aspirin vs. placebo 8.2 vs. 9.6% ( ) Mortality 7.5 vs. 7.9% ( ) MI 3.3 vs. 4.5% ( ) Stroke 2.1 vs. 3.4% ( ) Berger et al. JAMA 2009;301:
6 Clopidogrel Versus Aspirin in PAD CAPRIE Steering Committee. Lancet 1996;348:
7 % Improvement Walking Distance Miscellaneous Therapies- Cilostazol 60 P< P= NS Placebo Pentoxifylline Cilostazol Dawson et al. Am J Med 2000;7:523-30
8 Dual Antiplatelet Therapy (DAPT) in PAD Substudy of 3,096 patients with PAD from CHARISMA trial 92% had symptomatic PAD DAPT consisting of aspirin plus clopidogrel compared to aspirin monotherapy MI rates reduced with DAPT Minor but not severe bleeding increased in DAPT arm Event DAPT (%) Aspirin (%) P value Death, MI, stroke Death MI Stroke Major bleed Minor bleed <0.001 Cacoub et al. Eur Heart J 2009;30:
9 Newer Antiplatelets- EUCLID Trial 13,885 patients with symptomatic PAD randomized to ticagrelor or clopidogrel Primary endpoint- CV death, MI, or stroke Mean follow up of 30 months No difference in outcomes between groups Hiatt et al. NEJM 2017;376:32-40
10 PEGASUS PAD Sub-study Does DAPT with ticagrelor reduce events compared to aspirin monotherapy? 1,143 patients (5% of total) from PEGASUS-TIMI 54 analyzed posthoc Significant event reduction in ticagrelor arm at 3 years (NNT=25) Bonaca et al. J Am Coll Cardiol 2016;67:
11 PEGASUS PAD Sub-study Ticagrelor associated with lower rates of acute limb ischemia and peripheral revascularization Excess bleeding not evident at both 60 mg BID and 90 mg BID dosing Bonaca et al. J Am Coll Cardiol 2016;67:
12 Vorapaxar- TRAP2⁰P-TIMI 50 Study 5,845 patients with PAD 16% of patients received peripheral revascularization over mean f/u 2.5 years Vorapaxar associated with reductions in need for revascularization Vorapaxar increased moderate/severe bleeding Bonaca et al. J Am Coll Cardiol Intv. 2016;9:
13 Rivaroxaban in PAD- COMPASS Results 7,470 patients with leg PAD or carotid disease Patients randomized to aspirin, rivaroxaban, or combo therapy Primary endpoints included MACE (death/mi/cva) and MALE (ALI/CLI/amputation) Combo treatment reduced MACE compared to aspirin alone Anand et al. Lancet 2018;391:219-29
14 Adverse limb events reduced with rivaroxaban Anand et al. Lancet 2018;391:219-29
15 Statins Statins should be prescribed to all patients with PAD- class I, LOE A Statins increase walking distance and physical activity in claudicants Statin use is associated with improved patency following lower extremity revascularization Statins improve limb salvage rates in patients who have undergone peripheral revascularization Statins reduce rates of stroke, myocardial infarction, and death in patients with PAD Vogel et al. Circ Interv. 2013;6: , Mohler et al. Circulation 2003;108:1481-6, Aiello et al. J Vasc Surg 2012;55:371-80
16 Smoking Cessation Programs Work 124 smokers with PAD randomized to usual nicotine cessation counseling vs. intensive program Intensive program included counseling and education on pharmacologic methods to aid cessation Group Abstinent (%) P Value 3 month follow up - - Minimal Intensive month follow up - - Minimal Intensive Hennrikus et al. JACC 2010;56:
17 Cessation Medications- Varenicline Rigotti et al. Circulation 2010;121:221-9
18 Change in treadmill walking distance (%) Exercise Therapy Meta-Analysis Exercise training Control Exercise prescriptions come in one of two forms Supervised exercise Home-based exercise program Randomized trials support both types of programs to improve quality-of-life and walking distance in claudicants Onset of claudication pain Maximal claudication pain Gardner and Poehlman. JAMA 1995;274:975-80
19 Types of Structured Exercise Programs Gerhard-Herman et al. Circulation 2017;135:e
20 CMS Coverage of Supervised Exercise Programs min sessions in outpatient hospital or physician office setting Coverage of up to 36 sessions over 12 week period Sessions must be supervised by qualified personnel (physician, physician assistant, nurse practitioner) Exercise prescription must occur after face-to-face visit between patient and provider that includes counseling on cardiovascular disease prevention Available at CMS.gov, Decision memo for supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD), accessed February 22, 2018
21 Exercise Versus Revascularization- ERASE Trial Fakhry et al. JAMA 2015;314:
22 Exercise Versus Revascularization- CLEVER Trial 18 month f/u data of patients randomized to exercise, stenting, or medical therapy Only patients with aorto-iliac disease included Sustained improvement with stenting and exercise relative to medical therapy alone Peak Walking Distance (m) Murphy et al. J Am Coll Cardiol 2015;65:
23 Summary Antiplatelets, statins, nicotine cessation, and exercise are recommended as first-line therapies for treatment of PAD Clopidogrel monotherapy is more effective that aspirin at reducing composite adverse cardiovascular events (MACE) in patients with PAD DAPT utilizing either clopidogrel or ticagrelor reduces MACE compared to aspirin alone DAPT with ticagrelor is associated with reductions in adverse limb events (MALE)
24 Summary (continued) Vorapaxar use is associated with reduced rates of peripheral revascularization Rivaroxaban plus aspirin reduces MACE and MALE in patients with PAD Exercise therapy with or without revascularization improves functional outcomes in claudicants
A new era in the treatment of peripheral artery disease (PAD)?
A new era in the treatment of peripheral artery disease (PAD)? Prof. Dr. Jan Beyer-Westendorf Head of Thrombosis Research, University Hospital Carl Gustav Carus, TU Dresden; Germany Senior Lecturer Thrombosis
More information7 th Munich Vascular Conference
7 th Munich Vascular Conference Secondary prevention of major cardiovascular events in patients with CHD or PAD - What can we learn from EUCLID and COMPASS, evaluating Clopidogrel, Ticagrelor and Univ.-Prof.
More informationACC NY Cardiovascular Symposium
ACC NY Cardiovascular Symposium Peripheral Vascular Disease: Watch the Heart and the Brain Evolving Role of Exercise, ACE-Inhibitors, Interventional and Surgical Options Mark A. Creager, M.D President,
More informationIs there enough evidence for DAPT after endovascular intervention for PAOD?
Is there enough evidence for DAPT after endovascular intervention for PAOD? Prof. I. Baumgartner Head Clinical & Interventional Angiology University Hospital Bern Disclosure Speaker name:...i. Baumgartner...
More informationPeripheral Artery Disease Role of Exercise, Endovascular and Surgical Options
Peripheral Artery Disease Role of Exercise, Endovascular and Surgical Options Jeffrey W. Olin, D.O., F.A.C.C., F.A.H.A. Professor of Medicine (Cardiology) Director of Vascular Medicine & the Vascular Diagnostic
More informationJohn E. Campbell, MD. Assistant Professor of Surgery and Medicine Department of Vascular Surgery West Virginia University, Charleston Division
John E. Campbell, MD Assistant Professor of Surgery and Medicine Department of Vascular Surgery West Virginia University, Charleston Division John Campbell, MD For the 12 months preceding this CME activity,
More informationThe Changing Landscape of Managing Patients with PAD- Update on the Evidence and Practice of Care in Patients with Peripheral Artery Disease
Interventional Cardiology and Cath Labs The Changing Landscape of Managing Patients with PAD- Update on the Evidence and Practice of Care in Patients with Peripheral Artery Disease Manesh R. Patel MD Chief,
More informationHow Do We Optimize the Medical Therapy of Patients with Critical Limb Ischemia?
How Do We Optimize the Medical Therapy of Patients with Critical Limb Ischemia? Ehrin J. Armstrong, MD MSc MAS Director, Interventional Cardiology Director, Vascular Laboratory VA Eastern Colorado Healthcare
More informationΑντιθρομβωτική αγωγή σε ασθενείς με περιφερική αρτηριακή νόσο των κάτω άκρων
Αντιθρομβωτική αγωγή σε ασθενείς με περιφερική αρτηριακή νόσο των κάτω άκρων Μ. Ματσάγκας, MD, PhD, FEBVS Καθηγητής Αγγειοχειρουργικής Πανεπιστήμιο Θεσσαλίας Prevalence (millions) PAD Affects Millions
More informationTicagrelor versus Clopidogrel in Symptomatic Peripheral Artery Disease (EUCLID Trial)
Audience Interaction The chat box is available on the left hand side. Let us know who you are and where you re viewing from! Questions can be entered by hitting the green box with a question mark in it
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 informationMedical Therapy of Peripheral Artery Disease
Medical Therapy of Peripheral Artery Disease Alvaro Alonso, MD Assistant Professor of Medicine Associate Director, Interven4onal Cardiology Fellowship Program Tulane University Heart & Vascular Ins4tute
More informationCORONARY AND PERIPHERAL ARTERY ATHEROSCLEROSIS: WHAT CHOICE FOR ANTIPLATELET THERAPY
02_02 03/02/17 14.04 Pagina 9 CORONARY AND PERIPHERAL ARTERY ATHEROSCLEROSIS: WHAT CHOICE FOR ANTIPLATELET THERAPY P. Gresele Department of Medicine, Division of Internal and Cardiovascular Medicine, University
More informationOptimal medical treatment for polyvascular patient
Optimal medical treatment for polyvascular patient Dr. M. Sprynger 21 st of April 2018 Moderators: Prof. Dr. T. De Backer and Dr. P. Borgoens Optimal medical treatment for polyvascular patient Plenary
More informationAntithrombotic Therapy for Long-Term Secondary Prevention Considerations for Long-Term DAPT
Antithrombotic Therapy for Long-Term Secondary Prevention Considerations for Long-Term DAPT Marc P. Bonaca, MD, MPH Vascular Section, Cardiovascular Division Investigator TIMI Study Group Brigham and Women
More informationCarlo Patrono, MD, FESC. New York, 8 th December Catholic University School of Medicine, Rome, Italy. New York Cardiovascular Symposium
Aspirin in Primary and Secondary Cardiovascular Disease Prevention. Still Four Questions: About Enteric-Coated, Indicated Doses, Use in Diabetes, Use in PVD Carlo Patrono, MD, FESC Catholic University
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 informationPAD and CRITICAL LIMB ISCHEMIA: EVALUATION AND TREATMENT 2014
PAD and CRITICAL LIMB ISCHEMIA: EVALUATION AND TREATMENT 2014 Van Crisco, MD, FACC, FSCAI First Coast Heart and Vascular Center, PLLC Jacksonville, FL 678-313-6695 Conflict of Interest Bayer Healthcare
More informationControversies in Cardiac Pharmacology
Controversies in Cardiac Pharmacology Thomas D. Conley, MD FACC FSCAI Disclosures I have no relevant relationships with commercial interests to disclose. 1 Doc, do I really need to take all these medicines?
More informationThe Future of Oral Antiplatelets in PAD and CAD Christopher Paris, MD, FACC, FSCAI
The Future of Oral Antiplatelets in PAD and CAD Christopher Paris, MD, FACC, FSCAI Interventional Cardiologist Cardiovascular Institute of the South Director of Cardiovascular Services St. Charles Parish
More informationPeripheral Arterial Disease: Objectives. Disclosure. Definition: Peripheral Arterial Disease (PAD)
Geriatric Grand Rounds Tuesday, April 21, 2009 12:00 noon Dr. Bill Black Auditorium Glenrose Rehabilitation Hospital In keeping with Glenrose Rehabilitation Hospital policy, speakers participating in this
More informationPeripheral Arterial Disease (PAD): Presentation, Diagnosis, and Treatment
Peripheral Arterial Disease (PAD): Presentation, Diagnosis, and Treatment Prepared and Presented by Jon Manocchio, Pharm D Blanchard Valley Hospital October 2011 Introduction PAD is a condition that is
More informationClaudication Treatment Comparative Effectiveness: 6 Month Outcomes from the CLEVER Study
Claudication Treatment Comparative Effectiveness: 6 Month Outcomes from the CLEVER Study Authors: Murphy TP, Cutlip DE, Regensteiner JG, Mohler ER, Cohen DC, Reynolds MR, Lewis BA, Cerezo J, Oldenburg
More informationAntiplatelet therapy for peripheral artery disease
Review Article Antiplatelet therapy for peripheral artery disease Rosetta Melfi, Elisabetta Ricottini Unit of Cardiovascular Sciences, Department of Medicine, Campus Bio-Medico University of Rome, Rome,
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 informationLa terapia antiaggregante nel paziente con stroke
La terapia antiaggregante nel paziente con stroke Paolo Gresele Dipartimento di Medicina, Sez. Medicina Interna e Cardiovascolare Università di Perugia XXVII Congresso Nazionale FCSA Milano, 20-22 Ottobre
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 informationTreatment Strategies For Patients with Peripheral Artery Disease
Treatment Strategies For Patients with Peripheral Artery Disease Presented by Schuyler Jones, MD Duke University Medical Center & Duke Clinical Research Institute AHRQ Comparative Effectiveness Review
More informationPlatelet inhibition PLUS low-dose anticoagulation a new paradigm for all PAD patients?
Platelet inhibition PLUS low-dose anticoagulation a new paradigm for all PAD patients? Thomas HW Stadlbauer, MD Klinikum rechts der Isar, Technical University of Munich Disclosure Speaker name: Thomas
More informationRazionale ed evidenze scientifiche di Doppia Antiaggregazione Piastrinica a lungo termine nel Paziente con Sindrome Coronarica Acuta
Razionale ed evidenze scientifiche di Doppia Antiaggregazione Piastrinica a lungo termine nel Paziente con Sindrome Coronarica Acuta Giuseppe Musumeci SC Cardiologia Ospedale Santa Croce e Carle Cuneo
More informationMost Important Clinical Trials of the Past Decade in Vascular Intervention
Most Important Clinical Trials of the Past Decade in Vascular Intervention Andrew J. P. Klein, MD, FACC, FSCAI Interventional Cardiology Vascular and Endovascular Medicine Piedmont Heart Institute Atlanta,
More informationΠΑΝΕΠΙΣΤΗΜΙΟ ΙΩΑΝΝΙΝΩΝ
ΠΑΝΕΠΙΣΤΗΜΙΟ ΙΩΑΝΝΙΝΩΝ ΕΡΕΥΝΗΤΙΚΟ ΚΕΝΤΡΟ ΑΘΗΡΟΘΡΟΜΒΩΣΗΣ Σημαντικές Εξελίξεις στη Θρόμβωση 2014 2015 TRA 2P TIMI 50 και TRACER Substudies ΚΑΛΑΝΤΖΗ ΚΑΛΛΙΡΡΟΗ Καρδιολόγος ιδάκτωρ Ιατρικής Σχολής Πανεπιστημίου
More informationDual Antiplatelet duration in ACS: too long or too short?
Dual Antiplatelet duration in ACS: too long or too short? Leonardo Bolognese, MD, FESC, FACC Cardiovascular Department, Arezzo, Italy Paradigm Shift the ideal duration of DAPT: a moving target Early (stent-related)
More informationMedical Management of Vascular Disease KEITH E SWANSON MD ND ACADEMY OF FAMILY PHYSICIANS FAMILY MEDICINE UPDATE JANUARY 2017
Medical Management of Vascular Disease KEITH E SWANSON MD ND ACADEMY OF FAMILY PHYSICIANS FAMILY MEDICINE UPDATE JANUARY 2017 Objectives 1. Appreciate the long term implications of PAD 2. Appreciate the
More informationIs the combination of antithrombotics and lowdose anticoagulants worthwhile in PAD The VOYAGER trial
Is the combination of antithrombotics and lowdose anticoagulants worthwhile in PAD The VOYAGER trial Thomas HW Stadlbauer Department of Vascular and Endovascular Surgery, Klinikum rechts der Isar, Technical
More informationAntiplatelet Therapy in Primary CVD Prevention and Stable Coronary Artery Disease. Καρακώστας Γεώργιος Διευθυντής Καρδιολογικής Κλινικής, Γ.Ν.
Antiplatelet Therapy in Primary CVD Prevention and Stable Coronary Artery Disease Καρακώστας Γεώργιος Διευθυντής Καρδιολογικής Κλινικής, Γ.Ν.Κιλκίς Primary CVD Prevention A co-ordinated set of actions,
More informationDapagliflozin and Outcomes in Patients with Peripheral Artery Disease: Insights from DECLARE-TIMI 58
Dapagliflozin and Outcomes in Patients with Peripheral Artery Disease: Insights from DECLARE-TIMI 58 Marc P. Bonaca MD MPH for the DECLARE TIMI 58 Investigators American College of Cardiology March 2019
More informationClaudication Exercise vs. Endoluminal Revascularization
Claudication Exercise vs. Endoluminal Revascularization Anthony J. Comerota, MD, FACS, FACC Director, Jobst Vascular Institute Adjunct Professor of Surgery, University of Michigan Disclosures NIH Research
More informationLDL Cholesterol Lowering with Evolocumab and Outcomes in Patients with Peripheral Artery Disease: Insights from the FOURIER Trial
LDL Cholesterol Lowering with Evolocumab and Outcomes in Patients with Peripheral Artery Disease: Insights from the FOURIER Trial Marc P. Bonaca, Patrice Nault, Robert P. Giugliano, Anthony C. Keech, Armando
More informationThe Great debate: thrombocardiology post-compass
The Great debate: thrombocardiology post-compass Anticoagulation should replace antiplatelets in CAD prevention - CON Jean-Philippe COLLET Jean-philippe.collet@psl.aphp.fr Sorbonne Université_Action Study
More informationLearning Objectives. Epidemiology of Acute Coronary Syndrome
Cardiovascular Update: Antiplatelet therapy in acute coronary syndromes PHILLIP WEEKS, PHARM.D., BCPS-AQ CARDIOLOGY Learning Objectives Interpret guidelines as they relate to constructing an antiplatelet
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 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 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 informationΔιάρκεια διπλής αντιαιμοπεταλιακής αγωγής. Νικόλαος Γ.Πατσουράκος Καρδιολόγος, Επιμελητής Α ΕΣΥ Τζάνειο Γενικό Νοσοκομείο Πειραιά
Διάρκεια διπλής αντιαιμοπεταλιακής αγωγής Νικόλαος Γ.Πατσουράκος Καρδιολόγος, Επιμελητής Α ΕΣΥ Τζάνειο Γενικό Νοσοκομείο Πειραιά International ACS guidelines: Recommendations on duration of dual
More informationArteriopatie periferiche. Trattamento delle arteriopatie periferiche: AVK versus Antiaggregante
Arteriopatie periferiche Trattamento delle arteriopatie periferiche: AVK versus Antiaggregante Anna Falanga USC Immunoematologia e Medicina Trasfusionale ASST Papa Giovanni XXIII, Bergamo Obiettivi della
More informationOptimal medical therapy in patients with stable CAD
Optimal medical therapy in patients with stable CAD Robert Storey Professor of Cardiology, University of Sheffield and Academic Director and Honorary Consultant Cardiologist, Cardiology and Cardiothoracic
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 informationRe- Setting our COMPASS for Secondary Prevention in Atherosclerotic Vascular Disease
Re- Setting our COMPASS for Secondary Prevention in Atherosclerotic Vascular Disease Robert C. Welsh, MD, FRCPC Professor of Medicine, University of Alberta Zone Clinical Department Head, Cardiac Sciences
More informationΠροβληματισμοι στην χρηση αντιαιμοπεταλιακων στα οξέα ισχαιμικά σύνδρομα
Α ΚΑΡΔΙΟΛΟΓΙΚΗ ΚΛΙΝΙΚΗ ΚΑΙ ΟΜΩΝΥΜΟ ΕΡΓΑΣΤΗΡΙΟ ΙΑΤΡΙΚΗ ΣΧΟΛΗ ΠΑΝΕΠΙΣΤΗΜΙΟΥ ΑΘΗΝΩΝ ΙΠΠΟΚΡΑΤΕΙΟ ΓΕΝΙΚΟ ΝΟΣΟΚΟΜΕΙΟ ΑΘΗΝΩΝ Διευθυντής: Καθηγητής ΔΗΜΗΤΡΙΟΣ ΤΟΥΣΟΥΛΗΣ Προβληματισμοι στην χρηση αντιαιμοπεταλιακων
More informationGuidelines for Management of Peripheral Arterial Disease
Guidelines for Management of Peripheral Arterial Disease Subhash Banerjee, MD, FACC, FSCAI Professor of Medicine, Univ. of Texas Southwestern Medical Center Chief, Division of Cardiology, VA North Texas
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 informationInvestor Conference Call
Investor Conference Call Data from the Phase III COMPASS trial, A Randomized Controlled Trial of Rivaroxaban for the Prevention of Major Cardiovascular Events in Patients With Coronary or Peripheral Artery
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 informationMedical therapy after angioplasty / stenting
Nurse and Technician Forum Part I Medical therapy after angioplasty / stenting Erich Minar Department Angiology Medical University Vienna Disclosure Speaker name: Erich Minar I do not have any potential
More informationWhat s New in the Management of Peripheral Arterial Disease
What s New in the Management of Peripheral Arterial Disease Sibu P. Saha, MD, MBA Professor of Surgery Chairman, Directors Council Gill Heart Institute University of Kentucky Lexington, KY Disclosure My
More informationGuidelines PATHOLOGY: FATAL PERIOPERATIVE MI NON-PMI N = 25 PMI N = 42. Prominent Dutch Cardiovascular Researcher Fired for Scientific Misconduct
PATHOLOGY: FATAL PERIOPERATIVE MI NON-PMI N = 25 PMI N = 42 Preoperative, Intraoperative, and Postoperative Factors Associated with Perioperative Cardiac Complications in Patients Undergoing Major Noncardiac
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 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 informationTicagrelor versus Clopidogrel in Symptomatic Peripheral Artery Disease
Original Article versus in Symptomatic Peripheral Artery Disease William R. Hiatt, M.D., F. Gerry R. Fowkes, M.D., Gretchen Heizer, M.S., Jeffrey S. Berger, M.D., Iris Baumgartner, M.D., Peter Held, M.D.,
More informationDr Julia Hopyan Stroke Neurologist Sunnybrook Health Sciences Centre
Dr Julia Hopyan Stroke Neurologist Sunnybrook Health Sciences Centre Objectives To learn what s new in stroke care 2010-11 1) Acute stroke management Carotid artery stenting versus surgery for symptomatic
More informationOptimal Duration and Dose of Antiplatelet Therapy after PCI
Optimal Duration and Dose of Antiplatelet Therapy after PCI Donghoon Choi, MD, PhD Severance Cardiovascular Center Yonsei University College of Medicine Optimal Duration of Antiplatelet Therapy after PCI
More informationBalancing Efficacy and Safety of P2Y12 Inhibitors for ACS Patients
SYP.CLO-A.16.07.01 Balancing Efficacy and Safety of P2Y12 Inhibitors for ACS Patients dr. Hariadi Hariawan, Sp.PD, Sp.JP (K) TOPICS Efficacy Safety Consideration from Currently Available Antiplatelet Agents
More informationACS: What happens after the acute phase? Frans Van de Werf, MD, PhD Leuven, Belgium
ACS: What happens after the acute phase? Frans Van de Werf, MD, PhD Leuven, Belgium 4/14/2011 Cumulative death rates in 3721 ACS patients from UK and Belgium at ± 5 year (GRACE) 25 20 15 19% TOTAL 14%
More informationPeripheral Artery Disease Compendium
Peripheral Artery Disease Compendium Circulation Research Compendium on Peripheral Artery Disease Epidemiology of Peripheral Artery Disease Pathogenesis of the Limb Manifestations and Exercise Limitations
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 informationΑντιαιμοπεταλιακη αγωγη (ποια, πο τε και για πο σο)
Αντιαιμοπεταλιακη αγωγη (ποια, πο τε και για πο σο) Dimitrios Alexopoulos, MD, FESC, FACC Cardiology Department, Patras University Hospital, Patras, Rio, Greece. Patras University Hospital I, Dimitrios
More informationQuale terapia antiaggregante nello STEMI? Prasugrel vs ticagrelor
Quale terapia antiaggregante nello STEMI? Prasugrel vs ticagrelor Leonardo Bolognese Cardiovascular Department, Arezzo, Italy Platelet Reactivity in Patients with STEMI Undergoing Primary PCI Campo G et
More informationSupplementary Table S1: Proportion of missing values presents in the original dataset
Supplementary Table S1: Proportion of missing values presents in the original dataset Variable Included (%) Missing (%) Age 89067 (100.0) 0 (0.0) Gender 89067 (100.0) 0 (0.0) Smoking status 80706 (90.6)
More informationPrevenzione secondaria dell ischemia cerebrale di origine arteriosa. Marco Cattaneo. Ospedale San Paolo Università degli Studi di Milano
Prevenzione secondaria dell ischemia cerebrale di origine arteriosa Marco Cattaneo Ospedale San Paolo Università degli Studi di Milano Cerebral Ischemia of Arterial Origin (CIAO) Cumulative meta-analysis
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 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 information5/2/2016. Outpatient Stroke Management Sheila Smith MD May 5, 2016
Outpatient Stroke Management Sheila Smith MD May 5, 2016 1 Management of Outpatient Stroke Objectives Review blood pressure management post stroke Review antithrombotic therapy Review statin therapy Discuss
More informationDECLARATION OF CONFLICT OF INTEREST. Lecture fees: AstraZeneca, Ely Lilly, Merck.
DECLARATION OF CONFLICT OF INTEREST Lecture fees: AstraZeneca, Ely Lilly, Merck. Risk of stopping dual therapy. S D Kristensen, FESC Aarhus Denmark Acute coronary syndrome: coronary thrombus Platelets
More informationAdjunctive Antithrombotic for PCI. SCAI Fellows Course December 9, 2013
Adjunctive Antithrombotic for PCI SCAI Fellows Course December 9, 2013 Theodore A Bass, MD FSCAI President SCAI Professor of Medicine, University of Florida Medical Director UF Shands CV Center,Jacksonville
More informationP 2 Y 12 Receptor Inhibitors
P 2 Y 12 Receptor Inhibitors Clopidogrel, Prasugrel and Ticagrelor Which Drug and for Whom? Cheol Whan Lee, MD Professor of Medicine, University of Ulsan College of Medicine, Heart Institute, Asan Medical
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 informationVascular Protection in Patients with CAD and PAD: New Options
Vascular Protection in Patients with CAD and PAD: New Options Professor Dr Eike Sebastian Debus Direktor Klinik für Gefäßmedizin Gefäßchirurgie Angiologie Interventionelle Therapie Deutsches Aortenzentrum
More information03/30/2016 DISCLOSURES TO OPERATE OR NOT THAT IS THE QUESTION CAROTID INTERVENTION IS INDICATED FOR ASYMPTOMATIC CAROTID OCCLUSIVE DISEASE
CAROTID INTERVENTION IS INDICATED FOR ASYMPTOMATIC CAROTID OCCLUSIVE DISEASE Elizabeth L. Detschelt, M.D. Allegheny Health Network Vascular and Endovascular Symposium April 2, 2016 DISCLOSURES I have no
More informationACCP Cardiology PRN Journal Club
ACCP Cardiology PRN Journal Club 1 Optimising Crossover from Ticagrelor to Clopidogrel in Patients with Acute Coronary Syndrome [CAPITAL OPTI-CROSS] Monique Conway, PharmD, BCPS PGY-2 Cardiology Pharmacy
More informationSESSION 5 2:20 3:35 pm
SESSION 2:2 3:3 pm Strategies to Reduce Cardiac Risk for Noncardiac Surgery SPEAKER Lee A. Fleisher, MD Presenter Disclosure Information The following relationships exist related to this presentation:
More informationClopidogrel has been evaluated in clinical trials that included cardiovascular patients
REVIEW ARTICLE Comparative Benefits of Clopidogrel and Aspirin in High-Risk Patient Populations Lessons From the CAPRIE and CURE Studies Jack Hirsh, CM, MD, FRCPC, FRACP, FRSC, DSc; Deepak L. Bhatt, MD,
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 informationPrasugrel vs. Ticagrelor in ACS/PCI Which one to choose? V. Voudris MD FESC FACC 2 nd Cardiology Division Onassis Cardiac Surgery Center
Prasugrel vs. Ticagrelor in ACS/PCI Which one to choose? V. Voudris MD FESC FACC 2 nd Cardiology Division Onassis Cardiac Surgery Center Hospitalizations in the U.S. Due to ACS Acute Coronary Syndromes
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 informationDoes COMPASS Change Practice?
Does COMPASS Change Practice? C. Michael Gibson, M.S., M.D. Professor of Medicine, Harvard Medical School Chief, Clinical Research, Beth Israel Deaconess CV Division Chairman, PERFUSE Study Group Founder,
More informationClopidogrel vs New Antiplatelet Therapy (Prasugrel) Adnan Kastrati, MD Deutsches Herzzentrum, Technische Universität München, Germany
Clopidogrel vs New Antiplatelet Therapy () Adnan Kastrati, MD Deutsches Herzzentrum, Technische Universität München, Germany Seoul, April 3, 21 Dual Antiplatelet Therapy for Stenting MACE, % 12 1 8 6 In
More informationStephan Windecker Department of Cardiology Swiss Cardiovascular Center and Clinical Trials Unit Bern Bern University Hospital, Switzerland
Advances in Antiplatelet Therapy in PCI and ACS Stephan Windecker Department of Cardiology Swiss Cardiovascular Center and Clinical Trials Unit Bern Bern University Hospital, Switzerland Targets for Platelet
More informationΠεριφερική Αρτηριακή Νόσος Νόσος Καρωτίδων
Νεώτερα δεδομένα στην αντιαιμοπεταλιακή αγωγή που θα επηρεάσουν τις μελλοντικές κατευθυντήριες οδηγίες Περιφερική Αρτηριακή Νόσος Νόσος Καρωτίδων Μιλτιάδης Ματσάγκας, MD, PhD, FEBVS Αναπληρωτής Καθηγητής
More informationTRIPLE 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 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 informationManagement of Stable Ischemic Heart Disease. Vinay Madan MD February 10, 2018
Management of Stable Ischemic Heart Disease Vinay Madan MD February 10, 2018 1 Disclosure No financial disclosure. 2 Overview of SIHD Diagnosis Outline of talk Functional vs. Anatomic assessment Management
More informationBetter CABGs vs Better PCI Devices
CABG vs PCI 2017 Multivessel Coronary Disease Better CABGs vs Better PCI Devices ACC New York, Dec 8, 2017 No Disclosures CABG vs PCI 2017 Stable Multivessel Coronary Disease 1. Are These The two Critical
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 informationCoronary plaque erosion: a clinical case. Dr. Giampaolo Niccoli, MD, PhD, FESC Institute of Cardiology Catholic University, Rome, Italy
Coronary plaque erosion: a clinical case, MD, PhD, FESC Institute of Cardiology Catholic University, Rome, Italy Coronary plaque erosion: a clinical case B.M. Age: 59 years Sex: female. Cardiological risk
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 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 informationTicagrelor versus Clopidogrel in Symptomatic Peripheral Artery Disease
The new england journal of medicine Original Article versus in Symptomatic Peripheral Artery Disease William R. Hiatt, M.D., F. Gerry R. Fowkes, M.D., Gretchen Heizer, M.S., Jeffrey S. Berger, M.D., Iris
More informationThe Struggle to Manage Stroke, Aneurysm and PAD
The Struggle to Manage Stroke, Aneurysm and PAD In this article, Dr. Salvian examines the management of peripheral arterial disease, aortic aneurysmal disease and cerebrovascular disease from symptomatology
More information