C.R.E.D.O. Multicenter Multinational (USA, Canada) Prospective Randomized Double Blind Placebo Controlled Trial
|
|
- Ginger Cummings
- 5 years ago
- Views:
Transcription
1 Clopidogrel for the Reduction of Events During Observation Multicenter Multinational (USA, Canada) Prospective Randomized Double Blind Placebo Controlled Trial From Steinhubl et al, JAMA 2002;228:
2 Aim of the Study Safety and efficacy of a loading dose of Clopidogrel prior to elective PCI Safety and efficacy of 1 Year vs 1 Month combined treatment with Clopidogrel 75 mg + ASA after elective PCI
3 Inclusion Criteria Pts with symptomatic CAD scheduled for PCI without contraindications to antithrombotic or antiplatelet treatment or stent implantation and with no ST segment elevation within 24 hrs or planned staged procedures or recent (<7 days) administration of GP IIb-IIIa inhibitors, clopidogrel or thrombolytics
4 3-24 hrs before PCI 300 mg Clopidogrel Loading Dose + ASA 325 mg Placebo + ASA 325 mg GP IIb-IIIa Inhib. (mainly Abciximab) on prespecified or Bail-out Indications Clopidogrel 75 mg + ASA 325 mg for 1 Month 75 mg Clopidogrel + ASA 325 mg for 1 Year Placebo + ASA 325 mg for 1 Year 28 Days and 1 Year Clinical Follow-Up
5 Outcomes At 28 Days Death, MI, Urgent TVR in the per protocol population (all pts undergoing PCI) with prespecified secondary analysis of pts receiving clopidogrel loading dose or placebo <6 hrs or >6 hrs before PCI At 1 Year Death, MI, Stroke with prespecified secondary endpoints of TVR
6 Power Calculation based on a Retrospective Analysis of 2450 Pts in the EPISTENT trial: 28 Days Events 13.4% P< % 7.5% No Ticlopidine Ticlopidine Expected Pre-PTCA Pre-PTCA for Clopid. Loading (expected placebo) Dose + 1 Year From Steinhubl et al, JACC 1998;32:
7 Clinical Characteristics (I) Clopidogrel Loading Dose + Clopidogrel 1 Year N= 1053 Placebo Loading Dose + Clopidogrel 1 Mo N= 1063 Age (yrs) NS Male Sex (%) 70.7% 72.1% NS Diabetes (%) 27.5% 25.4% NS Statins (%) 53.6% 57.5% p=0.07 Ca ++ Chan. Block. (%) 25.5% 29.4% p=0.08 MI Indication (%) UAP NS SA PTCA Treatment (%) Medical NS CABG
8 Clinical Characteristics (II) Clopidogrel Loading Dose + Clopidogrel 1 Year N= 900 Placebo Loading Dose + Clopidogrel 1 Mo N= 915 Received >1 Stent (%) NS Total Stent Length (mm) NS GP IIb-IIIa Antag. (%) 47.4% 43.3% p=0.08
9 Death, MI and Urgent TVR at 28 Days NS -18.5% Clopid. No Loading Clopid. Loading 8.3% 6.8% 0 Days
10 Death, MI and Urgent TVR at 28 Days P= % Clopid. No Loading Clopid. < 6 Hrs Loading Clopid. > 6 Hrs 0 Days
11 Death, MI, Urgent TVR at 28 Days
12 Death, MI and Stroke at 1 Year P= % 8.5% -26% Clopid. 1 Mth Clopid. 1 Year Mths
13 Death, MI, Stroke at 1 Year in Key Subgroups 0 1/ Hrs
14 1 Year Primary and Secondary Prespecified EndPoints 1 Year Clopidogrel 1 Month Clopidogrel Death MI Stroke TVR
15 Loading Dose-1 Year Clopidogrel Major Bleedings 1 Month Clopidogrel P = P = Days 1 Year More than ½ of major procedural bleedings due to CABG
16 Conclusions Prolongation of treatment with an ADP inhibitor such as clopidogrel beyond 1 month after PCIreduces the incidence of death/mi at 1 year There is a strong trend to reduction of death/mi/urgent TVR at 28 days after a loading dose of 300 mg of clopidogrel administered at least 6 hrs before PCI
17 Questions and Criticisms Did pretreatment interfere with long-term results? Did the poor compliance to long-term treatment with clopidogrel (only 63/61% of pts took the study drug) modify results? Can we improve it? Can we reduce the excess of bleeding?
18 Aspirin Dose and Bleeding Events in CURE Pts with non-st Elevation ACS Aspirin Alone (p=0.057) Aspirin/Clopidogrel (p=0.042) Major or Life Threatening Bleeding Events ASA <100 mg mg mg >300 mg From Peters et al EHJ 2002;Suppl.4:510
19 Will a higher loading dose help? Pts pretreated with 200 mg Aspirin / Hrs From Muller et al, Heart 2001;85:92-93
20 Do we still need IIb-IIIa inhibitors in pts with effective clopidogrel pretreatment? ISAR- REACT: after 600 mg loading dose Clopidogrel: Randomization to Abciximab or Placebo
21 TOPSTAR Study 109 Pts with 375 mg Clopidogrel and 500 mg ASA 24 Hrs before PCI Tirofiban 10 μg + 18 Hrs Infusion Placebo bolus + 18 Hrs infusion Prior 30 min 12 Hrs 48 Hrs From Bonz et al, JACC 2002;40:662-8
22 TOPSTAR Study 109 Pts with 375 mg Clopidogrel and 500 mg ASA 24 Hrs before PCI Tirofiban 10 μg + 18 Hrs Infusion 40% Placebo bolus + 18 Hrs infusion 63% Positive Troponin T (>0.01 μg/ml) From Bonz et al, JACC 2002;40:662-8
23 Is 1 Year Treatment Enough? CHARISMA: Stable Angina Pts with 42 Mths F-Up From Metha et al, Lancet 2001;358: Pts undergoing PCI in the CURE trial
24 Questions and Criticisms What about cost-effectiveness? Mechanism of clinical benefit? prevention of periprocedural damage, TVR late events and non TVR late events Long-term treatment with clopidogrel advised for pts who receive drug eluting stents (3 mths SIRIUS, 6 mths TAXUS)
Oral Antiplatelet Therapy in PCI/ACS. Dominick J. Angiolillo, MD, PhD, FACC, FESC Director of Cardiovascular Research Assistant Professor of Medicine
Oral Antiplatelet Therapy in PCI/ACS Dominick J. Angiolillo, MD, PhD, FACC, FESC Director of Cardiovascular Research Assistant Professor of Medicine Basic Concepts Thrombus Formation Two key elements:
More informationAntiplatelet and Antithrombotic Therapies in PCI Defining the Optimal Strategy
Antiplatelet and Antithrombotic Therapies in PCI Defining the Optimal Strategy Franz-Josef Neumann Herz-Zentrum Bad Krozingen Antiplatelet and Antithrombotic Therapies in PCI Defining the Optimal Strategy
More informationP2Y 12 blockade. To load or not to load before the cath lab?
UPDATE ON ANTITHROMBOTICS IN ACUTE CORONARY SYNDROMES P2Y 12 blockade. To load or not to load before the cath lab? Franz-Josef Neumann Personal: None Institutional: Conflict of Interest Speaker honoraria,
More informationRole of Clopidogrel in Acute Coronary Syndromes. Hossam Kandil,, MD. Professor of Cardiology Cairo University
Role of Clopidogrel in Acute Coronary Syndromes Hossam Kandil,, MD Professor of Cardiology Cairo University ACS Treatment Strategies Reperfusion/Revascularization Therapy Thrombolysis PCI (with/ without
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 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 informationAdults With Diagnosed Diabetes
Adults With Diagnosed Diabetes 1990 No data available Less than 4% 4%-6% Above 6% Mokdad AH, et al. Diabetes Care. 2000;23(9):1278-1283. Adults With Diagnosed Diabetes 2000 4%-6% Above 6% Mokdad AH, et
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 informationAnti-platelet Therapies in Cardiovascular Disease: From Stable CAD to ACS and Afib!
Anti-platelet Therapies in Cardiovascular Disease: From Stable CAD to ACS and Afib! Roxana Mehran, MD Columbia University Medical Center Cardiovascular Research Foundation Disclosures Research support
More informationStent Thrombosis Importance of Pharmacotherapy
Stent Thrombosis Importance of Pharmacotherapy George D. Dangas, MD, FSCAI Columbia University Medical Center Cardiovascular Research Foundation New York City SCAI-2007 Orlando, FL Presenter Disclosure
More informationFacilitated Percutaneous Coronary Intervention in Acute Myocardial Infarction. Is it beneficial to patients?
Facilitated Percutaneous Coronary Intervention in Acute Myocardial Infarction Is it beneficial to patients? Seung-Jea Tahk, MD. PhD. Suwon, Korea Facilitated PCI.. background Degree of coronary flow at
More informationOptimal antiplatelet and anticoagulant therapy for patients treated in STEMI network
Torino 6 Joint meeting with Mayo Clinic Great Innovation in Cardiology 14-15 Ottobre 2010 Optimal antiplatelet and anticoagulant therapy for patients treated in STEMI network Diego Ardissino Ischemic vs
More informationCangrelor: Is it the new CHAMPION for PCI? Robert Barcelona, PharmD, BCPS Clinical Pharmacy Specialist, Cardiac Intensive Care Unit November 13, 2015
Cangrelor: Is it the new CHAMPION for PCI? Robert Barcelona, PharmD, BCPS Clinical Pharmacy Specialist, Cardiac Intensive Care Unit November 13, 2015 Objectives Review the pharmacology and pharmacokinetic
More informationNovel Anticoagulation Therapy in Acute Coronary Syndrome
Novel Anticoagulation Therapy in Acute Coronary Syndrome Soon Jun Hong Korea University Anam Hospital 1 Thrombus Formation Cascade Coagulation Cascade Platelet Cascade TXA2 Aspirin R Inhibitor Fondaparinux
More informationThe use of percutaneous coronary intervention (PCI) as
Antithrombotic Therapy During Percutaneous Coronary Intervention The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy Jeffrey J. Popma, MD; Peter Berger, MD; E. Magnus Ohman, MD, FCCP;
More informationTRIAL UPDATE 1. ISAR TRIPLE SECURITY Trial. Dr Deven Patel Royal Free Hospital
TRIAL UPDATE 1 ISAR TRIPLE SECURITY Trial Dr Deven Patel Royal Free Hospital NO CONFLICT OF INTEREST TO DECLARE ISAR TRIPLE Comparison of 6 weeks vs 6 months Triple Therapy in patients on oral anticoagulation
More informationAntiplatelet Therapy After PCI: How Much and How Long?
Antiplatelet Therapy After PCI: How Much and How Long? Adnan Kastrati Deutsches Herzzentrum, Munich, GERMANY Antiplatelet Therapy after PCI: How much and how long? The simplest and extreme response: Give
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 informationAdjunctive Antithrombotic for PCI. SCAI Fellows Course December 8, 2014
Adjunctive Antithrombotic for PCI SCAI Fellows Course December 8, 2014 Theodore A Bass, MD FSCAI Immediate Past-President SCAI Professor of Medicine, University of Florida Medical Director UF Health CV
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 informationColumbia University Medical Center Cardiovascular Research Foundation
STEMI and NSTEMI Pharmacology Confusion: How to Choose and Use Antithrombins (Unfractionated and Low Molecular Heparins, Bivalirudin, Fondaparinux) and Antiplatelet Agents (Aspirin, Clopidogrel and Prasugrel)
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 informationUpdated and Guideline Based Treatment of Patients with STEMI
Updated and Guideline Based Treatment of Patients with STEMI Eli I. Lev, MD Director, Cardiac Catheterization Laboratory Hasharon Hospital, Rabin Medical Center Associate Professor of Cardiology Tel-Aviv
More informationSpeaker s name: Thomas Cuisset, MD, PhD
Speaker s name: Thomas Cuisset, MD, PhD X I have the following potential conflicts of interest to report: x Consulting: Daiichi Sankyo, Eli Lilly Employment in industry Stockholder of a healthcare company
More informationTiming of Surgery After Percutaneous Coronary Intervention
Timing of Surgery After Percutaneous Coronary Intervention Deepak Talreja, MD, FACC Bayview/EVMS/Sentara Outline/Highlights Timing of elective surgery What to do with medications Stopping anti-platelet
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 informationAntiplatelet Therapy: how, why, when? For Coronary Stenting
Antiplatelet Therapy: how, why, when? For Coronary Stenting Dominick J. Angiolillo, MD, PhD, FACC, FESC, FSCAI Director of Cardiovascular Research Associate Professor of Medicine University of Florida
More informationSurveying the Landscape of Oral Antiplatelet Therapy in Acute Coronary Syndrome Management
Surveying the Landscape of Oral Antiplatelet Therapy in Acute Coronary Syndrome Management Jeffrey S Berger, MD, MS Assistant Professor of Medicine and Surgery Director of Cardiovascular Thrombosis Disclosures
More informationBivalirudin should be indicated for all patients with STEMI. Adnan Kastrati Deutsches Herzzentrum, Munich, Germany
Bivalirudin should be indicated for all patients with STEMI Adnan Kastrati Deutsches Herzzentrum, Munich, Germany 1 Heparin+IIb/IIIa, heparin alone or bivalirudin in STEMI: Do we have the answer? 2 Heparin+IIb/IIIa,
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 informationUpdate on Antithrombotic Therapy in Acute Coronary Syndrome
Update on Antithrombotic Therapy in Acute Coronary Syndrome Laura Tsang November 13, 2006 Objectives: By the end of this session, you should understand: The role of antithrombotics in ACS Their mechanisms
More informationSCA ST- : recommandations européennes 2015 La durée de la bithérapie : à géométrie variable?
SCA ST- : recommandations européennes 2015 La durée de la bithérapie : à géométrie variable? tielle est 2 ré Totielle est interdite. Prof. Marco Roffi Hôpitaux Universitaires de Genève Research funding
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 informationAntiplatelet Therapy. Briain Mac Neill
Antiplatelet Therapy Briain Mac Neill Galway University Hospital & National University of Ireland Galway Milestones in ACS Management Anti-Thrombin Rx Heparin LMWH Bivalirudin Anti-Platelet Rx Aspirin
More informationAntiplatelet therapy and Coronary Interventions. Georgios I. Papaioannou, MD Hartford Hospital Grand Rounds 4/22/2003
Antiplatelet therapy and Coronary Interventions Georgios I. Papaioannou, MD Hartford Hospital Grand Rounds 4/22/2003 Objectives Pharmacology of GP IIb/IIIa inhibitors and Monitoring of Platelet Inhibition
More information(ClinicalTrials.gov ID: NCT ) Title: The Italian Elderly ACS Study Author: Stefano Savonitto. Date: 29 August 2011 Meeting: ESC congress, Paris
Early aggressive versus initially conservative strategy in elderly patients with non-st- elevation acute coronary syndrome: the Italian randomised trial (ClinicalTrials.gov ID: NCT00510185) Stefano Savonitto,
More informationCOAGULATION, BLEEDING, AND TRANSFUSION IN URGENT AND EMERGENCY CORONARY SURGERY
COAGULATION, BLEEDING, AND TRANSFUSION IN URGENT AND EMERGENCY CORONARY SURGERY VALTER CASATI, M.D. DIVISION OF CARDIOVASCULAR ANESTHESIA AND INTENSIVE CARE CLINICA S. GAUDENZIO NOVARA (ITALY) ANTIPLATELET
More informationHow Long Patietns Will Be on Dual Antiplatelet Therapy?
How Long Patietns Will Be on Dual Antiplatelet Therapy? Ron Waksman,, MD, FACC Professor of Medicine (Cardiology) Georgetown University Associate Director, Division of Cardiology, Washington Hospital Center
More informationPerspective of LM stenting with Current registry and Randomized Clinical Data
Asian Pacific TCT Perspective of LM stenting with Current registry and Randomized Clinical Data Patrick W. Serruys MD PhD Yoshinobu Onuma MD Seung-Jung Park MD, PhD 14:48-15:00, 2009 Symposium Arena, Level
More informationClinical Case. Management of ACS Based on ACC/AHA & ESC Guidelines. Clinical Case 4/22/12. UA/NSTEMI: Definition
Clinical Case Management of ACS Based on ACC/AHA & ESC Guidelines Dr Badri Paudel Mr M 75M Poorly controlled diabetic Smoker Presented on Sat 7pm Intense burning in the retrosternal area Clinical Case
More informationUpstream P2Y 12 RB. Stefano Savonitto Divisione di Cardiologia Arcispedale S. Maria Nuova Reggio Emilia
Upstream P2Y 12 RB Stefano Savonitto Divisione di Cardiologia Arcispedale S. Maria Nuova Reggio Emilia Dio può essere dimostrato Le dimostrazioni dell esistenza di Dio IA Dio non può essere dimostrato
More informationPathophysiology of ACS
Pathophysiology of ACS ~ 2.0 MM patients admitted to CCU or telemetry annually 0.6 MM ST-segment elevation MI 1.4 MM Non-ST-segment elevation ACS NSTEMI vs STEMI VANQWISH Boden et al N Engl J Med 1998;338:1785-1792
More informationPlatelet function testing to guide P2Y 12 -inhibitor treatment in ACS patients after PCI: insights from a national program in Hungary
Platelet function testing to guide P2Y 12 -inhibitor treatment in ACS patients after PCI: insights from a national program in Hungary Dániel Aradi MD PhD Interventional Cardiologist Assistant professor
More informationDirect Thrombin Inhibitors for PCI Pharmacology: Role of Bivalirudin in High-Risk PCI
Direct Thrombin Inhibitors for PCI Pharmacology: Role of Bivalirudin in High-Risk PCI Charles A. Simonton MD, FACC, FSCAI Sanger Clinic Medical Director Clinical Innovation and Research Carolinas Heart
More informationCase Challenges in ACS The Very Elderly in the Cath Lab
Case Challenges in ACS The Very Elderly in the Cath Lab Sameh Salama, MD, FSCAI Professor of Cardiology, Cairo University 86 yrs old male IDDM (controlled on insulin and oral hypoglycemics) Hypertensive
More informationAntiplatelet in diabetics: strong but incomplete umbrella
Antiplatelet in diabetics: strong but incomplete umbrella Seung-Whan Lee, MD. Heart Institute, University of Ulsan College of Medicine Asan Medical Center, Seoul, Korea Global Projections for the Number
More informationPrise en charge du SCA ST + en urgence. 9803mo01, 1
Prise en charge du SCA ST + en urgence 9803mo01, 1 9803mo01, 2 Trial of Routine ANgioplasty and Stenting after Fibrinolysis to Enhance Reperfusion in Acute Myocardial Infarction The TRANSFER-AMI trial
More informationClopidogrel When For What For How Long. T Benjanuwattra Chiang Mai Heart Cent
Clopidogrel When For What For How Long T Benjanuwattra Chiang Mai Heart Cent Evidence Based Medicine I don t want to put you to sleep But want you to be fully alert Atherothrombosis: A Generalized and
More informationΔοκιμασίες λειτουργικότητας αιμοπεταλίων και PCI
Δοκιμασίες λειτουργικότητας αιμοπεταλίων και PCI Ομάδες Εργασίας Φεβρουάριος 2016 Ξανθοπούλου Ιωάννα Καρδιολόγος Επιμ Β ΠΓΝΠατρών Nothing to disclose Platelet function testing (PFT) is helpful in identifying
More informationAngioplastica coronarica nel paziente anziano ad alto rischio emorragico
Attualità in Cardiologia Aprilia, Enea Hotel 22 ottobre 2011 Angioplastica coronarica nel paziente anziano ad alto rischio emorragico Fabrizio Tomai, MD, FACC, FESC Dept. of Cardiovascular Sciences - Interventional
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 informationTim Henry, MD Director, Division of Cardiology Professor, Department of Medicine Cedars-Sinai Heart Institute
Tim Henry, MD Director, Division of Cardiology Professor, Department of Medicine Cedars-Sinai Heart Institute Implications of Pre-loading on Patients Undergoing Coronary Angiography Angiography Define
More informationUpdate on the management of STEMI. Elliot Rapaport, M.D. San Francisco, CA December 14, 2007
Update on the management of STEMI Elliot Rapaport, M.D. San Francisco, CA December 14, 2007 Universal MI Definition Committee 2007 Recommendations Type 1 Spontaneous MI associated with ischemia and due
More informationClinical Controversies in Perioperative Medicine
Clinical Controversies in Perioperative Medicine Hugo Quinny Cheng, MD Division of Hospital Medicine University of California, San Francisco Cardiac Evaluation: New Guidelines A 70-y.o. man with progressive
More informationClopidogrel and ASA after CABG for NSTEMI
Clopidogrel and ASA after CABG for NSTEMI May 17, 2007 Justin Lee Pharmacy Resident University Health Network Objectives At the end of this session, you should be able to: Explain the rationale for antiplatelet
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 informationPrevention of Coronary Stent Thrombosis and Restenosis
Prevention of Coronary Stent Thrombosis and Restenosis Seong-Wook Park, MD, PhD, FACC Division of Cardiology, Asan Medical Center University of Ulsan College of Medicine, Seoul, Korea 9/12/03 Coronary
More informationIs the role of bivalirudin established?
Is the role of bivalirudin established? Rob Henderson Consultant Cardiologist Trent Cardiac Centre Nottingham University Hospitals Conflicts of Interest: None Declarations: Member NICE Unstable Angina
More informationDECLARATION OF CONFLICT OF INTEREST
DECLARATION OF CONFLICT OF INTEREST How to manage antiplatelet treatment in patients with diabetes in acute coronary syndrome Lars Wallentin Professor of Cardiology, Chief Researcher Cardiovascular Science
More informationDauer der doppelten Plättchenhemmung nach AMI / Stent
Dauer der doppelten Plättchenhemmung nach AMI / Stent Kardio-Lunch 04.06.2014 Christoph Kaiser Universitätsspital Basel Christoph.kaiser@usb.ch DAPT after Stenting 257 patients with PCI & stent: ASS &
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 informationAntiplatelet therapy in ACS/PCI. Thomas Cuisset, CHU Timone, Marseille DIU Cardiologie Interventionnelle Paris, Janvier 2013
Antiplatelet therapy in ACS/PCI Thomas Cuisset, CHU Timone, Marseille DIU Cardiologie Interventionnelle Paris, Janvier 2013 Oral Antiplatelet therapy in ACS/PCI Most Challenging Questions in Nov. 2012
More informationManagement of cardiovascular disease - coronary interventions -
Master Classes in Preventive Cardiology I Management of diabetes in patients with CVD European Heart House Management of cardiovascular disease - coronary interventions - Francesco Cosentino MD, PhD, FESC
More informationPPCI in STEMI. ESC at the 22nd Annual Conference of the Saudi Heart Association February 21th, 2011
PPCI in STEMI Dr Hassan Mhish Interventional Cardiology Consultant Cardiology Fellowship Program Director Prince Salman Heart Center King Fahd Medical City Riyadh, KSA ESC at the 22nd Annual Conference
More informationIndex. Note: Page numbers of article titles are in boldface type.
Cardiol Clin 24 (2006) 299 304 Index Note: Page numbers of article titles are in boldface type. A Abciximab in PCI, 180 182 ACE trial, 182 Actinomycin D-eluting stent, 224 ACUITY trial, 190 Acute myocardial
More informationDavid E. Kandzari, MD Director, Interventional Cardiology Research Scripps Clinic La Jolla, California
38 RCTs 18,000 pts Identifying the Optimal Duration of DAPT Less is More, More or Less David E. Kandzari, MD Director, Interventional Cardiology Research Scripps Clinic La Jolla, California kandzari.david@scrippshealth.org
More informationPatient characteristics Intervention Comparison Length of follow-up
ANTIPLATELET CHAPTER Aspirin compared with placebo Ref ID: 4158 Reference Antithrombotic TC. Collaborative meta-analysis randomised trials antiplatelet therapy for prevention death, myocardial infarction,
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 informationAbciximab plus Heparin versus Bivalirudin in Patients with NSTEMI Undergoing PCI. ISAR-REACT 4 Trial
Abciximab plus Heparin versus Bivalirudin in Patients with NSTEMI Undergoing PCI ISAR-REACT 4 Trial Adnan Kastrati, MD Deutsches Herzzentrum, Technische Universität, Munich, Germany On behalf of F.-J.
More informationAn update on the management of UA / NSTEMI. Michael H. Crawford, MD
An update on the management of UA / NSTEMI Michael H. Crawford, MD New ACC/AHA Guidelines 2007 What s s new in the last 5 years CT imaging advances Ascendancy of troponin and BNP Clarification of ACEI/ARB
More informationin High-risk PCI Patients?
Lunchtime Activities Is Potent t Oral P2Y 12 Inhibitor Enough to Prevent Thrombotic Events in High-risk PCI Patients? Young-Hoon Jeong, MD M.D., PhD Ph.D. Department of Internal Medicine, Gyeongsang National
More informationInterventional Cardiology
Clinical Investigations Interventional Cardiology Benefit of bolus-only platelet glycoprotein IIb/IIIa inhibition during percutaneous coronary intervention: Insights from the very early outcomes in the
More informationAnti-platelet therapies and dual inhibition in practice
Anti-platelet therapies and dual inhibition in practice Therapeutics; Sept. 25 th 2007 Craig Williams, Pharm.D. Associate Professor of Pharmacy Objectives 1. Understand the pharmacology of thienopyridine
More informationTreatment Strategies for the Prevention of Ischemic Complications in Patients Undergoing Percutaneous Coronary Intervention with Stent Placement
Treatment Strategies for the Prevention of Ischemic Complications in Patients Undergoing Percutaneous Coronary Intervention with Stent Placement Pharmaceutical Care Project Outcomes Literature Evaluation
More informationStent Thrombosis: Patient, Procedural, and Stent Factors. Eugene Mc Fadden Cork, Ireland
Stent Thrombosis: Patient, Procedural, and Stent Factors Eugene Mc Fadden Cork, Ireland Definitions Early 1 yr TAXUS >6months CYPHER Incidence and Timing BMS Registry data
More informationDisclosures. Inpatient Management of Non-ST Elevation Acute Coronary Syndromes. Edward McNulty MD, FACC. None
Inpatient Management of Non-ST Elevation Acute Coronary Syndromes Edward McNulty MD, FACC Assistant Clinical Professor UCSF Director, SF VAMC Cardiac Catheterization Laboratory Disclosures None New Guidelines
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 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 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 informationתרופות מעכבות טסיות חדשות ד"ר אלי לב מנהל שרות הצנתורים ח השרון מרכז רפואי רבין
תרופות מעכבות טסיות חדשות ד"ר אלי לב מנהל שרות הצנתורים ח השרון בי""י מרכז רפואי רבין 1. Why should clopidogrel be replaced? 2. Prasugrel 3. Ticagrelor 4. Conclusions CURE TRIAL ACS pts 20 % reduction
More informationThe Myth of Class Effect Antithrombotics Christopher Cannon, MD
The Myth of Class Effect Antithrombotics Christopher Cannon, MD Cardiovascular Division Brigham and Women s Hospital Associate Professor of Medicine Harvard Medical School Senior Investigator, TIMI Study
More informationClopidogrel Date: 15 July 2008
These results are supplied for informational purposes only. Prescribing decisions should be made based on the approved package insert in the country of prescription Sponsor/company: sanofi-aventis ClinicalTrials.gov
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 informationAdditional Contributor: Glenn Levine (USA).
2017 ESC Focused Update on Dual Antiplatelet Therapy in Coronary Artery Disease developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS) The Task Force for the Management
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 informationMINERVA MEDICA COPYRIGHT. Aspirin is accepted as standard antiplatelet. Dual antiplatelet therapy for primary and secondary prevention
This document is protected by international copyright laws. No additional reproduction is authorized. It is permitted for personal use to download and save only one file and print only one copy of this
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 informationANTITHROMBOTIC THERAPY 2010 Antitrombotik tedavi alan hastalarda operasyon hazırlığı
ANTITHROMBOTIC THERAPY 2010 Antitrombotik tedavi alan hastalarda operasyon hazırlığı Dr. Sabri DEMİRCAN Ondokuz Mayıs Üniversitesi Tıp Fakültesi Kardiyoloji ABD, Samsun Copyright 2001 Harcourt Canada Ltd.
More informationPAR-1 Antagonist: What Do Clinical Trials Teach Us?
Prevention of Atherothrombotic Events: What s the New Evidence? PAR-1 Antagonist: What Do Clinical Trials Teach Us? David A. Morrow, MD, MPH Director, Levine Cardiac Intensive Care Unit Senior Investigator,
More informationMeasurement of Antiplatelet Therapeutic Efficacy
Measurement of Antiplatelet Therapeutic Efficacy Bonnie H. Weiner MD MSEC MBA FSCAI FACC FAHA Professor of Medicine Director, Interventional Cardiology Research St Vincent Hospital Worcester MA Disclosure
More informationAdjunctive Pharmacological Therapies in PCI : Antiplatelets and Anticoagulants
Adjunctive Pharmacological Therapies in PCI : Antiplatelets and Anticoagulants Young-Hak Kim, MD Asan Medical Center, Seoul, Korea Why Drug? PCI localized therapy Drug systemic effect Fate of Disrupted
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 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 informationIssues in the Management of Diabetic Patients with Cardiovascular Disease
Issues in the Management of Diabetic Patients with Cardiovascular Disease Elliot Rapaport, MD December 13, 2008 1 Hyperglycemia and Acute Coronary Syndromes 2 Effect of Hyperglycemia in STEMI Impairs microvascular
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 informationOtamixaban for non-st-segment elevation acute coronary syndrome
Otamixaban for non-st-segment elevation acute coronary syndrome September 2011 This technology summary is based on information available at the time of research and a limited literature search. It is not
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 informationGENNARO SARDELLA MD, FACC,FESC
PhaRmacodynamic Effects of Switching therapy in PCI patients with high on Treatment platelet reactivity and genotype variation: high Clopidogrel dose versus Prasugrel (RESET GENE Study). (ClinicalTrials.gov
More informationSTEMI update. Vijay Krishnamoorthy M.D. Interventional Cardiology
STEMI update Vijay Krishnamoorthy M.D. Interventional Cardiology OVERVIEW Current Standard of Care in Management of STEMI Update in management of STEMI Pre-Cath Lab In the ED/Office/EMS. Cath Lab Post
More informationINNOVATIONS 2017: Acute Coronary Syndrome Antiplatelet Therapies in Medical and Invasive Strategies.
INNOVATIONS 2017: Acute Coronary Syndrome Antiplatelet Therapies in Medical and Invasive Strategies. José G. Díez, MD, FACC, FSCAI Associate Professor of Medicine, Baylor College of Medicine Hall Garcia
More information