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CPP : Cardiovascular Prevention and Pharmacotherapy

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2 "Percutaneous coronary intervention"
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Review Articles
De-escalation strategies of dual antiplatelet therapy in patients undergoing percutaneous coronary intervention for acute coronary syndrome
Young Bin Song
Cardiovasc Prev Pharmacother. 2022;4(2):63-69.   Published online April 26, 2022
DOI: https://doi.org/10.36011/cpp.2022.4.e11
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Abstract PDF
Antiplatelet therapy is important for reducing systemic and local thrombotic events in patients undergoing percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS). Antiplatelet treatment regimens, along with dual antiplatelet therapy consisting of aspirin and a P2Y12 inhibitor for patients receiving PCI, have frequently changed over the years. With improvements in the understanding of the prognostic relevance of bleeding events in patients with PCI, as well as the safety and efficacy of drug-eluting stents, several randomized controlled trials (RCTs) have been conducted on antiplatelet treatment strategies associated with a more favorable balance between ischemic and bleeding risks. Several key RCTs for appropriate antiplatelet therapy in patients receiving PCI for ACS have been reported, and practical guidelines have been updated. This manuscript presents the results of major RCTs on de-escalation strategies of dual antiplatelet treatment in patients receiving PCI for ACS.
Role of Novel Oral Anticoagulant for Patient with Atrial Fibrillation Underwent Percutaneous Coronary Intervention
Jang-Whan Bae
Cardiovasc Prev Pharmacother. 2019;1(1):19-29.   Published online July 31, 2019
DOI: https://doi.org/10.36011/cpp.2019.1.e1
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  • 1 Citations
Abstract PDF
Atrial fibrillation (AF) is very common arrhythmic disorder especially in elderly population, and makes higher major adverse cardiac events (MACEs) in the patients with acute coronary syndrome (ACS) or underwent percutaneous coronary intervention (PCI). Pivotal drug for AF patients to reduce systemic embolism was warfarin, and certain duration of dual antiplatelet therapy (DAPT) is important after PCI with stent. But, best regimen of antithrombotic agent after PCI in AF is unclear especially in the clinical use of novel oral anticoagulant (NOAC). This manuscript will deal those clinical studies to indicate optimal regimen and duration of NOAC use for AF patients underwent PCI. NOAC use on DAPT significantly reduces major or minor bleeding compared to warfarin in AF patients with ACS or underwent PCI. But, the duration of NOAC use is still unclear, and there is exist clear contraindication to use it in clinical field. NOAC use reduced major or minor bleeding significantly compared to warfarin, but the incidence of MACEs was similar between warfarin and NOAC. Physician should understand the advantage or disadvantage of NOAC use, and be able to tailor the regimen and duration of antithrombotics including NOAC in this higher risk patient population.

CPP : Cardiovascular Prevention and Pharmacotherapy