MACEs in the early-surgery group occurred in patients in whom antiplatelet therapy was discontinued, including 3 events in the 17 patients with bare-metal stents in whom antiplatelet therapy was discontinued and 2 events in 9 patients with drug-eluting stents without antiplatelet therapy. In contrast to our findings, Reddy et al. (5) did not show an association between discontinuation of antipl...

Since platelet activation and aggregation play a major role in thrombus formation in lumen of coronary arteries, they constitute a main target in treatment of stable ischemic heart disease and acute coronary syndromes. Antiplatelet therapy should be commenced as early as possible within the current indications in order to reduce the risk of both acute ischemic complications and recurrent athero...

BACKGROUND AND PURPOSE Antiplatelet therapy nonresponse is associated with worse clinical outcomes. We studied the clinical outcomes associated with platelet function-guided modifications in antiplatelet therapy in patients with ischemic stroke or transient ischemic attack. METHODS From January 2005 to August 2007, 324 patients with ischemic stroke underwent platelet function testing using pl...

Triple antiplatelet therapy has been known to be superior to the conventional dual regimen for preventing stent thrombosis after coronary stenting, and the addition of oral anticoagulation to antiplatelet therapy is also considered an option. However, the risks and benefits of a triple antiplatelet regimen plus additional oral anticoagulation must be taken into account. Here, we report a case o...

OBJECTIVE Strokes are infrequent but potentially serious complications following carotid intervention, but antiplatelet therapy can reduce these risks. There are currently no specific guidelines on dose or duration of peri-procedural antiplatelet treatment for patients undergoing carotid intervention. Within the ongoing Asymptomatic Carotid Surgery Trial-2 (ACST-2), this study aimed at assessin...

There are conflicting reports regarding postoperative bleeding risks associated with discontinuation of antiplatelet therapy at least 7 days preoperatively. Most of the studies in the spine literature are based on surveys or anecdotal evidence. The majority of surgeons discontinue therapy 7 days preoperatively, but this varies widely from 5 to 21 days. The purpose of this retrospective study wa...

BACKGROUND Antiplatelet therapy in patients with sirolimus-eluting stents (SES) may be stopped because of bleeding or an invasive procedure. METHODS AND RESULTS In 254 patients with SES, the incidence of discontinuation of antiplatelet therapy and subsequent adverse cardiac events was evaluated. Follow-up was complete for 97.2% of the population and mean follow-up was 15.6+/-8.9 months. Disco...

For patients with an acute coronary syndrome event, current guidelines recommend dual antiplatelet therapy for at least 12 months after drug-eluting stent placement. However, several clinical trials have assessed whether continuing dual antiplatelet therapy beyond 12 months is beneficial. We review the pros and cons of extending dual antiplatelet therapy.

BACKGROUND/AIMS Dual antiplatelet therapy has to be used for at least 1 month after placement of bare metal coronary stents and for a minimum of 1 year after placement of drug eluting stents. Because of the higher risk of bleeding, guidelines strongly recommend to delay elective surgery until dual antiplatelet therapy is ended. However, no data are available regarding the bleeding risk in patie...

OBJECTIVES To present two case reports of patients who received suboptimal oral antiplatelet therapy and to review recent changes in national guidelines for management of acute coronary syndromes. DATA SOURCES Personal observation by the authors, and clinical practice guidelines and related clinical trials of the American Heart Association and the American College of Cardiology. SUMMARY The...