Dual Antiplatelet Therapy for Coronary and Peripheral Arterial Disease

Description

Dual Antiplatelet Therapy for Coronary and Peripheral Arterial Disease is a complete reference containing updated information on the advantages and disadvantages of dual antiplatelet therapy, its duration, composition and anticipated changes. The basis for DAPT in arterial disease is discussed, allowing readers to understand platelet physiology and its relevance to ischemic events. Data on shorter than usual duration of DAPT, and on extended therapy beyond the recommendation of current guidelines is presented in great detail, summarizing a large body of evidence into concrete, relevant recommendation that is readily adaptable by practicing clinicians. A clinically relevant and updated compendium of data pertaining to this field is also presented, as well as the anticipated trends and innovations likely to occur in the next 3-5 years. Front Cover Dual Antiplatelet Therapy for Coronary and Peripheral Arterial Disease Dual Antiplatelet Therapy for Coronary and Peripheral Arterial Disease Copyright Contents Contributors Preface 1 - Platelets and arterial disease—initiation, progression, and destabilization of atherosclerotic vascular disease Initiation of atherosclerotic disease Transition to vulnerable plaque Thrombosis of the ruptured plaque Summary References 2 - Platelet physiology and pharmacology—relevant considerations for patient care Introduction Platelet physiology Formation and structure Platelet activation Initiation phase Extension phase Perpetuation phase Antiplatelet pharmacology Cyclooxygenase 1 inhibitor Aspirin P2Y12 inhibitors Clopidogrel Prasugrel Ticagrelor Cangrelor Thrombin receptor antagonists Vorapaxar Glycoprotein IIb/IIIa inhibitors Abciximab Eptifibatide Tirofiban Phosphodiesterase inhibitor Cilostazol Additional targets References 3 - The development of dual antiplatelet therapy: physiologic and clinical implications of multiple pathway inhibit ... Introduction Aspirin monotherapy Thienopyridines Ticlopidine Clopidogrel Prasugrel Dipyridamole Cilostazol Ticagrelor Conclusions References 4 - Acute coronary syndromes and percutaneous coronary intervention—current recommendations for dual antiplatelet t ... Introduction Rationale for the standard 12-month dual antiplatelet therapy Randomized trials assessing antiplatelet therapy Randomized trials assessing P2Y12 inhibitor choice Randomized trials assessing aspirin dosing or aspirin-free strategies Randomized trials of de-escalation, platelet function, and genotype types Current clinical practice guidelines Percutaneous coronary intervention for acute coronary syndrome Stable coronary artery disease Coronary artery bypass graft Switching of P2Y12 inhibitors Platelet function testing and genetic testing Risk stratification for ischemic and bleeding events Do the current guidelines reflect the data? Conclusion References 5 - Peripheral arterial disease—a different kind of arterial disease? The role of antiplatelet therapy in the preve ... Introduction Patients with peripheral arterial disease alone without clinically manifest coronary artery or cerebrovascular disease Patients with peripheral arterial disease and clinically manifest coronary artery or cerebrovascular disease Patients with symptomatic peripheral arterial disease Aspirin monotherapy P2Y12 inhibitor monotherapy Dual antiplatelet therapy Protease-activated receptor 1 antagonist Anticoagulation Endovascular revascularization Surgical revascularization Plaque and lesion characteristics of peripheral arterial disease versus coronary artery disease Summary References 6 - Cerebrovascular disease—what is the role of dual antiplatelet therapy for the prevention and treatment of ische ... Introduction Mechanisms of stroke Guidelines and current practice Primary prevention Treatment and secondary prevention Choice of antiplatelet drugs Antiplatelet regimens Antiplatelet therapy duration Future perspective Conclusion References 7 - Competing risks in the duration of dual antiplatelet therapy—the case for shorter treatment Introduction Competing risks of ischemia and bleeding: why bleeding is important and what is its clinical impact? Elements associated with a high bleeding risk Strategies to reduce bleeding: the case for a short dual antiplatelet therapy duration Current evidence for individualization of duration of dual antiplatelet therapy Dual antiplatelet therapy decision-making in patients with concurrent high ischemic and bleeding risk Conclusions References 8 - Dual antiplatelet therapy may prevent coronary ischemic events beyond one year—the case for extended treatment Introduction Rationale for prolonged dual antiplatelet therapy Randomized trials assessing prolonged dual antiplatelet therapy Moving beyond clopidogrel High-risk patient populations Current state of guidelines Conclusion References 9 - Clinical risk scores: a tool to understand bleeding and thrombotic risk Introduction Dual antiplatelet therapy: competing bleeding and thrombotic risks The perfect risk score Interpreting risk score quality assessment The early applications of risk scores in percutaneous coronary intervention The DAPT score The PARIS score The PRECISE-DAPT score Applying risk scores to practice Oral anticoagulation The future of dual antiplatelet therapy risk scores Conclusion References 10 - Moving from dual antiplatelet therapy to monotherapy based on P2Y12 receptor blockade—why it could be a novel ... Introduction Overview of platelet function and pathophysiology Rationale for dual antiplatelet therapy The rise and fall of aspirin The legacy of aspirin The downfall of aspirin Rationale for aspirin withdrawal Evidence at the molecular level Evidence from clinical trials Clinical trials evaluating P2Y12 inhibitor monotherapy SMART-CHOICE STOPDAPT-2 GLOBAL LEADERS TWILIGHT TICO Ongoing and future P2Y12 inhibitor monotherapy trials Conclusion References 11 - The conundrum of simultaneous antiplatelet and anticoagulant therapy: how to solve it? Options to reduce the bleeding risk of combined antiplatelet and anticoagulant therapy Radial access Various use of P2Y12 inhibitors Dropping aspirin Non–vitamin K antagonist oral anticoagulants Use of proton pump inhibitors Avoidance of nonsteroidal anti-inflammatory drugs Future perspectives Conclusion References 12 - A look into the future Index A B C D E G H I L M N O P R S T U V W Back Cover