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Antiplatelet and anticoagulation regimen in patients with mechanical valve undergoing PCI - State-of-the-art review.

MedStar author(s):

Ben-Dor, Itsik

Buchanan, Kyle

Citation: International Journal of Cardiology. 264:39-44, 2018 08 01.PMID: 29685692Institution: MedStar Heart & Vascular InstituteForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Anticoagulants | *Drug Therapy, Combination | *Heart Valve Prosthesis | *Hemorrhage | *Percutaneous Coronary Intervention/mt [Methods] | *Platelet Aggregation Inhibitors | *Purinergic P2Y Receptor Antagonists | Anticoagulants/ad [Administration & Dosage] | Anticoagulants/ae [Adverse Effects] | Drug Therapy, Combination/ae [Adverse Effects] | Drug Therapy, Combination/mt [Methods] | Heart Valve Prosthesis/cl [Classification] | Heart Valve Prosthesis/st [Standards] | Hemorrhage/ci [Chemically Induced] | Hemorrhage/pc [Prevention & Control] | Humans | Platelet Aggregation Inhibitors/ad [Administration & Dosage] | Platelet Aggregation Inhibitors/ae [Adverse Effects] | Purinergic P2Y Receptor Antagonists/ad [Administration & Dosage] | Purinergic P2Y Receptor Antagonists/ae [Adverse Effects] | Risk AdjustmentYear: 2018 ISSN:

0167-5273

Name of journal: International journal of cardiologyAbstract: A common clinical dilemma regarding treatment of patients with a mechanical valve is the need for concomitant antiplatelet therapy for a variety of reasons, referred to as triple therapy. Triple therapy is when a patient is prescribed aspirin, a P2Y12 antagonist, and an oral anticoagulant. Based on the totality of the available evidence, best practice in 2017 for patients with mechanical valves undergoing percutaneous coronary intervention (PCI) is unclear. Furthermore, the optimal duration of dual antiplatelet therapy after PCI is evolving. With better valve designs that are less thrombogenic, the thromboembolic risks can be reduced at a lower international normalized ratio target, thus decreasing the bleeding risk. This review will offer an in-depth survey of current guidelines, current evidence, suggested approach for PCI in this cohort, and future studies regarding mechanical valve patients undergoing PCI.Copyright (c) 2017 Elsevier B.V. All rights reserved.All authors: Ben-Dor I, Buchanan KD, Gajanana D, Iantorno M, Okubagzi PG, Pichard AD, Rogers T, Satler LF, Torguson R, Waksman RFiscal year: FY2019Fiscal year of original publication: FY2018Digital Object Identifier:

https://dx.doi.org/10.1016/j.ijcard.2018.03.107

Date added to catalog: 2018-05-08

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Title notes ( 3 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	29685692	Available		29685692

A common clinical dilemma regarding treatment of patients with a mechanical valve is the need for concomitant antiplatelet therapy for a variety of reasons, referred to as triple therapy. Triple therapy is when a patient is prescribed aspirin, a P2Y12 antagonist, and an oral anticoagulant. Based on the totality of the available evidence, best practice in 2017 for patients with mechanical valves undergoing percutaneous coronary intervention (PCI) is unclear. Furthermore, the optimal duration of dual antiplatelet therapy after PCI is evolving. With better valve designs that are less thrombogenic, the thromboembolic risks can be reduced at a lower international normalized ratio target, thus decreasing the bleeding risk. This review will offer an in-depth survey of current guidelines, current evidence, suggested approach for PCI in this cohort, and future studies regarding mechanical valve patients undergoing PCI.

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