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In patients with non-ST elevation acute coronary syndrome current guidelines also recommend immediate administration of dual antiplatelet therapy upon diagnosis; clopidogrel and ticagrelor are indicated in this setting, with ticagrelor considered superior for patients undergoing early invasive strategy (see later).
After placement of a stent or scaffold, the patient needs to take two antiplatelet medications (aspirin and one of a few other options) for several months to help prevent blood clots. The length of time a patient needs to be on dual antiplatelet therapy is individualized based risks of ischemic events and bleeding risk. [29]
DAPT is used in patients who have, or are at high risk of developing, unstable angina, NSTEMI myocardial infarctions, and other high-risk thrombotic conditions. [5] Dual antiplatelet therapy has been found to significantly reduce rates of heart attacks, strokes, and overall cardiovascular death, but is not used in low-risk patients because it ...
In patients undergoing primary percutaneous coronary intervention (PCI) for an ST-segment elevation myocardial infarction (STEMI), US, [12] European, [13] and Canadian [14] guidelines recommend that a P2Y 12 inhibitor should be administered as soon as possible, although it is unclear whether administration of these medications before the patient arrives at the hospital confers additional ...
A dual therapy stent is a coronary artery stent that combines the technology of an antibody-coated stent and a drug-eluting stent. [1] Currently, second-generation drug-eluting stents require long-term use of dual-antiplatelet therapy, which increases the risk of major bleeding occurrences in patients. [2]
Since platelets are involved in the clotting process, patients must take dual antiplatelet therapy starting immediately before or after stenting: usually an ADP receptor antagonist (e.g. clopidogrel or ticagrelor) for up to one year and aspirin indefinitely. [26] [1]
If the patient is 'low risk' using the CHA 2 DS 2-VASc score (that is, 0 in males or 1 in females), no anticoagulant therapy is recommended. In males with 1 stroke risk factor (that is, a CHA 2 DS 2 -VASc score=1), antithrombotic therapy with OAC may be considered, and people's values and preferences should be considered. [ 24 ]
Increased risk of bleeding (i.e. frequent falls, gastrointestinal bleeds) History of hematological disease; Severe liver disease; History of allergic reaction to ticlopidine or any thienopyridine drug such as clopidogrel; Because of the increased risk of bleeding, patients taking ticlopidine should discontinue the medication 10–14 days before ...