Unexpected Discontinuation of Dual Antiplatelet Therapy within 14 Days after Percutaneous Coronary Intervention: A Single-center Case Series
Journal Title: Journal of Advances in Medicine and Medical Research - Year 2015, Vol 5, Issue 5
Abstract
Objectives: To provide a descriptive case-series of patients who unexpectedly discontinued dual antiplatelet therapy (DAPT) within 14 days after percutaneous coronary intervention (PCI) (group A), and those who had taken measures for bleeding risk reduction before PCI (group B). Study Design: Case study. Place and Duration of Study: Cardiovascular Center, Kitano Hospital, the Tazuke Kofukai Medical Research Institute, between 2009 and 2011. Methods and Results: We retrospectively reviewed 346 patientsundergoing PCI in our hospital. In group A (n=12, 3.46%), 10 patients underwent emergent PCI including 3 cases of cardiopulmonary arrest. The procedures were 8 cases of bare metal stent implantation, 2 cases of drug-eluting stent (DES) implantation, and 2 cases of balloon angioplasty. The reasons for discontinuation included 6 cases of bleeding, out of which 4 cases involved pulmonary bleeding, and 3 involved sequential operation. The mean time of DAPT cessation was 3.3 days. The mortality rate of patients with pulmonary bleeding was 75%. In group B (n=9, 2.60%), 4 cases were emergent PCI and 5 were scheduled. Reasons for taking bleeding risk reduction measures included past history of bleeding, cancer, and poor adherence. The methods of bleeding risk reduction included avoidance of DES and the use of cilostazol, which resulted in noserious bleeding or thrombosis occurring. Conclusions: A descriptive case-series of patients who unexpectedly discontinued DAPT within 14 days and those who had taken bleeding risk reduction measures before PCI was provided. Our results imply that careful planning regarding the antiplatelet therapy and risk assessment for bleeding, including pulmonary bleeding, are warranted for patients undergoing PCI.
Authors and Affiliations
Takao Kato, Sayako Hirose, Shoichi Miyamoto, Eisaku Nakane, Toshiaki Izumi, Tetsuya Haruna, Ryuji Nohara, Moriaki Inoko
Keywords
Related Articles
- EP ID EP347090
- DOI 10.9734/BJMMR/2015/12927
- Views 65
- Downloads 0
Evaluation of Antioxidant and Acteylcholinesterase-inhibitory Properties of Methanol Extracts of Nauclealatifolia, Cymbopogon citratus and Cocos nucifera: An In vitro Study
Aims: To evaluate the in vitro antioxidant and acetylcholinesterase (AChE)-inhibitory potentials of methanol extracts of Nauclea latifolia (NL), Cymbopogon citratus (CC) and Cocos nucifera (CN). Study Design/Methodologie...
Impact of Oncologist Initiated Selective Review of Pathology Specimens in Multidisciplinary Onco-pathological Discussions on the Management of Malignancies in a University Hospital in India
Aim: Reported discrepancy rates after pathology review of surgical pathology specimens vary widely from 1.3% to as high as 80%. The purpose of this study was to assess the frequency of discordant diagnoses after onco – p...
Association between Clinical Malaria and Blood Lipids in North Eastern India
Background: Changes in lipid profile are seen in many patients infected with malaria parasite. The malaria parasite causes hepatocellular damage and disturbs lipid handling by the liver. Inside hepatocytes and erythrocyt...
Perception about Working in Rural Area after Graduation and Associated Factors: A Study among Final Year Medical Students in Medical Schools of Southeast Nigeria
Aims: Aim of study was to determine the perception of rural medical practice among final year medical students in medical schools of southeast Nigeria and the associated factors. Study Design: Descriptive cross-sectional...
A Person-centred View of the Aim, Goals and Tasks in Clinical Supervision: Proposals on Topics for Experiential Learning
Aim: This paper intends to highlight and review the traits of the person-centred clinical supervision model. This model is different to ‘mentoring’ supervision models. Specifically, the person-centred model has a minimal...