scholarly journals Functionally Complete Coronary Revascularisation in Patients Presenting with ST-elevation MI and Multivessel Coronary Artery Disease

2021 ◽  
Vol 16 ◽  
Author(s):  
Luigi Di Serafino ◽  
Fabio Magliulo ◽  
Giovanni Esposito
Keyword(s):  
Coronary Artery Disease ◽  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Coronary Revascularisation ◽  
Randomised Trials ◽  
Multivessel Coronary Artery Disease ◽  
Percutaneous Coronary ◽  
St Elevation ◽  
Artery Disease ◽  
The Right

Up to half of patients undergoing primary percutaneous coronary intervention of a culprit stenosis in the context of the ST-elevation MI may present with multivessel disease. The presence of non-culprit stenoses have been shown to affect the outcomes of these patients, and the results of the more recent randomised trials highlight the importance of complete coronary revascularisation. In this paper, the authors review the main trials published on the topic and discuss tools for the assessment of non-culprit stenoses, while considering the right time for carrying out a complete coronary revascularisation.

scholarly journals P2Y12 blocker monotherapy after percutaneous coronary intervention

2021 ◽  
Author(s):  
F. W. A. Verheugt ◽  
P. Damman ◽  
S. A. J. Damen ◽  
J. J. Wykrzykowska ◽  
E. C. I. Woelders ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Antiplatelet Therapy ◽  
Coronary Intervention ◽  
Randomised Trials ◽  
Novel Therapy ◽  
Percutaneous Coronary ◽  
Artery Disease ◽  
Meta Analyses

AbstractFor secondary prevention of coronary artery disease (CAD) antiplatelet therapy is essential. For patients undergoing a percutaneous coronary intervention (PCI) temporary dual antiplatelet platelet therapy (DAPT: aspirin combined with a P2Y12 blocker) is mandatory, but leads to more bleeding than single antiplatelet therapy with aspirin. Therefore, to reduce bleeding after a PCI the duration of DAPT is usually kept as short as clinically acceptable; thereafter aspirin monotherapy is administered. Another option to reduce bleeding is to discontinue aspirin at the time of DAPT cessation and thereafter to administer P2Y12 blocker monotherapy. To date, five randomised trials have been published comparing DAPT with P2Y12 blocker monotherapy in 32,181 stented patients. Also two meta-analyses addressing this novel therapy have been presented. P2Y12 blocker monotherapy showed a 50–60% reduction in major bleeding when compared to DAPT without a significant increase in ischaemic outcomes, including stent thrombosis. This survey reviews the findings in the current literature concerning P2Y12 blocker monotherapy after PCI.

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