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 61
- Downloads 0
Comparing Three Different Doses of Caudal Morphine for Analgesia after Salter Innominate Osteotomy
Background: Single dose caudal block application is preferred among children since it is a safe and easy method. Caudal morphine has an important advantage with its long half-life. However, caudal morphine application ha...
Exploring the Opinions of Parents and Teachers about Young People Receiving Puberty and Sex Education in Rural Kenya: A Qualitative Study
In Kenya, one of the most significant public health concerns is the spread of HIV. Additionally, 13,000 girls drop out of school every year due to pregnancy. Although the Kenyan Ministry of Education and other independen...
Birth Weight and Placental Weight Correlation of Fulani Ethnic Group Parturients in Nigeria
Aims: We aim to establish the relationship of birth weight to the placental weight of Fulani ethnic community which is an important population politically and economically not only in Nigeria but to West Africa in genera...
The Use and Abuse of Antimicrobial Agents in Dental Practice
It’s been over 60 years since the wide spread use of penicillin saved millions of lives from infection. Today there is a rapid emergence of antimicrobial resistance and it’s on the increase with each passing day. The den...
Anemia-an Unnoticed Entity in Asian Males A Focus on the Anemic Parameters of Adult Males in Pakistan
Background: There is a general lack of awareness that anemia could be present in a significant number of apparently healthy adult males which might then lead to a misdiagnosis and a prolonged suffering of the patient. Th...