Cardiology Fellow X Factor: An ACS Case of Therapeutic Challenges

Slides:



Advertisements
Similar presentations
August 30, 2009 at CET. Ticagrelor compared with clopidogrel in patients with acute coronary syndromes – the PLATO trial.
Advertisements

Invasive Ticagrelor compared with clopidogrel in patients with acute coronary syndromes – the PLATelet Inhibition and patient Outcomes trial Outcomes in.
Giuseppe Biondi-Zoccai Division of Cardiology, University of Turin, Turin, Italy.
Management of ST-elevation myocardial infarction according to European and American guidelines.
Leadership. Knowledge. Community. Canadian Cardiovascular Society Antiplatelet Guidelines ANTIPLATELET THERAPY IN PATIENTS WITH CHRONIC KIDNEY DISEASE.
ACS and Thrombosis in the Emergency Setting
Antiplatelet Therapy in Renal Dysfunction Moderator E. Magnus Ohman, MD Professor of Medicine Director Program for Advanced Coronary Disease Duke University.
Applications of bivalirudin in interventional cardiology
What’s New in Acute Coronary Syndromes? Claudia Bucci BScPhm, PharmD Clinical Coordinator, Cardiovascular Diseases Sunnybrook Health Sciences Centre 13.
Dr.Ali Eshraghi MD Interventional Cardiologist Non STE ACS  Angiographic Findings: 34% 3VD 28%2VD 26%SVD 10%LMCAD Culprit lesion charactristic: eccentric,scalloped,evidence.
2016 ACC/AHA Guideline Focused Update on Duration of Dual Antiplatelet Therapy in Patients With Coronary Artery Disease Developed in Collaboration with.
수요저널 우종신. ACC/AHA Guideline Focused Update 2011 Class I 1. After PCI, use of aspirin should be continued indefinitely. (Level of Evidence.
Date of download: 7/9/2016 Copyright © The American College of Cardiology. All rights reserved. From: Making Sense of Statistics in Clinical Trial Reports:
Date of download: 11/12/2016 Copyright © The American College of Cardiology. All rights reserved. From: Effectiveness of In-Laboratory High-Dose Clopidogrel.
Disclosures Speaker’s bureau: Research support: Consulting: Equity
Focused 2012 Update of the Canadian Cardiovascular Society Guidelines for the Use of Antiplatelet Therapy  Jean-François Tanguay, MD, CSPQ, FRCPC, FACC,
Anne Masich, PharmD PGY1 Resident University of Maryland
Proposed use of P2Y12 inhibitors
Has acute myocardial infarction mortality hit rock bottom
Prasugrel or ticagrelor selection by clinical factor and CYP2C19 phenotype status. Prasugrel or ticagrelor selection by clinical factor and CYP2C19 phenotype.
PCI in Patients With Diabetes: Show Me the Data
Learning Objectives. Learning Objectives Variable Response to Clopidogrel.
Preventing Thrombotic Complications in ACS: State of the Art
Statin Selection in the Elderly
Class I Medical Therapies for CAD and PAD
11/12/2018 CYP2C19-Clopidogrel Development of these slides was supported by funding from the IGNITE Network. When using or adapting any of these slides.
RAAS Blockade: Focus on ACEI
Know Your ABCs: Antiplatelet Therapy, Benefits/Bleeding, and Cardiac Surgery State of the Art: The Role of Antiplatelet Therapy in the Cardiac Surgical.
Glenn N. Levine et al. JACC 2016;68:
Achieving Long-Term Protection Post-MI
Emerging Data on ACS Management From ACC
PAD Patients vs Post-ACS Patients:
Figure 3 Metabolism pathway of antiplatelet agents
Glenn N. Levine et al. JACC 2016;68:
Unmet Needs in the Secondary Prevention in ACS
Introduction Antiplatelet Agents ADP Receptor Antagonists.
Nat. Rev. Cardiol. doi: /nrcardio
Statins and the Elderly Patient
It’s Elementary.
What Has Been Tried and What Is True?
Tailoring Antiplatelet Therapy in PCI
Panelists. One Size May Not Fit All: A New Aspirin Option for the High-Risk Patient.
Recurrent Angina: New Tools for an Old Problem
Antiplatelet Therapy and Secondary Prevention
Nat. Rev. Cardiol. doi: /nrcardio
Considerations for Percutaneous Coronary Intervention (PCI)
Treatment Options to Consider
Nat. Rev. Cardiol. doi: /nrcardio
Thank you for taking the pre-assessment
Figure 6 Pharmacodynamic profile of switching between clopidogrel and ticagrelor therapy: results from the RESPOND study Figure 6| Pharmacodynamic profile.
Nat. Rev. Cardiol. doi: /nrcardio
Nat. Rev. Cardiol. doi: /nrcardio
Focused 2012 Update of the Canadian Cardiovascular Society Guidelines for the Use of Antiplatelet Therapy  Jean-François Tanguay, MD, CSPQ, FRCPC, FACC,
Overview. Complex Cases in PCI: Tailoring Antiplatelet Therapy to Improve Outcomes.
Preventive Angioplasty in Myocardial Infarction Trial
Duration of Dual Antiplatelet Therapy
Nat. Rev. Cardiol. doi: /nrcardio
Category: PCI Research
What oral antiplatelet therapy would you choose?
Antithrombotics in Arterial Disease: Focus on Coronary Disease
The Challenge of AF and PCI: Practical Strategies to Improve Outcomes
Factor Xa Inhibitors in Coronary Artery Disease
Comparison of prescription rates and clinical outcomes in acute coronary syndrome patients who underwent percutaneous coronary intervention using different.
Roberta Rossini et al. JCIN 2018;11:
Cox regression of proportion mortality in the first 8 years for patients with three-vessel disease with a significant difference between the treatment.
Glenn N. Levine et al. JACC 2011;58:e44-e122
Davide Capodanno et al. JCIN 2009;2:
ESC Guideline on the Management of STEMI Recommendation for DAPT
Figure 3. Trials and possible strategies for un-guided and guided DAPT de-escalation. The figure shows studies and strategies on DAPT de-escalation approaches.
P2Y12 receptor inhibitor therapy for secondary prevention of patients with stable coronary artery disease. P2Y12 receptor inhibitor therapy for secondary.
Presentation transcript:

Cardiology Fellow X Factor: An ACS Case of Therapeutic Challenges

Case History and Presentation

Medications on Transfer

Case (cont)

Case History and Presentation

P2Y12 Inhibitor Options

Patient Factors Associated With Poor Clopidogrel Response

Prasugrel and Ticagrelor in Patients With Renal Dysfunction

Clopidogrel and Prasugrel Metabolism

Left System

Right Coronary Artery

Cardiac Catheterization Findings

Cardiothoracic Consultation

Antiplatelets in Patients With CKD

Supported PCI

Left Coronary Artery

Right Coronary Artery

Case (cont)

2011 ACCF/AHA/SCAI PCI Guidelines: Use of Platelet Function Testing

Follow Up

Case Conclusion/Follow-up

PLATO: Infections and CABG Mortality

Take-Home Points

Abbreviations

Abbreviations (cont)

Abbreviations (cont)

Abbreviations (cont)