Skip to content
Research Article Open access CC BY 4.0

Unexpected Discontinuation of Dual Antiplatelet Therapy within 14 Days after Percutaneous Coronary Intervention: A Single-center Case Series

Takao Kato, Sayako Hirose, Shoichi Miyamoto, Eisaku Nakane, Toshiaki Izumi, Tetsuya Haruna, Ryuji Nohara, Moriaki Inoko

Journal of Advances in Medicine and Medical Research · pp. 642–650 · Published 30 Sep 2014

10.9734/BJMMR/2015/12927

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.

Dual antiplatelet therapy discontinuation percutaneous coronary intervention cilostazol

References (24)

  1. 1 An International Randomized Trial Comparing Four Thrombolytic Strategies for Acute Myocardial Infarction [DOI]
  2. 2 A Randomized Comparison of a Sirolimus-Eluting Stent with a Standard Stent for Coronary Revascularization [DOI]
  3. 3 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention [DOI]
  4. 4 A Polymer-Based, Paclitaxel-Eluting Stent in Patients with Coronary Artery Disease [DOI]
  5. 5 A Randomized Comparison of Antiplatelet and Anticoagulant Therapy after the Placement of Coronary-Artery Stents [DOI]
  6. 6 A Clinical Trial Comparing Three Antithrombotic-Drug Regimens after Coronary-Artery Stenting [DOI]
  7. 7 Impact of Major Bleeding on 30-Day Mortality and Clinical Outcomes in Patients With Acute Coronary Syndromes [DOI]
  8. 8 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention: Executive Summary [DOI]
  9. 9 Cessation of dual antiplatelet treatment and cardiac events after percutaneous coronary intervention (PARIS): 2 year results from a prospective observational study [DOI]
  10. 10 Estimating Deaths From Cardiovascular Disease: A Review of Global Methodologies of Mortality Measurement [DOI]
  11. 11 The importance of the endothelium in atherothrombosis and coronary stenting [DOI]
  12. 12 Examination of the In Vivo Mechanisms of Late Drug-Eluting Stent Thrombosis [DOI]
  13. 13 Development and validation of a prognostic risk score for major bleeding in patients undergoing percutaneous coronary intervention via the femoral approach [DOI]
  14. 14 Epidemiology of cardiovascular disease in the 21st century: Updated updated numbers and updated facts
  15. 15 Lack of association between dual antiplatelet therapy use and stent thrombosis between 1 and 12 months following resolute zotarolimus-eluting stent implantation [DOI]
  16. 16 Systematic review and meta-analysis of randomized clinical trials appraising the impact of cilostazol after percutaneous coronary intervention [DOI]
  17. 17 Cilostazol Pharmacokinetics after Single and Multiple Oral Doses in Healthy Males and Patients with Intermittent Claudication Resulting from Peripheral Arterial Disease [DOI]
  18. 18 Randomized comparison of cilostazol versus ticlopidine hydrochloride for antiplatelet therapy after coronary stent implantation for prevention of late restenosis [DOI]
  19. 19 Alveolar Hemorrhage as a Complication of Treatment With Abciximab [DOI]
  20. 20 Use of platelet glycoprotein IIb/IIIa inhibitors and spontaneous pulmonary hemorrhage.
  21. 21 Alveolar hemorrhage associated with platelet glycoprotein IIb/IIIa receptor inhibitors.
  22. 22 Late stent thrombosis in the absence of prior intracoronary brachytherapy [DOI]
  23. 23 Randomized Comparison of Cilostazol vs Ticlopidine for Antiplatelet Therapy After Coronary Stenting [DOI]
  24. 24 New-Generation Drug-Eluting Stents for Patients With Myocardial Infarction [DOI]

Cited by 0

No indexed citations yet.

Related research

Article metrics

Real usage data collected on this platform.

66

Page views

0

PDF downloads

32

Outbound clicks

0

Citations

Views over time

Views by country

Approximate, from request IP at view time — not citizenship or institution. Countries with fewer than 5 views are grouped as "Other".

Traffic sources

Referring site, by host.

Views and downloads exclude known bots/crawlers. Citations combines this platform's own DOI-resolved index with each external source's own reported total — see Cited by above for individually listed citing works. Last refreshed 0 seconds ago.