When is triple therapy indicated?
When is triple therapy indicated?
When is triple therapy indicated? Triple therapy is indicated, if a patient should be treated with a therapeutic anticoagulation therapy and has had a PCI in the past week in case of an NSTEMI and a month in case of STEMI.
When is triple antiplatelet therapy used?
The most common clinical indication for TT is patients with atrial fibrillation (AF) who have acute coronary syndrome (ACS) or who have undergone percutaneous coronary intervention (PCI) with stent insertion, which accounts for approximately 5% to 8% of all patients who undergo PCI.
What do I give after PCI?
After PCI, clopidogrel should be continued for 1 month (IIbC). The ESC guidelines give 3 months duration (IIaB) as an option if the balance of bleeding and ischaemic risk favours the latter.
When should I start anticoagulation after PCI?
Oral anticoagulation plus P2Y12 antiplatelet combination is recommended for the first 6-12 months (potentially switching P2Y12 to aspirin for months 6-12 if PCI for stable ischemic heart disease), followed by anticoagulation monotherapy after 12 months.
How long should you use anticoagulation after a stent?
A substantial number of patients who undergo PCI with stent implantation after an acute myocardial infarction develop left ventricular thrombus and are at increased risk of embolism (6% to 12% annually), so anticoagulation therapy is recommended for at least 3 months for these patients.
Is there a role for triple therapy after ACS?
Currently, the use of dual therapy (preferably with a NOAC and clopidogrel) is recommended over triple therapy in these patients. The optimal duration should be guided by the assessment of an individual’s risk of thrombosis and bleeding events.
Do you continue heparin after PCI?
Conclusion: Heparin infusion after successful coronary interventions could increase the occurrence of bleeding and vascular injury; however, omission of heparin after a successful procedure did not significantly increase the incidence of ischaemic complications. Thus routine post-procedure heparin is not recommended.