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Roshini Claire Anthony, 2 days ago

A subgroup of patients with HBeAg-negative chronic hepatitis B virus (HBV) infection who ceased their long-term nucleotide analogue treatment maintained virological suppression, pointing to a group of patients who may be suitable for treatment cessation, according to a recent study.

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DAPT discontinuation after PCI safe in patients presenting with acute coronary syndrome

12 Feb 2019

Physician-guided cessation of dual-antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) is safe in patients presenting with acute coronary syndrome (ACS), a recent study has shown.

The study included 5,018 PCI patients (mean age 63.4 years; 25.4 percent female), of whom 41 percent (n=2,056) presented with ACS. Three modes of DAPT cessation were assessed: discontinuation, interruption and disruption.

Analysis by ACS presentation showed that 2-year DAPT discontinuation rates were comparable between patients with vs without ACS (37.2 percent vs 38.8 percent; p=0.25). In comparison, DAPT in those who presented with ACS was less likely to be interrupted (8.5 percent vs 10.7 percent; p<0.001) but more likely to be disrupted (16.4 percent vs 11.9 percent; p<0.001).

DAPT disruption in ACS-presenting participants was driven mostly by noncompliance (11.6 percent vs 7.6 percent; p<0.001) than by discontinuation due to bleeding complications (5.6 percent vs 4.6 percent; p=0.10).

In terms of outcomes, patients who presented with ACS at baseline were at a significantly higher risk of major adverse cardiovascular events (MACE; 8.12 percent vs 5.43 percent; p=0.0002). This was driven primarily by stent thrombosis (p=0.0006) and spontaneous myocardial infarction (MI; p=0.0002).

When the definition of MACE was narrowed to include only cardiac death, stent thrombosis and MI, researchers found that the corresponding risk was elevated in ACS-presenting patients with DAPT interruption (hazard ratio, 2.72; 95 percent CI, 1.35–5.48). Notably, no such effects were observed for those with DAPT disruption or discontinuation.

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Most Read Articles
Roshini Claire Anthony, 2 days ago

A subgroup of patients with HBeAg-negative chronic hepatitis B virus (HBV) infection who ceased their long-term nucleotide analogue treatment maintained virological suppression, pointing to a group of patients who may be suitable for treatment cessation, according to a recent study.

Rachel Soon, 4 days ago

Gels utilizing Stichopus horrens (golden sea cucumber/gamat) extract show a similar efficacy to standard-of-care hydrogels for promoting wound healing, according to a prospective study.

2 days ago
Higher cancer symptom burden in elderly adults is associated with functional impairment, reports a recent study.
Jairia Dela Cruz, 6 days ago
Use of mirabegron in the treatment of men with overactive bladder (OAB) appears to effectively alleviate urgency and storage symptoms, but not reduce the frequency of micturition episodes, according to data from the MIRACLE study.