Duration of anti-platelets – a 2018 update

April 22, 2018 Andrew To

Cumulative Incidence of Major Adverse Cardiovascular and Cerebrovascular Events, According to Study Group. DAPT trial

64F presented with chest pain, consistent with non-ST elevation myocardial infarction with preserved systolic function. At invasive angiogram, right coronary artery was successfully stented with a drug eluting stent. On hospital discharge, she was given Aspirin, Ticagrelor as dual anti-platelet agents. How long should the dual antiplatelet therapy be continued for?

Atrial Fibrillation and Coronary Artery Disease: Aspirin and Oral Anticoagulants

March 14, 2016 Andrew To

A normally well 76-year-old lady had an NSTEMI 2 years ago and had successful stenting with a drug eluting stent (DES) for a severe left anterior descending artery narrowing. She had residual mild diffuse disease elsewhere.

After 12 months of dual antiplatelet therapy with Aspirin and Ticagrelor, she is now on Aspirin, in addition to Atorvastatin 40mg and Cilazapril 2.5mg for hypertension.

When seen in clinic, she reported no angina but was found to have new incidental asymptomatic atrial fibrillation. She had no history of stroke or TIA.

The best strategy for managing her stroke risk is

1) Aspirin alone

2) Aspirin plus Warfarin

3) Aspirin plus Dabigatran

4) Warfarin alone

5) Dabigatran alone

Dual anti-platelet therapy and non-cardiac surgery

March 14, 2016 Andrew To

A 75-year-old male is now 7-month post anterior myocardial infarction. He had successful proximal LAD drug eluting stent, currently on Aspirin and Ticagrelor. He is awaiting total hip joint replacement, and the orthopaedic surgeon would like to know whether he could stop his anti-platelets.