ACC/AHA 2016: DAPT Update Flashcards Preview

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Flashcards in ACC/AHA 2016: DAPT Update Deck (24)
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1

If DES and low-risk (non-ACS), what duration of DAPT is best?

If a newer generation DES (everolimus or zotarolimus), can do 3 - 6 months instead of longer therapy

2

How long should aspirin therapy be in CAD patients?

Lifelong

3

Some factors associated with increased bleeding risk

Female, low body weight, advanced age, history of prior bleeding, CKD, DM, anemia

4

If ACS, stented, and then DAPT, drug of choice for DAPT

Ticagrelor > Clopidogrel
+
ASA

5

If NSTE-ACS without revascularization, drug of choice for DAPT

Ticagrelor > Clopidogrel
+
ASA

6

Avoid Prasugrel if

History of stroke or TIA
Weight < 60 mg
Age >/= 75 years
not doing PCI

7

If ACS, stented, low/moderate bleed risk, no history of stroke or TIA, can use

Prasugrel over Clopidogrel

8

P2Y12 inhibitor for triple therapy

Clopidogrel

9

If stable ischemic heart disease treated with DAPT after BMS implantation, give this P2Y12 inhibitor for this duration

Clopidogrel for 1 month minimum

If not at high risk for bleeding and have tolerated DAPT without a bleeding complication, longer than 1 month may be reasonable

10

If stable ischemic heart disease treated with DAPT after DES, give this P2Y12 inhibitor for this duration

Clopidogrel for 6 months

If not at high risk for bleeding and have tolerated DAPT without a bleeding complication, longer than 6 months may be reasonable

11

If stable ischemic heart disease treated with DAPT after DES who develop a high risk for bleeding or significant overt bleeding, it is reasonable to

Discontinue P2Y12 inhibitor after 3 months

12

Duration of time on P2Y12 inhibitor for patients with ACS after BMS/DES implantation treated with DAPT

At least 12 months

13

In ACS treated with DAPT after coronary stent implantation, reasonable P2Y12 inhibitor of choice

Ticagrelor > Clopidogrel

14

In ACS treated with DAPT after coronary stent implantation who are not at high risk for bleeding and do not have a history of stroke or TIA, reasonable P2Y12 inhibitor of choice

Prasugrel > Clopidogrel

15

In ACS treated with DAPT after DES who develop a high risk for bleeding or overt bleeding, it is reasonable to

Discontinue P2Y12 inhibitor after 6 months

16

In DAPT after stent who undergo CABG, should DAPT be resumed post-op?

Yes

17

If SIHD on DAPT and then undergo CABG, reasonable duration of DAPT therapy

12 months

18

When to not use DAPT in SIHD

if no stent, no ACS history, and no CABG within 12 months

19

If ACS managed with medical therapy alone (no revascularization or fibrinolytic therapy), duration of DAPT

12 months
Reasonable to treat for longer if not high bleeding risk and no bleeding complication

20

If STEMI + fibrinolytic, duration of clopidogrel therapy

Minimum 14 days, and ideally, at least 12 months

21

If BMS implantation, how long should elective noncardiac surgery be delayed?

30 days after BMS implantation

22

If DES implantation, how long should elective noncardiac surgery be delayed?

6 months after DES implantation ideally

23

If P2Y12 must be held for a surgery, recommend

restarting P2Y12 as soon as possible after surgery
continue aspirin if possible throughout the surgery

24

If DES implantation and having elective noncardiac surgery, and the risk of delaying surgery is greater than the risk of stent thrombosis, how early after DES can patient get the surgery?

3 months after DES implantation