From Coronaries to Cirrhosis: The Role of Percutaneous Coronary Intervention and Dual Antiplatelet Therapy in End-Stage Liver Disease

Drug-eluting stents (DES) have superior efficacy compared with bare metal stents (BMS) for treatment of coronary artery lesions. However, BMS continue to play an important role in percutaneous coronary intervention for patients who are at a high bleeding risk, because they require a shorter duration...

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Autores principales:	Taylor C. Remillard MD, Don C. Rockey MD
Formato:	article
Lenguaje:	EN
Publicado:	SAGE Publishing 2021
Materias:	Medicine (General) R5-920 Pathology RB1-214
Acceso en línea:	https://doaj.org/article/116e3cc4fdf24ed58f5ba4e5752f7a50
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spelling	oai:doaj.org-article:116e3cc4fdf24ed58f5ba4e5752f7a502021-11-21T01:33:54ZFrom Coronaries to Cirrhosis: The Role of Percutaneous Coronary Intervention and Dual Antiplatelet Therapy in End-Stage Liver Disease2324-709610.1177/23247096211005097https://doaj.org/article/116e3cc4fdf24ed58f5ba4e5752f7a502021-11-01T00:00:00Zhttps://doi.org/10.1177/23247096211005097https://doaj.org/toc/2324-7096Drug-eluting stents (DES) have superior efficacy compared with bare metal stents (BMS) for treatment of coronary artery lesions. However, BMS continue to play an important role in percutaneous coronary intervention for patients who are at a high bleeding risk, because they require a shorter duration of dual antiplatelet therapy. However, new developments in DES and understanding of the optimal time required for dual antiplatelet therapy after percutaneous coronary intervention may further limit the use of BMS. Furthermore, the use of dual antiplatelet therapy is complicated in patients with cirrhosis, who may have coagulopathy. In this article, we present the case of a patient with cirrhosis and end-stage chronic liver disease with coronary artery disease and a proximal left anterior descending stenosis who received a DES and had multiple episodes of gastrointestinal bleeding. We review the literature addressing DES and BMS in patients at high risk of bleeding. We also review the optimal duration of dual antiplatelet therapy.Taylor C. Remillard MDDon C. Rockey MDSAGE PublishingarticleMedicine (General)R5-920PathologyRB1-214ENJournal of Investigative Medicine High Impact Case Reports, Vol 9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine (General) R5-920 Pathology RB1-214
spellingShingle	Medicine (General) R5-920 Pathology RB1-214 Taylor C. Remillard MD Don C. Rockey MD From Coronaries to Cirrhosis: The Role of Percutaneous Coronary Intervention and Dual Antiplatelet Therapy in End-Stage Liver Disease
description	Drug-eluting stents (DES) have superior efficacy compared with bare metal stents (BMS) for treatment of coronary artery lesions. However, BMS continue to play an important role in percutaneous coronary intervention for patients who are at a high bleeding risk, because they require a shorter duration of dual antiplatelet therapy. However, new developments in DES and understanding of the optimal time required for dual antiplatelet therapy after percutaneous coronary intervention may further limit the use of BMS. Furthermore, the use of dual antiplatelet therapy is complicated in patients with cirrhosis, who may have coagulopathy. In this article, we present the case of a patient with cirrhosis and end-stage chronic liver disease with coronary artery disease and a proximal left anterior descending stenosis who received a DES and had multiple episodes of gastrointestinal bleeding. We review the literature addressing DES and BMS in patients at high risk of bleeding. We also review the optimal duration of dual antiplatelet therapy.
format	article
author	Taylor C. Remillard MD Don C. Rockey MD
author_facet	Taylor C. Remillard MD Don C. Rockey MD
author_sort	Taylor C. Remillard MD
title	From Coronaries to Cirrhosis: The Role of Percutaneous Coronary Intervention and Dual Antiplatelet Therapy in End-Stage Liver Disease
title_short	From Coronaries to Cirrhosis: The Role of Percutaneous Coronary Intervention and Dual Antiplatelet Therapy in End-Stage Liver Disease
title_full	From Coronaries to Cirrhosis: The Role of Percutaneous Coronary Intervention and Dual Antiplatelet Therapy in End-Stage Liver Disease
title_fullStr	From Coronaries to Cirrhosis: The Role of Percutaneous Coronary Intervention and Dual Antiplatelet Therapy in End-Stage Liver Disease
title_full_unstemmed	From Coronaries to Cirrhosis: The Role of Percutaneous Coronary Intervention and Dual Antiplatelet Therapy in End-Stage Liver Disease
title_sort	from coronaries to cirrhosis: the role of percutaneous coronary intervention and dual antiplatelet therapy in end-stage liver disease
publisher	SAGE Publishing
publishDate	2021
url	https://doaj.org/article/116e3cc4fdf24ed58f5ba4e5752f7a50
work_keys_str_mv	AT taylorcremillardmd fromcoronariestocirrhosistheroleofpercutaneouscoronaryinterventionanddualantiplatelettherapyinendstageliverdisease AT doncrockeymd fromcoronariestocirrhosistheroleofpercutaneouscoronaryinterventionanddualantiplatelettherapyinendstageliverdisease
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From Coronaries to Cirrhosis: The Role of Percutaneous Coronary Intervention and Dual Antiplatelet Therapy in End-Stage Liver Disease

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