Carlos Augusto Bueno Silva,Dr Serviço de Hemodinâmica e Cardiologia Intervencionista do Hospital São João de Deus – Divinópolis Sem conflito de interesses.
Download ReportTranscript Carlos Augusto Bueno Silva,Dr Serviço de Hemodinâmica e Cardiologia Intervencionista do Hospital São João de Deus – Divinópolis Sem conflito de interesses.
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Carlos Augusto Bueno Silva,Dr
Serviço de Hemodinâmica e Cardiologia
Intervencionista do Hospital São João de
Deus – Divinópolis
Sem conflito de interesses.
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Aspirina
Ticlopidina
Clopidogrel
Prasugrel
Cilostazol
Inibidores 2b3a
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ISIS 2 Lancet 1988;2:349-60
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The ISAR-REACT trial evaluated the efficacy of abciximab in 2159 patients undergoing elective
percutaneous coronary intervention (PCI) . All patients were pretreated with 600 mg of
clopidogrel at least two hours before PCI. When the study subjects were grouped into four subsets
based upon duration of clopidogrel pretreatment (2 to 3 hours, 3 to 6 hours, 6 to 12 hours, and >12
hours), there was no significant difference among the four groups in the incidence of death, MI, or
urgent revascularization at 30 days or in the rate of major bleeding.
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Absorption, metabolization, and antiplatelet effects of 300-, 600-, and 900-mg loading doses of clopidogrel: results
of the ISAR-CHOICE (Intracoronary Stenting and Antithrombotic Regimen: Choose Between 3 High Oral Doses
for Immediate Clopidogrel Effect) Trial.
von Beckerath N, Taubert D, Pogatsa-Murray G, Schömig E, Kastrati A, Schömig A
Circulation. 2005;112(19):2946.
).CONCLUSIONS: Single doses of clopidogrel higher than 600 mg are not associated with an
additional significant suppression of platelet function because of limited clopidogrel absorption.
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The ARMYDA-4 RELOAD study involved 503 patients already taking chronic clopidogrel
who required PCI. They were randomized to a 600-mg clopidogrel loading dose four to
eight hours before PCI or placebo. The primary end point was death, MI, or target vessel
revascularization at 30 days. In the overall population, this was slightly reduced in the
loading-dose group but not significantly so. But those patients with ACS (about 40% of
the trial population) did show a better outcome when given the additional loading
dose. There was no excess bleeding in the reload arm (6% in both groups).
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Heparina não fracionada
Heparina de baixo peso molecular
Inibidores diretos da trombina
Fondaparinux
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CSA de alto risco ( VS enoxaparina)
Similar eficácia, menor sangramento
Necessidade de HNF suplementear para ICP
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Carlos Augusto Bueno Silva,Dr
Serviço de Hemodinâmica e Cardiologia
Intervencionista do Hospital São João de
Deus – Divinópolis
Sem conflito de interesses.
Slide 2
Aspirina
Ticlopidina
Clopidogrel
Prasugrel
Cilostazol
Inibidores 2b3a
Slide 3
Slide 4
Slide 5
Slide 6
Slide 7
ISIS 2 Lancet 1988;2:349-60
Slide 8
Slide 9
Slide 10
Slide 11
Slide 12
Slide 13
Slide 14
Slide 15
Slide 16
The ISAR-REACT trial evaluated the efficacy of abciximab in 2159 patients undergoing elective
percutaneous coronary intervention (PCI) . All patients were pretreated with 600 mg of
clopidogrel at least two hours before PCI. When the study subjects were grouped into four subsets
based upon duration of clopidogrel pretreatment (2 to 3 hours, 3 to 6 hours, 6 to 12 hours, and >12
hours), there was no significant difference among the four groups in the incidence of death, MI, or
urgent revascularization at 30 days or in the rate of major bleeding.
Slide 17
Slide 18
Slide 19
Absorption, metabolization, and antiplatelet effects of 300-, 600-, and 900-mg loading doses of clopidogrel: results
of the ISAR-CHOICE (Intracoronary Stenting and Antithrombotic Regimen: Choose Between 3 High Oral Doses
for Immediate Clopidogrel Effect) Trial.
von Beckerath N, Taubert D, Pogatsa-Murray G, Schömig E, Kastrati A, Schömig A
Circulation. 2005;112(19):2946.
).CONCLUSIONS: Single doses of clopidogrel higher than 600 mg are not associated with an
additional significant suppression of platelet function because of limited clopidogrel absorption.
Slide 20
The ARMYDA-4 RELOAD study involved 503 patients already taking chronic clopidogrel
who required PCI. They were randomized to a 600-mg clopidogrel loading dose four to
eight hours before PCI or placebo. The primary end point was death, MI, or target vessel
revascularization at 30 days. In the overall population, this was slightly reduced in the
loading-dose group but not significantly so. But those patients with ACS (about 40% of
the trial population) did show a better outcome when given the additional loading
dose. There was no excess bleeding in the reload arm (6% in both groups).
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Slide 25
Slide 26
Slide 27
Slide 28
Slide 29
Slide 30
Slide 31
Slide 32
Slide 33
Slide 34
Slide 35
Slide 36
Heparina não fracionada
Heparina de baixo peso molecular
Inibidores diretos da trombina
Fondaparinux
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Slide 38
Slide 39
Slide 40
Slide 41
Slide 42
Slide 43
Slide 44
Slide 45
Slide 46
CSA de alto risco ( VS enoxaparina)
Similar eficácia, menor sangramento
Necessidade de HNF suplementear para ICP
Slide 47