CCS Antiplatelets 2018 Flashcards
What are 9 high risk clinical factors for thrombotic events?
- ACS presentation
- DM
- CKD
- Previous stent thrombosis
- Current Smoker
- Multiple stents/Multivessel PCI
- Long lesion length (> 60mm)
- Complex lesion (Bifurcating)
- LMCA or LAD stenting
What are 8 RFs for increased bleeding risk?
- Age > 75
- OAC use
- NSAID or Prednisone use
- CrCl < 30
- Anemia < 110
- Body weight < 60kg
- History of significant bleed
- Stroke/ICH
How long to continue DAPT in elective PCI if high risk bleeding? BMS?
3 months, 1 month
DAPT duration in a patient with low bleeding risk after PCI for non ACS?
-6 months, then reassess for extension up to 3 years
How long to delay surgery post BMS?
1 month post PCI
how long to delay surgery after DES PCI ?
3 months
When to hold Plavix pre op for non cardiac surgery?
5-7 days
When to hold Prasugrel pre op for non cardiac surgery?
7-10 days
How long to hold Ticagrelor/Plavix pre CABG? Prasugrel?
- 2-3 days
- 5 days
do you need to care about timing of Ticagrelor/Prasugrel switch from plavix?
No
How to switch from Prasugrel to Ticagrelor?
Ticagrelor without loading dose at timing of next scheduled Prasugrel dose
How to switch from Ticagrelor to Prasugrel?
Loading dose of Prasugrel 60mg then 10mg at timing of next Ticagrelor dose
How to de-escalate from Ticagrelor to Clopidogrel?
600mg Plavix followed by 75mg daily at next scheduled Ticagrelor dose
How to de-escalate from Prasugrel to Clopidogrel?
75mg daily at next dose without loading dose
How to manage elective PCI with AF?
-OAC + Plavix 3 months for DES and 1 month BMS
