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    Rebuttal: Leonardo Bolognese Cardiovascular Department, Arezzo, Italy

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    Nagatzul
    The document discusses whether it is reasonable to prolong antiaggregation treatment beyond 12 months for DES thrombosis. Leonardo Bolognese argues against continuing clopidogrel indefinitely, providing several arguments: late stent thromboses are often not due to clopidogrel nonadherence; most patients discontinue clopidogrel without issues; one year costs $1.4 billion globally; it may impede other procedures; and there are safety, compliance, and response variability concerns.

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    Rebuttal: Leonardo Bolognese Cardiovascular Department, Arezzo, Italy

    Uploaded by

    Nagatzul
    16 views5 pages
    The document discusses whether it is reasonable to prolong antiaggregation treatment beyond 12 months for DES thrombosis. Leonardo Bolognese argues against continuing clopidogrel indefinitely, providing several arguments: late stent thromboses are often not due to clopidogrel nonadherence; most patients discontinue clopidogrel without issues; one year costs $1.4 billion globally; it may impede other procedures; and there are safety, compliance, and response variability concerns.

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    Bolognese Sardella2008Rebuttal

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    The document discusses whether it is reasonable to prolong antiaggregation treatment beyond 12 months for DES thrombosis. Leonardo Bolognese argues against continuing clopidogrel indefinitely, providing several arguments: late stent thromboses are often not due to clopidogrel nonadherence; most patients discontinue clopidogrel without issues; one year costs $1.4 billion globally; it may impede other procedures; and there are safety, compliance, and response variability concerns.

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    © All Rights Reserved
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    Download as ppt, pdf, or txt
    16 views5 pages

    Rebuttal: Leonardo Bolognese Cardiovascular Department, Arezzo, Italy

    Uploaded by

    Nagatzul
    The document discusses whether it is reasonable to prolong antiaggregation treatment beyond 12 months for DES thrombosis. Leonardo Bolognese argues against continuing clopidogrel indefinitely, providing several arguments: late stent thromboses are often not due to clopidogrel nonadherence; most patients discontinue clopidogrel without issues; one year costs $1.4 billion globally; it may impede other procedures; and there are safety, compliance, and response variability concerns.

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    II Symposium: “Head to Head”

    in Interventional Cardiology
    DES thrombosis mightmare: is it reasonable to
    prolong antiaggregation treatment beyond 12 months?

    NO
    REBUTTAL

    Leonardo Bolognese
    ISO 9001
    Cardiovascular Department, Arezzo, Italy
    Should Clopidogrel be Continued
    Indefinitely? The Arguments Against

    The majority (71% to 83%) of late stent


    thromboses are not attributable to clopidogrel
    nonadherence

    Using common sense, we have to point out


    that 99% of the patients worldwide discontinue
    their thienopyridine medication without
    experiencing ST

    ISO 9001
    Should Clopidogrel be Continued
    Indefinitely? The Arguments Against

    the wide window of thrombotic risk call into


    question the assertion that extending dual
    antiplatelet therapy to or beyond12 months
    will mitigate or ameliorate the risk of stent
    thrombosis.

    One year of clopidogrel costs ~$1400, so for


    1,000,000 pts per year globally
    $1.4 billion per year, compounded

    ISO 9001
    Should Clopidogrel be Continued
    Indefinitely? The Arguments Against

    Chronic clopidogrel maintenance might


    impede the performance of other valuable
    procedures, such as screening colonoscopy

    Safety concerns

    Compliance concerns

    Clopidogrel response variability

    ISO 9001
    ISO 9001

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