Ep. 19 Intravenous Antiplatelet Therapy in Acute Coronary Syndrome with Dr. Hayder Hashim
BackTable CardiologyShow Notes
Preventing problems before they aggregate, P2Y12 inhibitor style! In this episode of the BackTable Cardiology Podcast, interventional cardiologist from MedStar Washington Hospital Center joins host Dr. Hady Lichaa for practical insights and key takeaways on antiplatelet use in the setting of acute coronary syndrome (ACS).---This podcast is supported by an educational grant from Cheisi.---SYNPOSISDr. Hashim talks through the use of intravenous antiplatelet therapies, specifically cangrelor, for managing acute coronary syndrome. Their discussion explores the pharmacokinetics, clinical advantages, and potential future applications of IV P2Y12 inhibitors. Dr. Hashim shares his wealth of experience in antiplatelet case studies and shares best practices when transitioning patients from IV to oral antiplatelet therapies. The conversation focuses on enhancing patient outcomes, minimizing complications, and lessons learned from different clinical scenarios.---TIMESTAMPS00:00 - Introduction03:31 - Intravenous Antiplatelet Therapies Overview06:01 - The Importance of IV P2Y12 Inhibitors09:15 - Guidelines and Usage of GP IIb/IIIa Inhibitors11:30 - Advantages of IV P2Y12 Inhibitors in Clinical Practice14:32 - Practical Applications and Case Studies24:42 - Cost Effectiveness, Hospital Administration, Financial Implications28:20 - Contraindications and Practical Considerations30:09 - Loading and Infusion Protocols34:58 - Bridging for Surgery39:48 - Anticoagulation and Heparin Goals48:55 - Future of IV Antiplatelet Therapy50:44 - Conclusion---RESOURCESAssociation of 2B3A inhibition with new antiplatelet regimens in the setting of acute coronary syndromes: a meta-analysis of randomized controlled trialshttps://academic.oup.com/eurheartj/article-abstract/34/suppl_1/P4861/2862796 Effect of Platelet Inhibition with Cangrelor during PCI on Ischemic Events - CHAMPION PHOENIXhttps://www.nejm.org/doi/full/10.1056/NEJMoa1300815 Morphine for treatment of cough in idiopathic pulmonary fibrosis (PACIFY COUGH): a prospective, multicentre, randomised, double-blind, placebo-controlled, two-way crossover trialhttps://pubmed.ncbi.nlm.nih.gov/38237620/ Abstract 4370674: Cangrelor Versus Oral P2Y12 Inhibitors During PCI in Cardiogenic Shock and Cardiac Arrest: A Systematic Review and Meta-analysishttps://www.ahajournals.org/doi/10.1161/circ.152.suppl_3.4370674Dr. Hayder Hashimhttps://www.medstarhealth.org/doctors/hayder-hashim-md Dr. Hady Lichaahttps://healthcare.ascension.org/find-care/provider/1336267533/hady-lichaa
More from BackTable Cardiology
Drug-coated balloons and a head-to-head trial against lithotripsy have put cutting and scoring balloons back at the center of complex percutaneous coronary intervention (PCI). On this episode of BackTable Cardiology, Dr. Nyal Borges interviews Dr. Ziad Ali, director of the DeMatteis Cardiovascular Institute, for an in-depth look at the mechanics, selection, and technique behind cutting and scoring balloons in complex PCI. They cover how these devices create a controlled dissection in fibrolipidic plaque, why they only fracture calcium that sits right at the lumen, and how lesion type and imaging should guide the choice between a conventional balloon, a specialty balloon and intravascular lithotripsy.
What does it actually take to open a chronically occluded pulmonary artery without pushing the patient into reperfusion pulmonary edema? On this episode of BackTable Cardiology, Dr. Hady Lichaa interviews Dr. Riyaz Bashir, interventional cardiologist and vascular medicine specialist at Mayo Clinic in Jacksonville, about the real-world, table-side technique of balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension (CTEPH). They walk through vascular access, telescoping sheath setup, right heart catheterization, pressure wire guidance, balloon sizing, and step-by-step planning for each lobe and lesion.
When your questions in cardiology go beyond the bedside and into healthcare innovation and transformation, is an executive MBA your next step? On this episode of BackTable Cardiology, Dr. Ankit Patel interviews Dr. Abdulla A. Damluji of the Cleveland Clinic about his journey from clinical cardiology to business school, and how an MBA empowered him to drive real change in healthcare. Dr. Damluji shares how business education gave him the tools to lead new programs, challenge the financial assumptions behind emerging technologies, and build a cardiovascular center focused on aging.
When a coronary lesion won’t open at conventional pressures, what can an ultra-high pressure balloon do differently? On this episode of BackTable Cardiology, host Dr. Hady Lichaa welcomes Dr. Deepak Kapoor, interventional cardiologist at the Medical College of Georgia at Augusta University, to discuss the science, safety, and real-world applications of ultra-high pressure (UHP) balloons in calcified coronary intervention. Dr. Kapoor walks through the evolution of balloon design, the main scenarios where UHP balloons are most useful, and the technical details that set these devices apart from standard non-compliant balloons and other calcium modification tools.
As new guidelines redefine risk stratification for pulmonary embolism (PE), emerging technologies are also changing what it means to achieve procedural success. On this episode of the BackTable Podcast, interventional radiologist Dr. Julie Bulman (BIDMC) and interventional cardiologist Dr. Jay Giri (Penn Medicine) join host Dr. Chris Beck to discuss the evolving frameworks and technologies redefining standards for catheter-directed treatment of intermediate- and high-risk PE. They discuss the role of multidisciplinary PERT teams, patient selection, the impact of new thrombectomy devices, and why autologous blood return is a growing consideration for procedural success.