Pharmacology in the Catheterization Laboratory EDITED BY Ron Waksman MD, FACC Associate Chief of Cardiology Director of Experimental Angioplasty and New Technologies Division of Cardiology Washington Hospital Center Washington, DC, USA Andrew E. Ajani , , , MBBS MD FJFICM , FRACP FCSANZ Associate Professor Interventional Cardiologist Director of Coronary Care Unit Director of Physician Training The Royal Melbourne Hospital Melbourne, Victoria, Australia AAjjaannii__FFmm__FFiinnaall..iinndddd iiiiii 99//2233//22000099 1111::5588::3355 SShhoobbhhaa This edition fi rst published 2010, © 2010 by Blackwell Publishing Ltd Blackwell Publishing was acquired by John Wiley & Sons in February 2007. Blackwell’s publishing program has been merged with Wiley’s global Scientifi c, Technical and Medical business to form Wiley-Blackwell. 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No warranty may be created or extended by any promotional statements for this work. Neither the publisher nor the author shall be liable for any damages arising herefrom. Library of Congress Cataloging-in-Publication Data Pharmacology in the catheterization laboratory / [edited by] Ron Waksman, Andrew E. Ajani. p. ; cm. Includes bibliographical references and index. ISBN 978-1-4051-5704-9 1. Cardiovascular agents. 2. Cardiac catheterization. I. Waksman, Ron. II. Ajani, Andrew E. [DNLM: 1. Myocardial Revascularization. 2. Anticoagulants--therapeutic use. 3. Catheterization--methods. 4. Coronary Disease--drug therapy. 5. Fibrinolytic Agents--therapeutic use. 6. Platelet Aggregation Inhibitors--therapeutic use. WG 169 P536 2009] RM345.P485 2009 615′.71--dc22 2009013415 A catalogue record for this book is available from the British Library. Set in 9.5/12pt Minion by Newgen Imaging Systems Pvt. Ltd., Chennai, India Printed and bound in Malaysia 1 2010 AAjjaannii__FFmm__FFiinnaall..iinndddd iivv 99//2233//22000099 1111::5588::3366 SShhoobbhhaa Contents Contributors, viii 9 Prasugrel: A novel P2Y receptor 12 Acknowledgements, xiii inhibitor, 59 Foreword, xiv Itsik Ben-Dor, Mickey Scheinowitz, and Preface, xv Ron Waksman 10 When to use glycoprotein IIb/IIIa inhibitors Part I Elective PCI anticoagulation and which one to use: Abciximab, tirofi ban, therapy/thrombin inhibitors or eptifi batide?, 67 Cheuk-Kit Wong and Harvey D. White 1 Optimal antithrombotic therapy, 3 Michel E. Bertrand 2 Low molecular weight heparin in the Part III Acute coronary syndrome catheterization laboratory, 10 STEMI/NSTEMI Yuri B. Pride, JoEllyn M. Abraham, and 11 Antithrombotic therapy for non ST-elevation C. Michael Gibson acute coronary syndromes, 81 3 Direct thrombin inhibitor: Bivalirudin, 16 Andrew Zinn and Frederick Feit Michele D. Voeltz and Steven V. Manoukian 12 Non antithrombotic postprocedural 4 Fondaparinux in the cardiac catheterization pharmacotherapy: The role of statins, laboratory, 23 beta-blockers, angiotensin-converting enzyme, Michael D. White and Richard C. Becker or aldosterone inhibitors in acute coronary syndromes and elective percutaneous coronary interventions, 93 Part II Antiplatelet therapy Itsik Ben-Dor, Ran Kornowski, and 5 Optimal antiplatelet therapy: Duration of Shmuel Fuchs antiplatelet therapy with drug-eluting and 13 Primary percutaneous coronary bare metal stents, 33 intervention for ST elevation myocardial Probal Roy and Ron Waksman infarction: Summary of optimal 6 Clopidogrel: How much, how soon, anticoagulation, glycoprotein IIb/IIIa and how long, 41 platelet inhibitors, and other antiplatelet Alaeddin Ayyad, and Deepak L. Bhatt therapies, 104 Bruce R. Brodie 7 Loading strategies of clopidogrel, 46 Germano Di Sciascio and Giuseppe Patti 14 Rescue percutaneous coronary intervention, 112 8 Cangrelor, 53 Damian J. Kelly and Anthony H. Gershlick Julie H. Oestreich and Steven R. Steinhubl v AAjjaannii__FFmm__FFiinnaall..iinndddd SSeecc11::vv 99//2233//22000099 1111::5588::3366 SShhoobbhhaa vi Contents 15 Facilitated primary percutaneous coronary 27 Ideal contrast agent, 210 intervention in acute ST-elevation myocardial Luis Gruberg infarction, 118 Amir Kashani and Robert P. Giugliano Part VI PCI complications 16 Streptokinase, alteplase, reteplase, or tenecteplase, 133 28 The no refl ow phenomenon: Etiology, Eric R. Bates prophylaxis, and treatment, 219 Tim A. Fischell 17 Intracoronary vs intravenous glycoprotein IIb/IIIa inhibitor use, 140 29 Arrhythmia management in the cardiac Sanjiv Sharma and Raj R. Makkar catheterization laboratory, 227 David S. Kwon and Adam Strickberger 18 Upstream vs procedural use of glycoprotein IIb/IIIa inhibitors in acute coronary 30 Tachyarrhythmias management, 229 syndromes, 145 Dorinna D. Mendoza and Zayd A. Eldadah Ralph Wessel and John A. Ambrose 31 Bradyarrhythmias management 19 High-dose tirofi ban, 154 (intravenous atropine, adrenaline, indications Bart Dawson, Debabrata Mukherjee, and for temporary pacing wire), 235 David J. Moliterno Khan Pohlel and Ziyad Ghazzal 20 Oral anticoagulation issues in percutaneous coronary intervention, 158 Part VII Postprocedural Scott Martin, Allen Jeremias, and pharmacotherapy Luis Gruberg 32 Management of patients on long-term anticoagulation, 243 Bryan P. Yan and Andrew E. Ajani Part IV Elective PCI miscellaneous 33 Indication for anticoagulation post- 21 Agents to optimize access of radial percutaneous coronary intervention, 250 artery approach, 167 Roswitha Wolfram Tift Mann 34 Clopidogrel use in patients requiring coronary artery bypass grafting, 257 Part V High-risk PCI Nilesh U. Patel and Mark W. Connolly 22 Diabetes mellitus, 173 Joseph Lindsay Part VIII Anticoagulation anomalies 23 Cardiogenic shock, 179 35 Heparin-induced thrombocytopenia, 263 Pantelis Diamantouros and E. Magnus Ohman Ignacio Cruz-Gonzalez, Maria Sanchez- 24 High-risk coronary intervention and renal Ledesma, and Ik-Kyung Jang dysfunction, 190 36 Thrombocytopenia, anemia, and Geoffrey Lee, Ronen Gurvitch, and transfusion of blood products in patients Andrew E. Ajani undergoing percutaneous coronary 25 Renal-protective agents, 195 interventions, 270 Giancarlo Marenzi and Antonio L. Bartorelli Eugenia Nikolsky and Pravin Kahale 26 Radiocontrast-induced nephropathy, 203 37 Antiplatelet therapy resistance: Defi nition, Giancarlo Marenzi and Antonio L. Bartorelli diagnosis, and clinical implications, 280 Saurabh Gupta and Peter J. Casterella AAjjaannii__FFmm__FFiinnaall..iinndddd SSeecc11::vvii 99//2233//22000099 1111::5588::3366 SShhoobbhhaa Contents vii 38 Reversal of anticoagulation: Protamine, 287 42 Systemic pharmacotherapy for in-stent Bengt Lindblad and Jan Holst restenosis: Steroids, 328 Valeria Ferrero and Flavio Ribichini 39 Thrombocytopenia post-percutaneous coronary interventions: Glycoprotein IIb/IIIa- 43 Oral agents to prevent in-stent restenosis (oral induced, 294 sirolimus and glitazones), 337 Ronen Gurvitch and Jeffrey Lefkovits Pramod Kumar Kuchulakanti 44 Novel pharmacotherapy in percutaneous coronary intervention, 346 Part IX Systemic pharmacotherapy for Andrew T. L. Ong in-stent restenosis 40 Is oral rapamycin plus bare metal stents a feasible alternative to drug-eluting Appendix, 354 stents? Lessons learned from Argentina Index, 371 observational and randomized studies (ORAR I, II, and III trials), 305 Alfredo E. Rodriguez 41 Systemic paclitaxel for prevention of restenosis, 321 Neil P. Desai AAjjaannii__FFmm__FFiinnaall..iinndddd SSeecc11::vviiii 99//2233//22000099 1111::5588::3366 SShhoobbhhaa Contributors JoEllyn M. Abraham, MD Richard C. Becker, MD Fellow, Division of Cardiovascular Medicine Professor of Medicine Cleveland Clinic Divisions of Cardiology and Hematology Cleveland, OH, USA Duke Clinical Research Institute Duke University School of Medicine Andrew E. Ajani, MBBS, MD, FRACP, Durham, NC, USA FJFICM, FCSANZ Associate Professor Itsik Ben-Dor, MD Interventional Cardiologist Professor Director of Coronary Care Unit Cardiology Department Director of Physician Training Interventional Cardiology Institute The Royal Melbourne Hospital Rabin Medical Center Melbourne, Victoria, Australia Petach-Tikva, Israel; Sackler Faculty of Medicine John A. Ambrose, MD, FACC Tel-Aviv University Chief of Cardiology Tel-Aviv, Israel UCSF Fresno Professor of Medicine Michel E. Bertrand, MD, FRCP, FESC, University of California FACC, FAHA San Francisco, CA, USA Emeritus Professor of Cardiology University of Lille Alaeddin Ayyad, MD Lille Heart Institute Cardiology Fellow Lille, France Department of Cardiology University of California San Diego Deepak L. Bhatt, MD, MPH, FACC, San Diego, CA, USA FAHA, FSCAI Chief of Cardiology Antonio L. Bartorelli, MD, FESC, FACC VA Boston Healthcare System Director Director, Interventional Cardiology Integrated Interventional Cardiovascular Program Department of Cardiovascular Sciences Brigham and Women’s Hospital and the VA Boston Centro Cardiologico Monzino Healthcare System I.R.C.C.S. Senior Investigator, TIMI Study Group University of Milan Harvard Medical School Milan, Italy Boston, MA, USA Eric R. Bates, MD Bruce R. Brodie, MD Professor of Medicine Clinical Professor of Medicine Division of Cardiovascular Diseases University of North Carolina Teaching Service Department of Internal Medicine Moses Cone Health System University of Michigan Chairman, LeBauer Cardiovascular Research Foundation Ann Arbor, MI, USA Greensboro, NC, USA viii AAjjaannii__FFmm__FFiinnaall..iinndddd SSeecc22::vviiiiii 99//2233//22000099 1111::5588::3366 SShhoobbhhaa Contributors ix Peter J. Casterella, MD Valeria Ferrero, MD Interventional Cardiologist Staff Cardiologist Catheterization Laboratory Seattle Cardiology Division of Cardiology, Università di Verona Seattle, WA, USA Ospedale Civile Maggiore Verona, Italy Mark W. Connolly, MD Director, Cardiovascular and Thoracic Surgery Tim A. Fischell, MD, FACC, FSCAI Heart and Vascular Institute Director of Cardiovascular Research Department of Cardiovascular and Thoracic Surgery Borgess Heart Institute St. Michael’s Medical Center Professor of Medicine Newark, NJ, USA Michigan State University Kalamazoo, MI, USA Ignacio Cruz-Gonzalez, MD, PhD Associate Professor of Medicine Shmuel Fuchs, MD, MACC, FSACI Harvard Medical School Specialist in Cardiology and Internal Medicine, Head Director, Cardiology Laboratory for Integrative Physiology Department of Internal Medicine B and Imaging Beilinson Hospital, Rabin Medical Center Interventional Cardiology Fellow Petach-Tikva, Israel Cardiology Division Massachusetts General Hospital Anthony H. Gershlick, MD Boston, MA, USA Professor of Interventional Cardiology Academic Department of Cardiology Bart Dawson, MD University Hospitals of Leicester Cardiovascular Medicine Fellow Leicester, UK Gill Heart Institute and Division of Cardiovascular Medicine Ziyad Ghazzal, MD, FACC, FSCAI University of Kentucky Professor of Medicine Cardiology/Interventional Lexington, KY, USA Cardiology Deputy VP/Dean Associate Dean for Clinical Affairs Neil P. Desai, PhD American University of Beirut Vice President, R&D Faculty of Medicine and Medical Center Abraxis Bioscience, LLC Beirut, Lebanon Los Angeles, CA, USA C. Michael Gibson, MS, MD Pantelis Diamantouros, MD, FRCPC Associate Professor Assistant Professor of Medicine Harvard Medical School Division of Cardiology Director, TIMI Data Coordinating Center Department of Internal Medicine Boston, MA, USA University of Western Ontario London, ON, Canada Robert P. Giugliano, MD, SM Senior Investigator Germano Di Sciascio, MD, FACC, FESC TIMI Study Group Assistant Professor of Cardiology Associate Physician Director, Department of Cardiovascular Sciences Cardiovascular Medicine Campus Bio-Medico University of Rome Brigham and Women’s Hospital Rome, Italy Assistant Professor in Medicine Harvard Medical School Zayd A. Eldadah, MD, PhD, FACC Boston, MA, USA Associate Director, Arrhythmia Research Cardiac Arrhythmia Center Luis Gruberg, MD, FACC Division of Cardiology Director, Cardiovascular Catheterization Laboratories Washington Hospital Center Professor of Medicine Washington, DC, USA Division of Cardiology SUNY-Stony Brook University Medical Center Frederick Feit, MD, FACC Health Science Center Associate Professor of Medicine Stony Brook, NY, USA Division of Cardiology, Department of Medicine New York University School of Medicine New York, NY, USA AAjjaannii__FFmm__FFiinnaall..iinndddd SSeecc22::iixx 99//2233//22000099 1111::5588::3366 SShhoobbhhaa x Contributors Saurabh Gupta, MD, FACC Pramod Kumar Kuchulakanti, Assistant Professor of Medicine MD, DM, FACC, FESC Division of Cardiovascular Medicine Interventional Cardiologist Oregon Health and Science University Director, Cardiac Catheterization Laboratory Portland, OR, USA Wockhardt Heart Center, Kamineni Hospitals Hyderabad, India Ronen Gurvitch, MBBS, FRACP Cardiologist David S. Kwon, MD, PhD Interventional Cardiology Fellow Cardiology Fellow The Royal Melbourne Hospital Cardiac Research Institute Melbourne, Victoria, Australia Washington Hospital Center Washington, DC, USA Jan Holst, MD, PhD Associate Professor Geoffrey Lee, MBCHB, FRACP Vascular Centre Cardiologist, Department of Cardiology University Hospital MAS The Royal Melbourne Hospital Malmö, Sweden Melbourne, Victoria, Australia Ik-Kyung Jang, MD, PhD Jeffrey Lefkovits, MBBS, FRACP, FCSANZ Associate Professor of Medicine Interventional Cardiologist Harvard Medical School The Royal Melbourne Hospital Director, Cardiology Laboratory for Integrative Physiology Melbourne, Victoria, Australia and Imaging, Cardiology Division Massachusetts General Hospital Bengt Lindblad, MD, PhD Boston, MA, USA Associate Professor Vascular Centre Allen Jeremias, MD, MSc University Hospital MAS Director, Vascular Medicine and Peripheral Intervention Malmö, Sweden Division of Cardiovascular Medicine SUNY-Stony Brook School of Medicine Joseph Lindsay, MD, FACC Stony Brook, NY, USA Division Director Emeritus, Cardiology Washington Hospital Center Pravin Kahale, MD, DM (Cardiology) Washington, DC, USA Interventional Cardiologist Department of Invasive Cardiology Raj R. Makkar, MD, FACC, FSCAI Adventist Wockhardt Hospital Director, Interventional Cardiology and Cardiac Surat, India Catheterization Laboratory Cedars-Sinai Medical Center Amir Kashani, MD, MS, CCDS, FACC Associate Professor Section of Cardiology UCLA School of Medicine Yale University School of Medicine Los Angeles, CA, USA New Haven, CT, USA; Clinical Instructor Tift Mann, MD, FACC Baylor College of Medicine Interventional Cardiologist Houston, TX, USA Wake Heart Associates Raleigh, NC, USA Damian J. Kelly, BSc, MRCP Cardiologist Specialist Registrar Steven V. Manoukian, MD, FACC, Department of Academic Cardiology FSCAI University Hospitals of Leicester, Glenfi eld Hospital Director of Cardiovascular Research Leicester, UK Sarah Cannon Research Institute Medical Director of Cardiology, Clinical Services Group Ran Kornowski, MD, FACC, FESC Hospital Corporation of America (HCA), Inc. Director, Interventional Cardiology Institute Interventional Cardiology Cardiology Department Centennial Heart Rabin Medical Center Nashville, TN, USA Petach-Tikva, Israel; Sackler Faculty of Medicine Tel-Aviv University Tel-Aviv, Israel AAjjaannii__FFmm__FFiinnaall..iinndddd SSeecc22::xx 99//2233//22000099 1111::5588::3377 SShhoobbhhaa Contributors xi Giancarlo Marenzi, MD, FESC Andrew T. L. Ong, MBBS, PhD, FRACP, Director, Coronary Unit FESC, FACC Centro Cardiologico Monzino, I.R.C.C.S. Consultant and Interventional Cardiologist Department of Cardiovascular Sciences Department of Cardiology University of Milan Westmead Hospital Milan, Italy Westmead, New South Wales, Australia Scott Martin, MD Nilesh U. Patel, MD Fellow, Division of Cardiovascular Medicine Chief, Minimally Invasive Robotic Cardiac Surgery Department of Medicine Department of Cardiovascular and Thoracic Surgery SUNY-Stony Brook School of Medicine St. Michael’s Medical Center Stony Brook, NY, USA Newark, NJ, USA Dorinna D. Mendoza, MD Giuseppe Patti, MD Cardiology Fellow Assistant Professor Division of Cardiology Department of Cardiovascular Sciences Washington Hospital Center Campus Bio-Medico University of Rome Washington, DC, USA Rome, Italy David J. Moliterno, MD Khan Pohlel, MD, FACC Professor and Chief of Cardiology Interventional Cardiologist Gill Heart Institute and Division of Athens Cardiology Group Cardiovascular Medicine Athens, GA, USA University of Kentucky Lexington, KY, USA Yuri B. Pride, MD Instructor in Medicine Debabrata Mukherjee, MD, FACC, Division of Cardiovascular Medicine FSCAI Beth Israel Deaconess Medical Center Professor of Medicine Harvard Medical School Director, Cardiac Catheterization Laboratory Boston, MA, USA Gill Heart Institute Division of Cardiovascular Medicine Flavio Ribichini, MD University of Kentucky Director, Catheterization Laboratory Lexington, KY, USA Università di Verona Ospedale Civile Maggiore Eugenia Nikolsky, MD, PhD Verona, Italy Director, Academic Affairs Clinical Trial Center Alfredo E. Rodriguez, MD, PhD, Cardiovascular Research Foundation FACC, FSCAI New York, NY, USA Director, Cardiovascular Research Center (CECI) Cardiac Unit, Otamendi Hospital Julie H. Oestreich, PharmD, PhD Buenos Aires School of Medicine Post-Doctoral Fellow Buenos Aires, Argentina Department of Pharmaceutical Sciences University of Kentucky Probal Roy, MD Lexington, KY, USA Interventional Cardiologist Australian School of Advanced Medicine E. Magnus Ohman, MD, FRCPI, FESC, Macquarie University FACC, FSCAI Sydney, New South Wales, Australia Professor of Medicine Associate Director, Duke Heart Center Maria Sanchez-Ledesma, MD Director, Program for Advanced Coronary Disease Fellow Research, Interventional Cardiology Duke Clinical Research Institute Cardiology Division Duke University Medical Center Massachusetts General Hospital Durham, NC, USA Harvard Medical School Boston, MA, USA AAjjaannii__FFmm__FFiinnaall..iinndddd SSeecc22::xxii 99//2233//22000099 1111::5588::3377 SShhoobbhhaa xii Contributors Mickey Scheinowitz, Phd, FACSM Harvey D. White, DSc, FCSANZ Associate Professor Director of Coronary Care and Green Lane Department of Biomedical Engineering & Cardiovascular Research Unit Neufeld Cardiac Research Institute Green Lane Cardiovascular Service Tel-Aviv University Auckland City Hospital Ramat-Aviv, Israel Auckland, New Zealand Sanjiv Sharma, MD, FACC, FSCAI Michael D. White, MD Clinical Instructor of Medicine Fellow, Interventional Cardiology Program UCLA School of Medicine Division of Cardiology Los Angeles, CA, USA; Duke University Medical Center Director, Research and Education Durham, NC, USA Bakersfi eld Heart Hospital Bakersfi eld, CA, USA Roswitha Wolfram, MD Professor of Medicine Steven R. Steinhubl, MD Department of Internal Medicine II Global Vice-President, Thrombosis Vienna General Hospital The Medicines Company Vienna, Austria Zurich, Switzerland The Geisinger Clinic Cheuk-Kit Wong, MD, FCSANZ Adjunct Research Faculty Consultant Cardiologist Danville, PA, USA Dunedin School of Medicine Otago University Adam Strickberger, MD Dunedin, New Zealand Professor, Georgetown University School of Medicine Cardiac Research Institute Bryan P. Yan, MBBS, FRACP Washington, DC, USA Assistant Professor Chinese University of Hong Kong Michele D. Voeltz, MD Interventional Cardiologist Assistant Professor of Medicine Prince of Wales Hospital Division of Cardiology Hong Kong, China Department of Medicine Sarah Cannon Research Institute Andrew Zinn, MD Hospital Corporation of America Division of Cardiology Nashville, TN, USA Department of Medicine New York University School of Medicine Ron Waksman, MD, FACC New York, NY, USA Associate Chief of Cardiology Director of Experimental Angioplasty and New Technologies Division of Cardiology Washington Hospital Center Washington, DC, USA Ralph Wessel, MD, FACC Associate Professor of Medicine Division of Cardiology Department of Internal Medicine UCSF Fresno Fresno, CA, USA AAjjaannii__FFmm__FFiinnaall..iinndddd SSeecc22::xxiiii 99//2233//22000099 1111::5588::3377 SShhoobbhhaa