Aspirina o clopidogrel post TAVI: Guías y estudios llenos de contradicciones

Is Clopidogrel Monotherapy Safe After a Month of Dual Antiplatelet Therapy in Diabetic Patients?

Currently, many randomized studies have suggested that short-term dual antiplatelet therapy (DAPT) followed by monotherapy reduces bleeding without increasing major cardiovascular events after percutaneous coronary intervention (PCI). A meta-analysis of six randomized studies has shown this benefit using ticagrelor monotherapy after short DAPT. However, there is no data on the results of clopidogrel monotherapy. Researchers<a href="https://solaci.org/en/2022/12/27/is-clopidogrel-monotherapy-safe-after-a-month-of-dual-antiplatelet-therapy-in-diabetic-patients/" title="Read more" >...</a>

ESC 2021 | MASTER DAPT: Doble antiagregación plaquetaria después de la angioplastia coronaria en pacientes con alto riesgo isquémico

ESC 2021 | MASTER DAPT: Dual Antiplatelet Therapy After Coronary Angioplasty in Patients at High Bleeding Risk

Courtesy of Dr. José Álvarez. In patients at high bleeding risk with drug-eluting stents, the duration of dual antiplatelet therapy has been subjected to ongoing review. Guidelines from the European Society of Cardiology (ESC) and the American College of Cardiology (ACC) suggest shortening this treatment to a maximum of three to six months (Class IIb).<a href="https://solaci.org/en/2021/08/31/esc-2021-master-dapt-dual-antiplatelet-therapy-after-coronary-angioplasty-in-patients-at-high-bleeding-risk/" title="Read more" >...</a>

Balancear el riesgo de sangrado vs trombótico para definir el tiempo de doble antiagregación

Very Short Dual Antiplatelet Therapy after Complex PCI

The 1-month outcomes of dual antiplatelet therapy (DAPT) followed by clopidogrel monotherapy were comparable to 12-month DAPT in patients with both simple and complex PCI. There was no significant interaction between DAPT period and procedure difficulty.  This is a post hoc study of the STOPDAPT-2 that looked at the complex PCI patient subgroup.   It is<a href="https://solaci.org/en/2021/05/24/very-short-dual-antiplatelet-therapy-after-complex-pci/" title="Read more" >...</a>

Single or Dual Antiplatelet Therapy in Stroke or Transient Ischemic Attack?

Antiplatelet therapy is key to prevent thrombotic events after a transient ischemic attack (TIA) or ischemic stroke. The role of aspirin is well established in this scenario, but there is emerging evidence for a short period of dual antiplatelet therapy (DAPT). Now, can this strategy avoid recurrent strokes without paying a price in terms of<a href="https://solaci.org/en/2021/05/05/single-or-dual-antiplatelet-therapy-in-stroke-or-transient-ischemic-attack/" title="Read more" >...</a>

duración terapia de doble antiagregación plaquetaria

Dual Antiplatelet Therapy and TAVR: Obsolete Guidelines

The current guidelines recommend dual antiplatelet therapy (DAPT) 3 to 6 months after transcatheter aortic valve replacement (TAVI). Some recent data finally condensed in the present meta-analysis and recently published in JAHA happen to challenge these guidelines.  Clinical studies that investigated single antiplatelet therapy versus DAPT until November 2020 were analyzed and divided according to<a href="https://solaci.org/en/2021/04/26/dual-antiplatelet-therapy-and-tavr-obsolete-guidelines/" title="Read more" >...</a>

La complejidad de la angioplastia puede definir el tiempo de doble antiagregación

Balancing Bleeding Risk vs. Thrombotic Risk to Define Dual Antiplatelet Therapy Duration

Patients who undergo complex angioplasty are at higher ischemic risk, but only benefit from extended dual antiplatelet therapy if there are no factors for high bleeding risk. These data suggest that the bleeding risk must weigh more than the ischemic risk on the determination of dual antiplatelet therapy duration. Complex angioplasty is associated with higher<a href="https://solaci.org/en/2019/04/05/balancing-bleeding-risk-vs-thrombotic-risk-to-define-dual-antiplatelet-therapy-duration/" title="Read more" >...</a>

ACC 2019 | STOPDAPT-2: Monoterapia con P2Y12 luego de un corto período de doble antiagregación post angioplastia

ACC 2019 | STOPDAPT-2: P2Y12 Monotherapy After Short-Term Dual Antiplatelet Therapy After Angioplasty

Aspirin is against the ropes: first, it was primary prevention; now, its use is being reconsidered even in relation to angioplasty. There might be paradigm changes as regards antiplatelet therapy after angioplasty. These two studies presented at the American College of Cardiology (ACC) 2019 Scientific Session can really change what we have been doing unquestioningly<a href="https://solaci.org/en/2019/03/25/acc-2019-stopdapt-2-p2y12-monotherapy-after-short-term-dual-antiplatelet-therapy-after-angioplasty/" title="Read more" >...</a>

TCT 2017 | SENIOR: DES con polímero reabsorbible y tiempo de doble antiagregación corto en pacientes añosos

TCT 2017 | SENIOR: DES with a Bioresorbable Polymer and Short Dual Antiplatelet Therapy in Elderly Patients

 Courtesy of the SBHCI. This study sought to assess the safety and efficacy of an everolimus-eluting stent with a biodegradable polymer (SYNERGY II) vs. a conventional stent (REBEL) in patients >75 years old with short duration of dual antiplatelet therapy. Before randomization, investigators recorded the planned duration of dual antiplatelet therapy (1 month for stable patients and 6 months<a href="https://solaci.org/en/2017/11/03/tct-2017-senior-des-with-a-bioresorbable-polymer-and-short-dual-antiplatelet-therapy-in-elderly-patients/" title="Read more" >...</a>

TCT 2017 | REDUCE: 3 vs 12 meses de doble antiagregación con el nuevo DES Combo

TCT 2017 | REDUCE: 3 vs 12 Months of Dual Antiplatelet Therapy with the New Combo DES

Courtesy of SBHCI. This new device has, on one hand, an abluminal sirolimus coating, and on the other hand, a luminal CD34 antibody coating for EPC capturing, to potentially accelerate post-PCI reendothelization. Between 2014 and 2016, the study included 1496 patients undergoing acute coronary syndrome (ACS), receiving the new COMBO stent. These patients were randomized<a href="https://solaci.org/en/2017/11/03/tct-2017-reduce-3-vs-12-months-of-dual-antiplatelet-therapy-with-the-new-combo-des/" title="Read more" >...</a>

Suspender la doble antiagregación genera más eventos trombóticos a 12 meses

Dual antiplatelet therapy discontinuation causes more thrombotic events at 12 months

Several randomized studies have shown that dual antiplatelet therapy (DAPT) is as effective to prevent thrombotic events in the segment treated with PCI, as it is with the rest of the coronary segments. This is very clear. The problem is there are a series of adverse events following P2Y12 inhibitor discontinuation. This phenomenon called rebound effect, happens<a href="https://solaci.org/en/2017/09/01/dual-antiplatelet-therapy-discontinuation-causes-more-thrombotic-events-at-12-months/" title="Read more" >...</a>