Pharmacology articles

ACC 2023 | COORDINATE-DIABETES

ACC 2023 | COORDINATE-DIABETES

Approximately only 2.7% of all diabetic patients with ischemic heart disease in the United States receive optimal treatment consisting in high doses of statins (ACEI/ARAII) or “cardio-stable” antihyperglycemic agents such as SGLT2I and GLP-1RA (three of them). Of the population, 37.4% does not use any medication. Randomization was conducted at the healthcare facility level, rather

ACC 2023 | A DUE-Study (Phase III)

In pulmonary hypertension (PHT), 10 mg macitentan plus 40 mg tadalafil is recommended as a safe combination therapy for newly diagnosed patients or in a significant proportion of patients during follow-up. Using a tablet with a fixed drug combination (FDC) could simplify treatment. The aim of this study was to evaluate the efficacy and safety of macitentan/tadalafil

ACC 2023 | YELLOW III Study. Effect of Evolocumab on Coronary Plaque Characteristics in Stable Coronary Artery Disease

Dr. Kini presented the results of the YELLOW III Study where she analyzed the effect of evolocumab on coronary plaque in patients with stable coronary artery disease. The study included 137 patients who underwent coronary angioplasty to the culprit vessel and endovascular imaging (OCT, NIRS/IVUS) to non-obstructive lesions (30%-50%). If their plaque was lipid-rich (defined

COMPASS: un nuevo lugar para el rivaroxaban en cardiopatía isquémica crónica

Rivaroxaban in Acute Coronary Syndrome

Acute coronary syndromes (ACS) involve high mortality risk, especially ST elevation ACS. Their treatment is based on reperfusion, dual antiplatelet therapy (DAPT) and anticoagulation, with enoxaparin (1 mg/kg twice a day) as the preferred anticoagulant according to the contemporary guidelines.  2.5 mg or 5 mg doses of rivaroxaban might be valid alternative treatments for this

¿Cuál es la mejor antiagregación en la angioplastia primaria a 12 meses?

Monotherapy with P2Y12 in Complex Interventions: Less and Less Risky

 Monotherapy in patients with complex angioplasty: meta-analysis of 5 randomized studies.  Even though prolonged dual antiplatelet therapy (DAPT) might reduce the risk of important ischemic complications, this reduction will come at the expense of a significant increase of bleeding risk, which makes us reassess the cost benefit ratio of this decision. This is also why

Resultados a 2 años de los stents liberadores de Zotarolimus vs stents libres de polímero liberadores de Biolimus. ¿Son seguros en pacientes con alto riesgo de sangrado?

Is Using Drug-Eluting Balloons and Single Antiplatlelet Therapy Safe for Patients at High Risk for Bleeding Who Undergo Percutaneous Coronary Intervention?

The safety and efficacy of drug-coated balloons (DCB) has been established for the treatment of in-stent restenosis of conventional bare-metal stents (BMS) and drug-eluting stents (DES). Furthermore, these devices are also used to treat de novo coronary lesions, as demonstrated in the BASKET-SMALL 2—where DCBs were non-inferior to stents—and the DEBUT RCT trials—, where DCBs

Diabetes y enfermedad vascular periférica: viejas drogas con nueva evidencia

Is it Possible to Reduce DAPT Time in Diabetic Patients?

Short-duration dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) with DES is growing steadily, especially for chronic coronary syndromes. There is also some evidence regarding its use in acute coronary syndrome. However, diabetes is a well-known risk factor for both restenosis and thrombosis, since it involves more complex and longer lesions in vessels that

Can We Use DAPT for 3 Months in Acute Coronary Syndrome?

Current guidelines recommend 12-month dual antiplatelet therapy (DAPT) after DES stenting for acute coronary syndrome (ACS) because of elevated MACE risk.  The development of more modern stents, with thin and ultrathin struts, compared against prior versions, has resulted in more effective devices in terms of stent thrombosis and restenosis.  Prolonged DAPT has been associated with

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

Fentanilo en la angioplatia: ¿Cuál es el precio de un mayor confort en el procedimiento?

Ticagrelor or Prasugrel Post-PCI in Daily Practice Patients

The ISAR-REACT 5 showed a significant reduction in the composite outcome of death, acute myocardial infarction (AMI), or stroke when using prasugrel vs. ticagrelor in patients with acute coronary syndrome (ACS), mainly at the expense of an AMI reduction. While this study changed clinical practice, it has stirred some criticism regarding certain methodological aspects, such

How Do We Manage Antiaggregation in BARC I Bleeding after AMI?

Dual antiplatelet therapy (DAPT) after acute myocardial infarction (AMI) has been shown useful to reduce thrombotic events, but one of its downsides is bleeding, especially in elderly patients. BARC bleeding type I, also called nuisance bleeding (NB), is of low frequency, but its evolution and impact remain unclear, as does its management.  A subanalysis of

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