Pharmacology articles

Seguridad de combinar los nuevos anticoagulantes y la doble antiagregación

Is Loading NSTEMI with DAPT Convenient?

Is Loading NSTEMI with DAPT Convenient?

Pretreating non-ST elevation acute myocardial infarction (NSTEMI) patients with P2Y12 receptor inhibitors is not associated with improved clinical outcomes as it is to increased bleeding. NSTEMI patients are often treated with platelet antiaggregants in the daily clinical practice despite the lack of evidence for its benefits. This Swedish registry prospectively included 64857 patients undergoing NSTEMI

TCT 2020 | Ticagrelor Monotherapy After ST-Segment Elevation Infarction

Ticagrelor monotherapy after 3 months of dual antiplatelet therapy in patients who experienced ST-segment elevation infarction significantly reduces major bleeding without increasing ischemic risk. This pre-specified analysis of the TICO study shows that ticagrelor monotherapy is safe even in patients with higher ischemic risk. Interrupting aspirin use after 3 months of dual antiplatelet therapy and continuing treatment

TCT 2020 | Xience se suma a la evidencia de doble antiagregación corta en alto riesgo de sangrado

TCT 2020 | Xience in Favor of Short Dual Antiaggregation Therapy with High Bleeding Risk

Following with aspirin alone after a short period of dual antiaggregation therapy (DAPT), 1 to 3 months, did not increase ischemic events in patients receiving a Xience stent while significantly reducing bleeding.  This study endorses the safety of short DAPT with contemporary drug eluting stents (DES) in patients presenting high bleeding risk.  The XIENCE Short

TCT 2020 | Administrar el comprimido de prasugrel molido previo a la angioplastia

TCT 2020 | Crushed Prasugrel Administration prior PCI

Prehospital administration of crushed tablets of prasugrel loading dose in the ambulance while patient is on his way to primary PCI does not improve reperfusion markers compared against uncrushed tablet administration according to the COMPARE CRUSH, presented at the virtual TCT 2020 and simultaneously published in Circulation. There were no differences in TIMI flow of

Doctor con tabletas de aspirinas

How To De-Escalate Prasugrel After Acute Coronary Syndrome?

Patients who undergo coronary angioplasty after acute coronary syndrome could de-escalate dual antiplatelet therapy with prasugrel to maintain the protection against ischemic events while lowering their hemorrhagic risk. The HOST-REDUCE-POLYTECH-ACS study (recently published in The Lancet) included 2338 patients who underwent coronary angioplasty in a setting of acute coronary syndrome. Patients were randomized to a year-long

FFR en diabéticos

Diabetes Could Decide between Ticagrelor and Prasugrel

Diabetes has an impact on the relative effect of ticagrelor and prasugrel in patients undergoing acute coronary syndrome (ACS) according to a recent analysis of the ISAR-REACT 5 published in JACC Intv. Similarly to the main study outcomes, this sub-analysis of the ISAR-REACT 5 has shown that the combined end point of death, MI or

Post TAVR ASA Monotherapy Consolidates

This meta-analysis to be published in J Am Cardiol supports the use of aspirin monotherapy (ASA) after transcatheter aortic valve replacement (TAVR). The use of aspirin alone is associated to less bleeding without increased ischemic events such as strokes or mortality.  The combined outcomes of four studies, including the recently published POPular TAVI (cohort A),

What Is the Healthiest Diet?

This review published in JACC focuses on the foods we shood consume rather than the foods we should avoid eating (the latter being the most common focus).  In this regard, the Mediterranean diet, with fish as protein source, should be the gold standard, the ultimate goal being to extend life expectancy. Promoting cardiovascular health based

THEMIS: eventos isquémicos y hemorrágicos en difícil equilibrio para el ticagrelor crónico

Ticagrelor to Improve Venous Graft Patency

Saphenous vein graft patency is one of CABG’s “Achilles heals”, especially after the ARTS trial came out showing bilateral internal mammary artery grafting was not superior to simple internal mammary artery grafting.  Antiaggregation more potent than aspirin might prolong venous graft patency in cases when the available techniques will fail to improve poor outcomes.    Previous

Seguridad de combinar los nuevos anticoagulantes y la doble antiagregación

Evidence or Theory? Antiaggregation Scheme after Peripheral Vascular Intervention

Antiaggregation indication after peripheral intervention (PVI) can vary up to 50% depending on center, operator, and procedure.  This highlights the huge variation in indication and the scarce evidence there is on this matter.  Most cardiologists would like to simply transfer the information from the coronaries to the superficial femoral, but we can confirm this does

ESC 2020 | Ticagrelor Might Increase Bleeding and Mortality in the Elderly

Ticagrelor compared against clopidogrel produces more bleeding and also more deaths in patients over 80 recently undergoing acute myocardial infarction. Contrary to what has been observed in the general population, these data from the SWEDEHEART registry of post MI patients over 80, show higher bleeding and mortality rates with ticagrelor compared against clopidogrel. These findings

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