Antiplatelet articles

FFR en diabéticos

Diabetes Could Decide between Ticagrelor and Prasugrel

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),

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

ESC 2020 | Against the Grain, ASA Monotherapy Appears Superior after TAVR

After TAVR, patients with no anticoagulation indication are favored by monotherapy with aspirin (ASA) vs. dual antiaggregation therapy (DAPT).  This study presented at ESC 2020, simultaneously published in NEJM, seems to go against the latest “fashion” (P2Y12 inhibitor monotherapy) and randomized patients to ASA monotherapy vs. DAPT with clopidogrel for 3 months. Unlike with the

Can Aspirin Use Be Interrupted After Angioplasty?

Aspirin discontinuation 1 to 3 months after angioplasty with continued P2Y12 inhibitor therapy reduces the bleeding risk without an increase in thrombotic events. This is also the case for patients admitted with acute coronary syndrome. Dual antiplatelet therapy with aspirin and a P2Y12 inhibitor has been shown to reduce the risk of major events compared with

EuroPCR 2020 | FABOLUS FASTER: buscando la inhibición plaquetaria más potente y rápida

EuroPCR 2020 | FABOLUS FASTER: In the Quest for the Fastest, Most Potent Platelet Inhibition

This small study tested the pharmacodynamic effects of several antiplatelet agents. It concluded that tirofiban (Aggrastat) provides “more potent and consistent” inhibition of platelet aggregation compared with cangrelor in patients with ST-segment elevation myocardial infarction undergoing primary angioplasty. Thirty minutes after the initiation of treatment, there was a nearly threefold difference between tirofiban and cangrelor

La FDA aprueba el ticagrelor en pacientes de alto riesgo como prevención primaria

The FDA Approves Ticagrelor for Primary Prevention in High Risk Patients

The FDA has approved the indication of ticagrelor as primary prevention in high risk CAD patients with no history of MI or stroke.  The lab producing ticagrelor has informed the FDA has based this decision on the THEMIS study, which included nearly 20,000 patients with stable CAD and type 2 diabetes. This decision has come

doble antiagregacion plaquetaria sexo

Optimal Intervention Timing for NSTEMI with No Antiaggregant Pre-Treatment

Patients undergoing non-ST elevation MI (NSTEMI) who are not pre-treated with P2Y12 receptor inhibitors will benefit from a very early intervention strategy.  The optimal intervention timing for NSTEMI patients is still under debate, despite multiple studies, but the ideal timing had never been tested in patients with no platelet aggregation inhibitor pretreatment.  After the surge of

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

Antiaggregation vs. Anticoagulation after Peripheral PCI

The truth is this question has no clear answer and what with do with peripheral stenting is transfer the evidence we have on coronary stenting, given the lack of standards and poor reporting on antithrombotic therapy outcomes in randomized studies on endovascular intervention.  Heterogeneity is worse when it comes to venous territory. Some time ago