Antiplatelet articles


Ticagrelor or Prasugrel for Acute Patients Who Undergo Angioplasty

Ticagrelor or Prasugrel for Acute Patients Who Undergo Angioplasty

We are still asking the same question: ticagrelor or prasugrel? With narrow margins between these drugs in terms of efficacy and bleeding, it is difficult to decide which to prescribe. While it has certain methodological limitations, this research published in JAMA seems to clarify the picture at least for patients with acute coronary syndromes who

Sangrados mayores en pacientes con AAS más rivaroxabán

AAS vs DAPT post TAVI: Meta-Analysis of Randomized Studies

Aspirin monotherapy (ASA) reduced the combined risk of thrombotic and bleeding events compared against dual antiplatelet therapy (DAPT) in patients receiving transcatheter aortic valve replacement (TAVR). This meta-analysis has only reproduced smaller randomize study outcomes and does not include the OCEAN-TAVI registry, the only one that has shown something different so far.  Even though ASA

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DAPT vs. Monotherapy: The Dilemma Remains After Surgery

Patients who undergo myocardial revascularization surgery and are discharged on dual antiplatelet therapy (DAPT)—aspirin plus clopidogrel—have a lower risk of major cardiovascular and cerebral events than patients on aspirin monotherapy. Furthermore, the risk of bleeding is not increased for those receiving DAPT. This information comes from a registry of over 18,000 patients recently published in the

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

Post TAVR Aspirin vs. Clopidogrel: Conflicting Findings and Guidelines

One month ago we shared a meta-analysis stating aspirin (ASA) as the best antiplatelet following TAVR vs. 3 to 6 dual antiplatelet therapy suggested by guidelines.  At that time, guideline recommendations appeared obsolete. Several studies had started to support ASA monotherapy as the best antiaggregation scheme after TAVR. However, in the light of this new

EuroPCR 2021 | CELEBRATE-02: Nuevo inhibidor de la glicoproteína IIb IIIa para infartos con ST

EuroPCR 2021 | CELEBRATE-02: Novel Glycoprotein IIb/IIIa Inhibitor for ST-Segment Elevation Infarction

Promising fast subcutaneous administration and a quick and potent antiplatelet effect, here comes a novel glycoprotein IIb/IIa inhibitor called RUC-4. This novel drug was tested in the CELEBRATE-02 study, presented at EuroPCR 2021 and simultaneously published in EuroIntervention. The mean platelet inhibition begins 15 minutes after injection and increases with each of the three tested doses

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

ACC 2021 | HOST-EXAM: Clopidogrel vs AAS como monoterapia post DAPT en las angioplastias

ACC 2021 | HOST-EXAM: Clopidogrel vs ASA monotherapy post DAPT in PCI patients

Clopidogrel monotherapy after dual antiplatelet therapy (DAPT) was associated with reduced mortality, MI, stroke, and other events in patients receiving PCI compared against aspirin monotherapy (ASA). This information was provided by the Korean HOST-EXAM study, presented at ACC 2021 scientific sessions, and simultaneously published in the Lancet. Researchers followed patients for 2 years and observed

ACC 2021 | ADAPTABLE: Bajas dosis de aspirina son iguales de efectivas y con muy bajo riesgo de sangrado

ACC 2021 | ADAPTABLE: Low Doses of Aspirin Are Equally Effective and Present Lower Bleeding Risk

Patients diagnosed with cardiovascular disease taking aspirin as secondary prevention can take lower doses and achieve the same efficacy level as those taking 325 mg. According to the ADAPTABLE study, presented at the American College of Cardiology (ACC) 2021 Congress and simultaneously published in the New England Journal of Medicine (NEJM), both schemes were associated with

ACC 2021 | TALOS-AMI: desescalar luego de 1 mes de ticagrelor a clopidogrel

ACC 2021 | TALOS-AMI: De-escalating from Ticagrelor to Clopidogrel after One Month

After one-month dual antiplatelet therapy (DAPT) with aspirin and ticagrelor, a net clinical benefit was observed when de-escalating to clopidogrel in acute myocardial infarction (AMI) patients treated with PCI.  We have discussed the pros and cons of de-escalating from a potent antiplatelets Such as ticagrelor to clopidogrel since the TOPIC presented at EuroPCR in 2017. What

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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

Tasa de stroke post cirugía vs angioplastia coronaria en un análisis de más de 10.000 pacientes

How to Discontinue Antiplatelet Therapy Prior Non-Cardiac Surgery

Both the indication and discontinuation of antiplatelet therapy to balance ischemic-bleeding risks has been left to physician criterion.  However, leaving the decision to one single specialist might not be the best. This is when the team’s role becomes essential.  This study looked at the advantages consensus decision-making amongst clinicians, surgeons and anesthesiologists to continue or