The international guidelines recommend the use of dual antiplatelet therapy (DAPT) with aspirin plus a P2Y12 inhibitor during 12 months in patients receiving percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS), to prevent events such as MI and stent thrombosis. This was a multicenter, placebo controlled, double blind study to determine whether ticagrelor alone,…
Clopidogrel Monotherapy Beyond 12 months: Long Term Analysis of the STOPDAPT-2
Short dual antiplatelet therapy (DAPT) has shown benefits in patients receiving drug eluting stents (DES), reducing bleeding with no concomitant increase in major adverse cardiovascular events (MACE). Traditionally, the therapeutic window was limited to monotherapy with P2Y12 inhibitors during the first year and there are few data on short DAPT followed by long term monotherapy…
Cilostazol in Diabetic Patients with Endovascular Peripheral Revascularization: One Step Beyond Symptom Improvement
In patients with peripheral vascular disease (PVD), the presence of diabetes has been significantly associated with increased failure of critical lower limb ischemia (CLI) treatment, and higher incidence of amputation. This relationship has been attributed mainly to comorbidities and patient characteristics, concomitant peripheral neuropathy and marked microvascular alteration. Also, a high proportion of these patients…
Optimal Duration of DAPT with Oral Anticoagulation After PCI?: 1 Month vs. 3 Months
While the benefits of dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 inhibitor are recognized, its primary complication is the occurrence of bleeding events, which negatively impact patient morbidity and mortality. Additionally, about 10% of patients undergoing percutaneous coronary intervention (PCI) are on oral anticoagulant therapy, which significantly increases the risk of bleeding when…
AHA 2023 | Use of Apixaban for Stroke Prevention in Subclinical Atrial Fibrillation
Subclinical atrial fibrillation (AF), generally asymptomatic and of short duration, often requires continuous long-term monitoring using pacemakers or defibrillators for its detection. While subclinical AF is linked to an increased risk of stroke, the usefulness of oral anticoagulation as a treatment remains uncertain. In a double-blind randomized trial, one group received apixaban and the other…
TCT 2023 | COMPARE 60/80 HBR TRIAL
This was a randomized study including patients at high risk of bleeding treated with short dual antiplatelet therapy (DAPT). A total 747 patients were recruited, 368 received PCI with the ultrathin Superflex stent with 60 µm struts (SUF), and 364 received the Terumo Tansei with 89 µm struts (SF). Primary end point was NACE at…
TCT 2023 | T-PASS TRIAL, ASA and Ticagrelor in Acute Coronary Syndrome
This is a multicenter randomized study including 2,850 patients with acute coronary syndrome. Patients were randomized to: dual antiplatelet therapy (DAPT) with ASA and ticagrelor during one month (1,426 patients), followed by ticagrelor monotherapy for 12 months, while the other group received DAPT with ASA and ticagrelor during 12 months (1,424 patients). This study was…
Anti-Lipid Therapy in PCI Patients: Monotherapy with Statins or Combination?
According to several studies, in patients with high-risk atherosclerotic disease, such as those affected by coronary artery disease, achieving target LDL levels through high-intensity statin therapy has been shown to lead to a significant reduction in long-term cardiovascular events. Therefore, the management of dyslipidemia has become a fundamental pillar of secondary prevention. However, reaching such…
ESC 2023 | Extended Monotherapy with Clopidogrel vs. DAPT in High-Risk Patients
An increasing number of patients currently present both an elevated ischemic risk and hemorrhagic risk. This means that the selection of the optimal antiplatelet treatment is a clinical challenge. Several studies have shown that P2Y12 monotherapy after minimum dual antiplatelet therapy (DAPT) is a novel strategy to reduce bleeding risk without increasing ischemic risk. Furthermore,…
ESC 2023 | STOPDAPT-3
Short Dual antiplatelet therapy (DAPT), one to three months, followed by P2Y12 inhibitor monotherapy has been shown to reduce bleeding events without increased cardiovascular events vs. standard DAPT, according to guidelines. However, the rate of major bleeding within the first month after procedure remains significant when using these strategies. The use of aspirin-free therapies (ASA)…
SOLACI-SBHCI 2023 | Patient-centered Selection Anti-platelet Treatment for ACS-PCI Patients: Real World Evidence of Prasugrel – Dr. Roxana Mehran
Read the most outstanding articles from SOLACI-SBHCI 2023 Congress. In this case, check the presentation by Dr. Roxana Mehran, entitled “Patient-centered Selection Anti-platelet Treatment for ACS-PCI Patients: Real World Evidence of Prasugrel”.