Timely percutaneous intervention of STEMI patients effectively reduces MI size and mortality, which currently makes it the first line of treatment. A fundamental aspect is activation and platelet aggregation, which is why, in addition to creating networks to optimize STEMI treatment, prehospital drug treatments have been implemented. The COMPARECrush looked at whether early and powerful…
Antiplatelet Treatment with Ticagrelor vs. Clopidogrel in Patients with Chronic Coronary Syndrome
Achieving rapid and maximum inhibition of platelet aggregation can reduce complications related to scheduled percutaneous coronary intervention (PCI) in chronic coronary syndromes (CCS). Over the last few decades, the optimal timing for initiating P2Y12 inhibitors and their appropriate dosage have been the subject of numerous studies; however, they have not been clearly established yet. Higher…
Single Antiplatelet Therapy Following Percutaneous Left Atrial Appendage Occlusion
Percutaneous left atrial appendage occlusion (LAAO) has surged as an effective alternative to treat patients with atrial fibrillation (AF) presenting counterindications for oral anticoagulants. However, the optimal antithrombotic treatment after LAAO is still debated, seeing as it should prevent device related thrombosis (DRT) while minimizing bleeding risk. The aim of this retrospective study carried out…
ACC 2024 | ULTIMATE-DAPT Trial
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…