Cangrelor is an intravenous P2Y12 inhibitor approved to reduce peri-procedural ischemic events in patients undergoing PCI that have not previously received any other P2Y12 inhibitor. The CHAMPION PHOENIX trial randomized a total of 11,145 patients to cangrelor vs. clopidogrel. The study sought to explore the effect of cangrelor on peri-procedural acute myocardial infarction…
Optimal Duration of DAPT: How to Predict Long-Term Events
Courtesy of Dr. Santiago F. Coroleu. Dual antiplatelet therapy (DAPT) with aspirin and clopidogrel after percutaneous coronary intervention (PCI) reduces the risk for coronary thrombotic events (CTEs) at the expense of increasing risk for major bleeding (MB). However, the lack of information to accurately predict the occurrence of each event in out-of-hospital patients under…
Ticagrelor Reduces Events in Diabetics with Prior MI
All studies on diabetics have shown these patients have higher risk rates of thrombotic events. This study sought to determine the optimal antiaggregation therapy with ticagrelor to prevent thrombotic events in diabetic patients with prior MI. The study analyzed diabetic patient and non-diabetic patient subgroups (n=6806 and n=14355, respectively) from the PEGASUS–TIMI 54…
DAPT after PCI with EES: 6 or 12 Months?
Original Title: 6-Month versus 12-Month Dual-Antiplatelet Therapy Following Long Everolimus-Eluting Stent Implantation. The IVUS-XPL Randomized Clinical Trial. Reference: Hong et al. JACC Cardiovasc Interv. 2016 May 11. [Epub ahead of print] Courtesy of Dr. Brian Nazareth Donato. This publication stems from the IVUS-XPL published by JAMA in November 2015. This study presents outcomes on the…
Does Ticagrelor Reduce Events in Peripheral Artery Disease?
Original Title: Ticagrelor for Prevention of Ischemic Events after Myocardial Infarction in Patients with Peripheral Artery Disease. Reference: Marc P. Bonaca et al. J Am Coll Cardiol. 2016 Jun 14;67(23):2719-28. Peripheral artery disease is associated with high rates of ischemic and bleeding events in patients with prior myocardial infarction. This study evaluates the safety…
STEMI: Best P2Y12 inhibitor according to network meta-analysis
Original Title: Optimal P2Y12 inhibitor in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention: a network meta-analysis. Reference: Rafique AM et al. J Am Coll Cardiol Intv 2016;9:1036–46. Courtesy of Dr. Alejandro Lakowsky. Researchers drew up a network meta-analysis incorporating 37 trials with more than 88,000 patients undergoing ST elevation…
Effects of switching from prasugrel to ticagrelor in patients with ACS
Original Title: Pharmacodynamic Effects of Switching from Prasugrel to Ticagrelor Results of the Prospective, Randomized SWAP-3 Study Reference: J Am Coll Cardiol Intv. 2016;() Epub ahead of print. Courtesy of Dr. Agustín Vecchia. At present, the pharmacodynamic effects of switching from prasugrel to ticagrelor in patients under dual APT remain unknown. The present prospective, randomized,…
Optimal Duration of Dual Antiplatelet Therapy: New ACC-AHA Guidelines
Original Title: 2016 ACC/AHA Guideline Focused Update on Duration of Dual Antiplatelet Therapy in Patients with Coronary Artery Disease. Reference: Levine GN et al. Circulation. 2016 Mar 29. [Epub ahead of print]. Courtesy of Dr. Alejandro Lakowsky. The new ACC-AHAGuidelines on the optimal duration of dual antiplatelet therapy(DAPT) in patients with coronary artery disease have just been…
Ticagrelor vs Clopidogrel in low risk coronary syndrome
Original Title: Effects of Ticagrelor versus Clopidogrel in Troponin-Negative Patients With Low-Risk ACS Undergoing Ad Hoc PCI. Reference: Dominick J et al. J Am Coll Cardiol. 2016;67(6):603-613. Many patients admitted with low-risk acute coronary syndrome (ACS) are not pre-treated with a P2Y12 receptor inhibitors despite the invasive strategy in place, with angiography and PCI in the…
Different Thienopyridine Loading Strategies to Get the Fastest Effect
Original Title: Randomized Comparison of Different Thienopyridine Loading Strategies in Patients Undergoing Elective Coronary Intervention. The Excelsior LOAD Trial. Reference: Willibald Hochholzer et al. J Am Coll Cardiol Intv. 2016, online before print. This study assesses how to provide a more rapid antiaggregant effect. It compares the effect of a prasugrel load vs. a 600…
Aspirin or Clopidogrel as Monotherapy after 12 month DAPT
Original Title: Clopidogrel versus Aspirin as an Antiplatelet Monotherapy after 12-Month Dual-Antiplatelet Therapy in the Era of Drug-Eluting Stents. Reference: Taek Kyu Park et al. Circ Cardiovasc Interv. 2016 Jan;9(1):e002816. Courtesy of Dr. José Amadeo Guillermo Álvarez. The use of dual antiplatelet therapy (DAPT) over 12 months after hospitalization for acute myocardial infarction (AMI) or drug…