Original Title: Outcomes of Patients with Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention Receiving an Oral Anticoagulant and Dual Antiplatelet Therapy, a Comparison of Clopidogrel vs. Prasugrel from the TRANSLATE-ACS Study. Reference: Jackson L.R. et al. JACC Cardiovasc Interv. 2015 Dec 21;8(14):1880-9. Courtesy of Dr Agustín Vecchia. In these last years, new and more powerful antiaggregants have…
Different Options for Aspirin Hypersensitivity in PCI
Original Title: Efficacy and Safety of Available Protocols for Aspirin Hypersensitivity for Patients Undergoing Percutaneous Coronary Intervention. A Survey and Systematic Review. Reference: Bianco M et al. Circ Cardiovasc Interv. 2016 Jan;9(1):e002896. The follow up strategy for aspirin hypersensitive patients undergoing PCI remains unclear. A systematic search included 283 patients from 11 studies. Primary end point…
Dual Antiplatelet Therapy after Everolimus Eluting Stenting
Original Title: Benefits and Risks of Extended Dual Antiplatelet Therapy after Everolimus-Eluting Stents. For the Dual Antiplatelet Therapy (DAPT) Study Investigators. Reference: James B. Hermiller et al. JACC: Cardiovascular Interventions 2015, online before print. The DAPT study had shown that continued aspirin plus thienopyridine beyond a year reduces ischemic events. Given the fairly low rate of thrombosis…
ADAPT-DES: Proton Pump Inhibitors and Clopidogrel in Patients with DES
Original Title: Proton Pump Inhibitors, Platelet Reactivity, and Cardiovascular Outcomes After Drug-Eluting Stents in Clopidogrel-Treated Patients. The ADAPT-DES Study. Some proton pump inhibitors interfere with clopidogrel metabolism and could attenuate P2Y12 reception. Prior observational and randomized studies have reported contradicting results on the clinical significance of this drug interaction. The aim of this trial was…
Prasugrel in the Treatment of Clopidogrel Nonresponders Undergoing PCI
Original Title: Prasugrel in Clopidogrel Nonresponders Undergoing Percutaneous Coronary Intervention (RECLOSE-3 study). Reference: Valenti R, et al. JACC Cardiovasc Interv. 2015 Oct;8(12):1563-70. Clopidogrel Nonresponders have higher risk of adverse events (cardiovascular death and stent thrombosis) compared to responders. Studies published so far have failed to demonstrate the use of platelet function tests in ACS patient…
DAPT Substudy: Score to Personalize Optimal Dual Antiaggregation Therapy Duration
Original Title: Individualizing Treatment Duration of Dual Antiplatelet Therapy after Percutaneous Coronary Intervention: An Analysis from the DAPT Study. Presenter: Yeh RW. Optimal dual antiplatelet therapy duration for patients receiving stents has started to become clearer, but a new scoring method (DAPT Score) may help single out patients who could either benefit or suffer from extended…
PEGASUS-TIMI 54 Subanalysis: Discontinuation of Ticagrelor Mostly Due to Dyspnea or Bleeding
Original Title: Long-term tolerability of ticagrelor for secondary prevention: insights from PEGASUS-TIMI 54 trial. Presenter: Bonaca MP. The higher rate of premature discontinuation of ticagrelor vs placebo in the PEGASUS-TIMI 54 of stable outpatients with prior MI is attributed to more frequent dyspnea and bleeding, according to a new study. Among patients who tolerated therapy for…
Net clinical benefit of bivalirudin in STEMI patients
Original title: Bivalirudin Versus Heparin With or Without Glycoprotein IIb/IIIa Inhibitors in Patients With STEMI Undergoing Primary Percutaneous Coronary Intervention: Pooled Patient-Level Analysis From the HORIZONS-AMI and EUROMAX Trials. Reference: Stone GW et al. J Am CollCardiol. 2015 Jan 6;65(1):27-38. The HORIZONS-AMI (Harmonizing Outcomes with RevasculariZatiON and Stents in Acute Myocardial Infarction) that included 3602 STEMI patients undergoing…
Less Bleeding at the Expense of a Higher Risk of Acute Thrombosis with Bivalirudin
Original title: Bivalirudin versus heparin in patients treated with percutaneous coronary Intervention: a meta-analysis of randomised trials. Reference: Salvatore Cassese et al. EuroIntervention 2014;10-online publish-ahead-of-print August 2014. Current recommendations for the use of bivalirudin in PCI patients are mostly based on studies comparing bivalirudin vs. heparin combined with glycoprotein IIb/IIIa inhibitors. Whether bivalirudin is superior to heparin alone…
Increased security with bivalirudin than with heparin alone in patients without ST segment.
Original title: Heparin monotherapy or bivalirudin during percutaneous coronary intervention in patients with non-ST-segment elevation acute coronary syndromes or stable ischemic heart disease: results from the Evaluation of Drug-Eluting Stents and Ischemic Events registry. Reference: Bangalore S et al. CircCardiovascInterv. 2014;Epub ahead of print. Bivalirudin compared to unfractionated heparin as monotherapy is associated with a lower risk of…
Decreased bleeding with radial access leaves little to bivalirudin for additional benefit
Original title: Bivalirudin or heparin in primary angioplasty performed through the transradial approach: results from a multicentre registry. Reference: Sciahbasi A et al. Eur Heart J: Acute Cardiovasc Care. Epub ahead of print. Bivalirudin benefit has been demonstrated in terms of bleeding; however when primary angioplasty is performed by radial access this information is not clear. To get…