Read the most outstanding articles from SOLACI-SBHCI 2023 Congress. In this case, check the presentation by Dr. Marco Valgimigli, entitled “Is very short DAPT safe in HBR patients undergoing complex PCI”
Secondary Prevention with P2Y12 Inhibitors: How Consolidated Is This Long Term Alternative vs. Aspirin?
Secondary prevention with P2Y12 inhibitors vs aspirin monotherapy in CAD patients Antiaggregation therapy plays a central role at long term to prevent new cardiovascular events in atherosclerosis patients. After repeat myocardial infarction (MI) or stroke, prognosis can vary considerably. Even though the current guidelines prefer aspirin as the first choice for secondary prevention over P2Y12…
Abbreviated Therapy in Patients with Acute Coronary Syndrome: How Safe Is Conservative DAPT Treatment?
Abbreviated dual antiplatelet therapy in patients at high risk for bleeding and acute myocardial infarction. Patients with acute coronary syndrome (ACS) who undergo stent placement (percutaneous coronary intervention, PCI) conventionally require at least 12 months of dual antiplatelet therapy (DAPT) to reduce ischemic events. Patients with ACS who are also at high risk for bleeding…
Abbreviated Antiaggregant Treatment in High Bleeding Risk Patients from the MASTER-DAPT (15-Month Followup)
Benefits of abbreviated antiaggregant treatment in high bleeding risk patients. Dual antiplatelet therapy (DAPT), established by different guidelines, reduces the risk of ischemic events at the expense of increased bleeding. This habitual APT strategy cannot be applied to patients at high risk of bleeding, which is why this populations are treated with shorter DAPT schemes…
Rivaroxaban in Acute Coronary Syndrome
Acute coronary syndromes (ACS) involve high mortality risk, especially ST elevation ACS. Their treatment is based on reperfusion, dual antiplatelet therapy (DAPT) and anticoagulation, with enoxaparin (1 mg/kg twice a day) as the preferred anticoagulant according to the contemporary guidelines. 2.5 mg or 5 mg doses of rivaroxaban might be valid alternative treatments for this…
Monotherapy with P2Y12 in Complex Interventions: Less and Less Risky
Monotherapy in patients with complex angioplasty: meta-analysis of 5 randomized studies. Even though prolonged dual antiplatelet therapy (DAPT) might reduce the risk of important ischemic complications, this reduction will come at the expense of a significant increase of bleeding risk, which makes us reassess the cost benefit ratio of this decision. This is also why…
Is Using Drug-Eluting Balloons and Single Antiplatlelet Therapy Safe for Patients at High Risk for Bleeding Who Undergo Percutaneous Coronary Intervention?
The safety and efficacy of drug-coated balloons (DCB) has been established for the treatment of in-stent restenosis of conventional bare-metal stents (BMS) and drug-eluting stents (DES). Furthermore, these devices are also used to treat de novo coronary lesions, as demonstrated in the BASKET-SMALL 2—where DCBs were non-inferior to stents—and the DEBUT RCT trials—, where DCBs…
Is it Possible to Reduce DAPT Time in Diabetic Patients?
Short-duration dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) with DES is growing steadily, especially for chronic coronary syndromes. There is also some evidence regarding its use in acute coronary syndrome. However, diabetes is a well-known risk factor for both restenosis and thrombosis, since it involves more complex and longer lesions in vessels that…
Can We Use DAPT for 3 Months in Acute Coronary Syndrome?
Current guidelines recommend 12-month dual antiplatelet therapy (DAPT) after DES stenting for acute coronary syndrome (ACS) because of elevated MACE risk. The development of more modern stents, with thin and ultrathin struts, compared against prior versions, has resulted in more effective devices in terms of stent thrombosis and restenosis. Prolonged DAPT has been associated with…
Ticagrelor or Prasugrel Post-PCI in Daily Practice Patients
The ISAR-REACT 5 showed a significant reduction in the composite outcome of death, acute myocardial infarction (AMI), or stroke when using prasugrel vs. ticagrelor in patients with acute coronary syndrome (ACS), mainly at the expense of an AMI reduction. While this study changed clinical practice, it has stirred some criticism regarding certain methodological aspects, such…
How Do We Manage Antiaggregation in BARC I Bleeding after AMI?
Dual antiplatelet therapy (DAPT) after acute myocardial infarction (AMI) has been shown useful to reduce thrombotic events, but one of its downsides is bleeding, especially in elderly patients. BARC bleeding type I, also called nuisance bleeding (NB), is of low frequency, but its evolution and impact remain unclear, as does its management. A subanalysis of…