Against what common sense dictates, continuing oral anticoagulation pre- and post- transcatheter aortic valve replacement (TAVR) is safe, according to this article soon to be published in JACC Interventions. There was no increase in hemorrhagic or vascular complications and, paradoxically, those who continued using anticoagulant agents received fewer transfusions that those who did not. A…
More Evidence for Short Term DAPT: Approaching “the Class Effect”
Patients at high risk of bleeding undergoing coronary angioplasty with Orsiro stent can be considered for a short dual antiplatelet scheme. These data come from the SMART-CHOICE study recently published in JAHA, adding the Orsiro stent to the list of devices supporting 3-month DAPT. This study included 2993 patients undergoing coronary angioplasty randomized to 3…
Diabetes and Peripheral Vascular Disease: Old Drugs, New Evidence
This paper, recently published in JAHA, showed that patients with type 2 diabetes mellitus exhibiting lower-limb vascular disease benefit from combining cilostazol and clopidogrel. Treatment for at least 6 months with clopidogrel (75 mg/QD) plus cilostazol (100 mg/BID) significantly reduces ischemic events—including stroke, infarction, and death from vascular causes—compared with clopidogrel monotherapy. Adding cilostazol reduces ischemic events, but that…
Watch again our Webinar on Short Dual Therapy in Patients with High Bleeding Risk
Watch again our Webinar on “Short Dual Therapy in Patients with High Bleeding Risk” on our Youtube account. The event was held on 12/08/2020 and had the participation of more than 200 people and the support of ABBOTT. What things will I learn if I watch this video? 04:02 | Innovation: Short Dual Therapy in…
AHA 2020 | Clopidogrel Resists as the Best Option in Elective Patients
High risk patients undergoing elective PCI treated with a more potent antiplatelet scheme (ticagrelor) vs. the classic clopidogrel do not see a benefit in protection against periprocedural events and instead see increased costs and minor bleeding rate. These are the outcomes of the ALPHEUS study presented at AHA 2020 simultaneously published in the Lancet. Ticagrelor…
Antiplatelet Therapy in Elderly Population: Are the New P2Y12 Inhibitors Safe?
Should elderly patients stick to clopidogrel? The first large study on prasugrel showed an unacceptable increase of bleeding in elderly patients, suggesting the use of 5 mg (although the sample size was small, which hindered the determination of dose efficacy). Later, ticagrelor showed better efficacy than clopidogrel without apparent safety concerns. However, specific evidence on elderly…
Ticagrelor or Prasugrel in ST Elevation MI
In patients undergoing ST elevation acute myocardial infarction (STEMI) receiving primary PCI, no significative differences between prasugrel and ticagrelor were found. However, the latter was associated to a significantly higher number of repeat MI when considered separately. Few studies have compared the efficacy and safety of the two most potent oral P2Y12 receptor inhibitors in…
Angioplasty in Aspirin-Free Stable Patients with Prasugrel: Innovation Continues
Potent P2Y12 receptor inhibitors, such as prasugrel and ticagrelor, have been tested mainly in a setting of acute coronary syndromes. There is little evidence on stable patients, particularly for prasugrel. Designing a study with that purpose seemed challenging enough, but adding aspirin discontinuation in patients without a particularly high bleeding risk took this research to…
Is Loading NSTEMI with DAPT Convenient?
Pretreating non-ST elevation acute myocardial infarction (NSTEMI) patients with P2Y12 receptor inhibitors is not associated with improved clinical outcomes as it is to increased bleeding. NSTEMI patients are often treated with platelet antiaggregants in the daily clinical practice despite the lack of evidence for its benefits. This Swedish registry prospectively included 64857 patients undergoing NSTEMI…
TCT 2020 | Ticagrelor Monotherapy After ST-Segment Elevation Infarction
Ticagrelor monotherapy after 3 months of dual antiplatelet therapy in patients who experienced ST-segment elevation infarction significantly reduces major bleeding without increasing ischemic risk. This pre-specified analysis of the TICO study shows that ticagrelor monotherapy is safe even in patients with higher ischemic risk. Interrupting aspirin use after 3 months of dual antiplatelet therapy and continuing treatment…
TCT 2020 | Xience in Favor of Short Dual Antiaggregation Therapy with High Bleeding Risk
Following with aspirin alone after a short period of dual antiaggregation therapy (DAPT), 1 to 3 months, did not increase ischemic events in patients receiving a Xience stent while significantly reducing bleeding. This study endorses the safety of short DAPT with contemporary drug eluting stents (DES) in patients presenting high bleeding risk. The XIENCE Short…