Original Title: Bivalirudin Is Associated with Improved In-Hospital Outcomes Compared with Heparin in Percutaneous Vascular Intervention. Observational, Propensity –Matched Analysis From the Premier Hospital Database. Reference: Carey Kimmeslstiel, et al. Circ Cardiovasc Interv. 2016 Jan;9(1). Courtesy of Dr. Carlos Fava Lower limb vascular interventions are increasing in number and bleeding is one of its most…
Cost-Effectiveness of Left Atrial Appendage Closure and the New Anticoagulants vs. Warfarin in Atrial Fibrillation
Original Title: Time to Cost-Effectiveness Following Stroke Reduction Strategies in AF Warfarin vs. NOACs vs. LAA Closure. Reference: Vivek Y. Reddy et al. J Am Coll Cardiol. 2015;66(24):2728-2739. Left atrial appendage closure and the new anticoagulants (NOACs) have emerged as safe and effective alternatives to warfarin for stroke in patients with non-valvular atrial fibrillation. This analysis…
Risks and benefits of extending dual antiplatelet therapy in patients with and without MI
Original title: Benefits and Risks of Extended Duration Dual Antiplatelet Therapy after PCI in Patients With and Without Acute Myocardial Infarction. The DAPT Study. Reference: Robert W. Yeh et al. J Am Coll Cardiol. 2015, online before print. The risks and benefits of prolonged antiplatelet therapy after PCI could be different in patients presenting with AMI compared to…
Duration of double antiaggregation therapy in patients with oral anticoagulation
Original title: Duration of Triple Therapy in Patients Requiring Oral Anticoagulation After Drug-Eluting Stent ImplantationThe ISAR-TRIPLE Trial. Reference: Katrin A. Fiedler et al. J Am Coll Cardiol. 2015;65(16):1619-1629. Patients with oral anticoagulation indication after drug eluting stenting require aspirin and clopidogrel; however, the triple scheme has high bleeding risk and optimal duration is yet to be determined. The…
Long term ticagrelor after an acute myocardial infarction
Original title: Long-Term Use of Ticagrelor in Patients with Prior Myocardial Infarction. PEGASUS-TIMI 54. Referencia: Marc P. Bonaca et al. N Engl J Med. 2015 Mar 14. Patients with acute myocardial infarction (AMI) have an increased risk of recurrent events suggesting that this population could benefit from intensive secondary prevention. Current guidelines recommend adding to aspirin an…
Double Anti platelet aggregation would be sufficient for six months after angioplasty in patients with stable coronary disease NSTSEACS.
Original title: 6- Versus 24-Month Dual Antiplatelet Therapy After Implantation of Drug. Reference: Eluting Stents in Patients Nonresistant to Aspirin The Randomized, Multicenter ITALIC Trial. JACC.VOL. 65, NO. 8, 2015 Current recommendations on dual antiplatelet therapy (DAPT) are under review, particularly in acute coronary events due largely to the advent of second-generation stents. This work studied the hypothesis…
Zotarolimus eluting stent with one month of dual antiplatelet therapy
Original title: Zotarolimus-Eluting Versus Bare-Metal Stents in Uncertain Drug-Eluting Stent Candidates. Reference: Marco Valgimigli et al. J Am Coll Cardiol. 2015;65(8):805-815. The use of drug eluting stents (DES) in patients at high risk of bleeding or thrombosis has not been studied prospectively. Data on patients at high risk of bleeding and low restenosis are limited. This study compared…
Pretreatment with clopidogrel only for ST elevation AMI patients
Original title: Prognostic impact of clopidogrel pretreatment in patients with acute coronary syndrome managed invasively. Reference: Almendro-Delia M et al. Am J Cardiol. 2015; Epub ahead of print. This study analyzed the ARIAM data including 9621 AMI patients diagnosed with coronary angiography receiving clopidogrel in 49 center between 2002 and 2012. Most patients had STEMI (63%), and most…
Never ending controversy over the duration of post DES dual antiplatelet therapy
Original title: Second Generation Drug-Eluting Stents Implantation Followed by Six Versus Twelve-Month – Dual Antiplatelet Therapy- The SECURITY Randomized Clinical Trial. Reference: Antonio Colombo et al. J Am CollCardiol. 2014 Nov 18;64(20):2086-97. The optimal duration of dual antiplatelet therapy after second-generation DES implantation is still debated and apparently will remain controversial for some time. The aim of this…
Risks and benefits of Dual Antiplatelet beyond the year of a drug-eluting stent
Original title: Twelve or 30 Months of Dual Antiplatelet Therapy after Drug-Eluting Stents. Reference: Laura Mauri et al. N Engl J Med 2014;371:2155-66. Dual antiplatelet therapy is recommended after a drug-eluting stent to prevent thrombotic complications. The clinical benefit of this scheme it is not clear beyond one year. Patients were registered to receive a…
Thienopyridine Pretreatment in Non ST Elevation ACS syndrome
Original title: Reappraisal of thienopyridine pretreatment in patients with non-ST elevation acute coronary syndrome: a systematic review and meta-analysis. Reference: Bellemain-Appaix A. et al. BMJ. 2014;Epub ahead of print. This meta-analysis included 7 studies that included a total 32383 patients admitted with non ST elevation ACS; 17545 (54.5%) underwent PCI. These studies were published between 2001 and 2013:…