Original title: Impact of diabetes mellitus and metabolic syndrome on acute and chronic on-clopidogrel platelet reactivity in patients with stable coronary artery disease undergoing drug-eluting stent placement. Reference: Feldman L. et al. Am Heart J. 2014; Epub ahead of print. Diabetes mellitus type 2 (T2DM) or metabolic syndrome patients undergoing drug eluting stent implantation have 3 to 4…
Resistance to Aspirin Associated to Greater Risk of In-Stent Thrombosis and Death
Original title: Aspirin Treatment and Outcomes After Percutaneous Coronary InterventionResults of the ISAR-ASPI Registry. Reference: Katharina Mayer et al. J Am CollCardiol. 2014;64(9):863-871. Aspirin administration, as part of the double antiagregation scheme, is essential in the context of PCI. The correlation between high platelet reactivity to on-clopidogrel treatment and higher events rates has been well established, while data…
3 to 6 months of dual antiplatelet after DES reduced bleeding and did not raise mortality or infarction.
Original title: Meta-analysis of randomized clinical trials comparing short term -vs- long term dual antiplatelet therapy following drug eluting stents. Reference: El-Hayek G et al. Am J Cardiol. 2014; Epub ahead of print. This meta-analysis examined the data of four randomized and controlled studies (EXCELLENT, PRODIGY, RESET y OPTIMIZE) including 8157 patients receiving sirolimus, paclitaxel, everolimus or zotarolimus…
Higher event rate in those with non-ST elevation ACS who received revascularization at PLATO study. Beyond this, ticagrelor reduced mortality.
Original title: Ticagrelor vs. clopidogrel in patients with non-ST-elevation acute coronary syndrome with or without revascularization: results from the PLATO trial. Reference: Lindholm D et al. Eur Heart J. 2014; Epub ahead of print. The PLATO study randomized 18624 patients with ACS to aspirin and ticagrelor (180 mg loading dose followed by 90 mg every 12 hours) versus…
At least one month of antiplatelet seems sufficient after a zotarolimus -eluting stent
Original title: Lack of association between dual antiplatelet therapy use and stent thrombosis between 1 and 12 months following Resolute zotarolimus-eluting stent implantation. Reference: Silber S, Kirtane AJ, Belardi JA, et al. Eur Heart J. 2014; Epub ahead of print. Dual antiplatelet aggregation optimal time after implantation of a new generation drug-eluting stent (DES) is still discussed. This…
Almost 40 % of those who initially receive clopidogrel then switch to prasugrel or ticagrelor in clinical practice.
Original title: In-hospital switching of oral P2Y12 inhibitor treatment in patients with acute coronary syndrome undergoing percutaneous coronary intervention: Prevalence, predictors and short-term outcome. Reference: Dimitrios Alexopoulos et al. Am Heart J 2014;167:68-76.e2. Given the availability of 3 Oral P2Y12 receptor inhibitors (clopidogrel, prasugrel, and ticagrelor) with different safety and efficacy profiles, the change from one to another…
Stent reestenosis, the only subgroup that benefits from longer double antiaggregation
Original title: Short vs. Long Term Duration of Dual Antiplatelet Therapy in Patients treated for InstentRestenosis. A PRODIGY Trial substudy. Reference: Gianluca Campo el al. J Am CollCardiol, article in press. In the study PRODIGY (Prolonging Dual Antiplatelet Treatment After Grading Stent- Induced Intimal Hyperplasia) we found that the 24 months ratio of dual antiaggregation was not…
Clopidogrel suspension, without rebound in stable patients
Original title: A randomised controlled trial of platelet activity before and after cessation of clopidogrel therapy in patients with stable cardiovascular disease. Reference: Ford I et al. J Am Coll Cardiol. 2013;E-pub ahead of print. Some previous studies have suggested an excess of cardiovascular events after discontinuation of clopidogrel, and this could be due to a rebound…
Looking for the best anti-aggregation scheme after TAVI
Original title: Comparison of Two Antiplatelet Therapy Strategies in Patients Undergoing Transcatheter Aortic Valve Implantation. Reference: Eric Durand et al. Am J Cardiol 2013, et al. Percutaneous aortic valve replacement has been shown to be superior to medical treatment in inoperable patients and not inferior to surgery in high-risk patients. Anti-platelet therapy in these patients is usually…
Infarct size reduction to 30 days could result in clinical benefit at one year
Original title: Intralesional abciximab and thrombus aspiration in patients with large anterior myocardial infarction: One-year results from the INFUSE-AMI trial. Reference: Stone GW et al. Circ Cardiovasc Interv. 2013;Epub ahead of print. The intra-coronary infusion of Abciximab added to thromboaspiration seems to improve outcomes at one year in patients undergoing primary angioplasty for ST-segment elevation with anterior…
Cilostazol reduces restenosis of DES in lesions larger than 40 mm.
Original title: Comparison of Dual Versus Triple Antiplatelet Therapy After Drug-Eluting Stent According to Stent Length (from the Pooled Analysis of DECLARE Trials). Reference: Seung-Whan Lee et al. Am J Cardiol 2013, article in press. Cilostazol, an inhibitor of phosphodiesterase III , associated with aspirin and clopidogrel showed decrease angiographic restenosis both in conventional stents as well as…