The THEMIS study published this week in NEJM, tested chronic ticagrelor + aspirin in diabetic patients with stable coronary artery disease (CAD), but with no prior history of Myocardial infarction (MI) or stroke. The tempting hypothesis behind this study is that reducing ischemic events might increase bleeding events, and this calls for careful cost/benefit assessment. …
Pulmonary Illness and E-Cigarettes: New Devices with New Diseases
We are seeing patients with similar clinical characteristics that shared the used of e-cigarettes. Even though we have been unable to identify one single responsible component or a set of them, clearly the use of e-cigarettes has brought new pathologies. E-cigarettes are electronic battery powered devices that heat a liquid forming an inhalable aerosol. Several…
TCT 2019 | MODEL U-SES: More Devices for High Risk of Bleeding and Short DAPT
Courtesy of SBHCI. This study tested the safety of dual antiplatelet therapy (DAPT) after only three months of bioresorbable polymer sirolimus DES implantation (Ultimaster). Secondary end point was following with P2Y12 inhibitor monotherapy after the first 3 months compared with aspirin. It included 1695 patients treated with sirolimus eluting Ultimaster receiving 3-month DAPT. After the…
TCT 2019 | EVOLVE Short DAPT: Only 3-month DATP in High Risk Bleeding
Courtesy of the SBHCI. This study used the thin strut everolimus eluting stent with ultrathin abluminal bioresorbable polymer coating chromium platinum stent, basically the Synergy stent. Drug release and polymer degradation within four months facilitate endothelization and would allow a shorter DAPT. Presented during the scientific sessions of TCT 2019, this study included 2009 high…
TCT 2019 | AUGUSTUS ACS: Apixaban vs. Warfarin and Aspirin vs. Placebo in AF and ACS
Courtesy of SBHCI. The safety and efficacy of antithrombotic and antiplatelet treatments in patients with atrial fibrillation admitted with acute coronary syndrome (who receive medical treatment or angioplasty) may vary from that in patients undergoing elective treatment. At 14 days from elective angioplasty or hospitalization due to acute coronary syndrome, patients were randomized in a 2×2…
TCT 2019 | TWILIGHT: Minimal DAPT in High Bleeding Risk Patients
Courtesy of the SBHCI. Monotherapy with a P2Y12 inhibitor after a minimum period (3 months) of dual antiplatelet antiaggregation (DAPT) is a valid treatment option to reduce bleeding in patients at high risk of bleeding complications. The present double-blind study presented at TCT 2019 simultaneously published in NEJM analyzed ticagrelor monotherapy (prior 3 months DAPT)…
ESC 2019 | EVOPACS: Evolocumab to Reduce Cholesterol in Acute Coronary Syndromes
Eight weeks of treatment with evolocumab added to a regimen of high-intensity statins in patients with acute coronary syndrome reduced significantly LDL cholesterol levels and was safe, compared with statins + placebo, according to the EVOPACS study presented last Saturday at the European Society of Cardiology (ESC) Congress 2019 Scientific Sessions in Paris and simultaneously…
ESC 2019 | HOPE 4: Overcoming Obstacles to Treat Risk Factors in Developing Countries
Exhaustive intervention carried out by healthcare non-medical healthcare professionals with the support of community members resulted in a significant reduction of systolic blood pressure, LDL cholesterol levels and CAD risk in patients of Malaysia and Colombia, according to this study presented at ESC 2019 in Paris and simultaneously published in Lancet. This intervention translated into…
ESC 2019 | AFIRE: Monotherapy with Rivaroxaban in Atrial Fibrillation and Stable CAD
In patients with atrial fibrillation and stable coronary artery disease who have not had revascularization procedures in the last 12 months, monotherapy with rivaroxaban seems the best treatment strategy compared to rivaroxaban plus antiplatelet antiaggregation. This is what resulted from the AFIRE study, presented during the ESC 2019 in Paris and published in NEJM. Monotherapy…
ESC 2019 | DAPA-HF: Dapagliflozin Shows Benefit for All Subgroups
Dapagliflozin (a sodium glucose co-transporter 2 [SGLT2] inhibitor), when indicated concomitantly with standard therapy, reduces significantly the risk of worsening heart failure events and cardiovascular events, and improves symptoms in patients with heart failure and reduced ejection fraction according to this new work presented during last Sunday’s scientific sessions at the European Society of Cardiology…
ESC 2019 | PARAGON-HF: Sacubitril/Valsartan Somewhat Disappointing, though a Few Would Benefit.
The combination Sacubitril/valsartan did not reduce the risk of rehospitalization for heart failure or cardiovascular death in patients with cardiac failure symptoms and preserved ejection fraction, according to the new study presented on Sunday at ESC 2019 scientific session in Paris and simultaneously published in NEJM. Despite the negative results, we remain hopeful that this…