Defining dual antiplatelet therapy (DAPT) seems a never-ending story. We go from trials showing the safety of shorter schemes thanks to new generation stents to others suggesting up to two years of DAPT. Rather than finding a general scheme, it seems to be about adjusting DAPT on a case by case basis, according to ischemia…
ESC 2018 | GLOBAL LEADERS: Ticagrelor Monotherapy Is Not Superior to Classic Therapies After Angioplasty
Dropping aspirin after the first month and continuing with ticagrelor monotherapy was not better than standard dual antiplatelet therapy (aspirin plus ticagrelor or clopidogrel) in patients who underwent coronary angioplasty. Patrick Serruys presented this work (which was simultaneously published in The Lancet) at the European Society of Cardiology (ESC) Congress 2018 and explained that, given…
ESC 2018 | ARRIVE: Aspirin in the Eye of the Storm of Primary Prevention
Aspirin failed to reach the primary endpoint in a population that was at risk of experiencing cardiovascular disease. However, something that a short time ago seemed obvious could not be proved by randomizing 12,000 patients. The ARRIVE trial, presented at the European Society of Cardiology (ESC) Congress 2018 and simultaneously published in The Lancet, joins the…
ESC 2018 | CLARIFY: No Survival Benefit with Beta-Blockers Beyond 1 Year After Infarction
This is another study that concludes that beta-blockers have no impact on mortality at 1 year after infarction in stable patients and offer no survival benefit to patients with stable ischemic heart disease who have not experienced a myocardial infarction. This analysis represents 5 years of follow-up in a large, multinational registry and also shows a lack…
ESC 2018 | ASCEND: Aspirin for Primary Prevention in Diabetic Patients Fails the Cost-Benefit Analysis
The obvious risk of bleeding posed by aspirin was too clear in this work, casting a shadow of doubt over the indication of aspirin for primary prevention in diabetic patients. According to the ASCEND trial, presented at the European Society of Cardiology (ESC) 2018 Congress and simultaneously published in NEJM, aspirin reduces cardiovascular events as…
ESC 2018 | MATRIX: 1-Year Superiority of Transradial Access
Transradial access should be the access of choice in patients with acute coronary syndrome, while bivalirudin has not shown any benefit for this population. The long-term follow-up from the MATRIX (Minimizing Adverse Hemorrhagic Events by Transradial Access Site and Systemic Implementation of Angiox) trial confirms the results at 30 days: transradial access is here to stay…
ESC 2018 | MARINER: Rivaroxaban as Thromboprophylaxis after Hospitalization
For acute patients hospitalized for a clinical disease (e.g.: heart failure), indicating rivaroxaban for 6.5 weeks after discharge did not significantly reduce the risk of symptomatic venous thromboembolism. Efficacy primary end point rate was low, with 0.83% in patients treated with rivaroxaban vs 1.1% of patients receiving placebo. This work presented at ESC and…
SOLACI-SOCIME 2018 | New Indications
Read articles on the main presentations of the first day of SOLACI-SOCIME 2018 Congress. See the presentation by Dr. Flavio Ribichini, entitled “New Indications”. We are interested in your opinion. Please, leave your comments, thoughts, questions, etc., below. They will be most welcome.
Women in Cardiology: Still Underrepresented in a Field Full of Men
JAMA Cardiology dedicated a special with 4 articles on different issues women continue to face when considering this area of expertise, or when they have already chosen this fascinating field but still feel undervalued or discriminated compared with their male colleagues. One of the studies showed the career preferences of med school students. What trainees…
New European Hypertension Guidelines Contrast with American Recommendations
The European guidelines on hypertension have been updated and now feature differences compared with American guidelines regarding how to diagnose and treat patients with high blood pressure. The main difference particularly lies in how aggressive physicians should be in lowering blood pressure. These data are available from a preview of the document presented at the…
Can We Prevent Cardiovascular Events without Aspirin?
As regards the use of antithrombotic agents, the risk of bleeding will always be an issue, and in the case of aspirin this risk is twice as big: it does have the desired antiaggregation effect, but on top of the increased bleeding risk, it has a damaging effect on stomach lining that increases the risk…