A new analysis from the CANTOS trial shows that individuals who initially respond to canakinumab benefit the most from this new drug as regards cardiovascular events. This sub-analysis presented at the American Heart Association 2017 Scientific Sessions and simultaneously published in the Lancet showed that the magnitude of the reduction in C-reactive protein following a…
DACAB: Ticagrelor and Aspirin Improve Vein Graft Patency
According to this Chinese study, dual antiplatelet therapy with ticagrelor and aspirin improves vein graft patency a year after surgery without increasing the risk for major bleeding. Treatment with the P2Y12 inhibitor ticagrelor in combination with aspirin has been widely accepted for patients with acute coronary syndrome undergoing angioplasty. However, there were no related data regarding surgical revascularization. Read also: “Ticagrelor…
New High Blood Pressure Guidelines
The wait is finally over: the high blood pressure guidelines that have been in the works for the past 3 years saw the light of day at the American Heart Association (AHA) 2017 Scientific Sessions. As expected, after the findings of the SPRINT trial and other recently published studies, the treatment goal was lowered and is…
PRESERVE: IV Bicarbonate and Oral N-Acetylcysteine Do Not Prevent Contrast-Associated Acute Kidney Injury
Use of IV bicarbonate instead of saline and administration of oral N-acetylcysteine are not effective strategies for preventing contrast-associated acute kidney injury in patients with chronic kidney disease undergoing angiography, according to the randomized PRESERVE trial that was presented at the AHA 2017 Scientific Sessions and published simultaneously in the New England Journal of Medicine…
NCDR ACTION Registry: Anticoagulated Patients with No Higher Risk of Bleeding in Emergency Procedures
Patients with a history of atrial fibrillation treated with warfarin or any of the new direct oral anticoagulants undergoing acute myocardial infarction do not present higher risk of bleeding when receiving angiography or angioplasty. In fact, this subgroup of anticoagulated patients showed lower in-hospital mortality than the control group. After analyzing 6471 patients undergoing ST elevation MI…
FOURIER: Evolocumab Found Beneficial for Patients with Peripheral Vascular Disease of Prior MI
Patients with peripheral vascular disease or prior acute myocardial infarction (especially within the first two years after the event) could find a particular benefit the PCSK9 receptor inhibitor evolocumab. Given its high cost, the drug is not yet cost/effective and when prescribed, most patients were no table to complete the treatment. Read also: “Missed Opportunities with…
The End of Aspirin for Anticoagulated Patients Undergoing PCI
The discussion about the best anti-thrombotic strategy for patients with atrial fibrillation undergoing PCI seemed never-ending until the RE-DUAL PCI trial was published in the New England Journal of Medicine (NEJM). This study has arrived to simplify the tough choice between the risk of a thrombotic event vs. the risk of bleeding with a simpler scheme, without…
TCT 2017 | SENIOR: DES with a Bioresorbable Polymer and Short Dual Antiplatelet Therapy in Elderly Patients
Courtesy of the SBHCI. This study sought to assess the safety and efficacy of an everolimus-eluting stent with a biodegradable polymer (SYNERGY II) vs. a conventional stent (REBEL) in patients >75 years old with short duration of dual antiplatelet therapy. Before randomization, investigators recorded the planned duration of dual antiplatelet therapy (1 month for stable patients and 6 months…
TCT 2017 | REDUCE: 3 vs 12 Months of Dual Antiplatelet Therapy with the New Combo DES
Courtesy of SBHCI. This new device has, on one hand, an abluminal sirolimus coating, and on the other hand, a luminal CD34 antibody coating for EPC capturing, to potentially accelerate post-PCI reendothelization. Between 2014 and 2016, the study included 1496 patients undergoing acute coronary syndrome (ACS), receiving the new COMBO stent. These patients were randomized…
Fentanyl in Angioplasty: What Is the Price of More Comfort During the Procedure?
Fentanyl is a potent opiate commonly administered in the cath lab. Recently, questions on its safety have been raised by research demonstrating that intravenous morphine significantly delays the absorption of oral P2Y12 platelet inhibitors. The mechanism might be slowed gastric emptying. The Platelet Aggregation with tiCagrelor Inhibition and FentanYl (PACIFY) trial enrolled 212 patients undergoing indicated…
FOURIER: Efficacy of Evolocumab for Ultra-Low LDL Levels
It seems that a LDL level of 70 mg/dL is no longer low enough for high-risk secondary patients; in consequence, this study attempted to set a new target, one that appears almost impossible to reach: 40 mg/dL or lower. This study, simultaneously presented at the European Society of Cardiology Congress 2017 and published in The Lancet, showed…