Original Title: Effects of Ticagrelor versus Clopidogrel in Troponin-Negative Patients With Low-Risk ACS Undergoing Ad Hoc PCI. Reference: Dominick J et al. J Am Coll Cardiol. 2016;67(6):603-613. Many patients admitted with low-risk acute coronary syndrome (ACS) are not pre-treated with a P2Y12 receptor inhibitors despite the invasive strategy in place, with angiography and PCI in the…
Different Thienopyridine Loading Strategies to Get the Fastest Effect
Original Title: Randomized Comparison of Different Thienopyridine Loading Strategies in Patients Undergoing Elective Coronary Intervention. The Excelsior LOAD Trial. Reference: Willibald Hochholzer et al. J Am Coll Cardiol Intv. 2016, online before print. This study assesses how to provide a more rapid antiaggregant effect. It compares the effect of a prasugrel load vs. a 600…
Aspirin or Clopidogrel as Monotherapy after 12 month DAPT
Original Title: Clopidogrel versus Aspirin as an Antiplatelet Monotherapy after 12-Month Dual-Antiplatelet Therapy in the Era of Drug-Eluting Stents. Reference: Taek Kyu Park et al. Circ Cardiovasc Interv. 2016 Jan;9(1):e002816. Courtesy of Dr. José Amadeo Guillermo Álvarez. The use of dual antiplatelet therapy (DAPT) over 12 months after hospitalization for acute myocardial infarction (AMI) or drug…
Triple Antithrombotic Scheme in AMI Patients undergoing PCI
Original Title: Outcomes of Patients with Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention Receiving an Oral Anticoagulant and Dual Antiplatelet Therapy, a Comparison of Clopidogrel vs. Prasugrel from the TRANSLATE-ACS Study. Reference: Jackson L.R. et al. JACC Cardiovasc Interv. 2015 Dec 21;8(14):1880-9. Courtesy of Dr Agustín Vecchia. In these last years, new and more powerful antiaggregants have…
Different Options for Aspirin Hypersensitivity in PCI
Original Title: Efficacy and Safety of Available Protocols for Aspirin Hypersensitivity for Patients Undergoing Percutaneous Coronary Intervention. A Survey and Systematic Review. Reference: Bianco M et al. Circ Cardiovasc Interv. 2016 Jan;9(1):e002896. The follow up strategy for aspirin hypersensitive patients undergoing PCI remains unclear. A systematic search included 283 patients from 11 studies. Primary end point…
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…
Dual Antiplatelet Therapy after Everolimus Eluting Stenting
Original Title: Benefits and Risks of Extended Dual Antiplatelet Therapy after Everolimus-Eluting Stents. For the Dual Antiplatelet Therapy (DAPT) Study Investigators. Reference: James B. Hermiller et al. JACC: Cardiovascular Interventions 2015, online before print. The DAPT study had shown that continued aspirin plus thienopyridine beyond a year reduces ischemic events. Given the fairly low rate of thrombosis…
ADAPT-DES: Proton Pump Inhibitors and Clopidogrel in Patients with DES
Original Title: Proton Pump Inhibitors, Platelet Reactivity, and Cardiovascular Outcomes After Drug-Eluting Stents in Clopidogrel-Treated Patients. The ADAPT-DES Study. Some proton pump inhibitors interfere with clopidogrel metabolism and could attenuate P2Y12 reception. Prior observational and randomized studies have reported contradicting results on the clinical significance of this drug interaction. The aim of this trial was…
Prasugrel in the Treatment of Clopidogrel Nonresponders Undergoing PCI
Original Title: Prasugrel in Clopidogrel Nonresponders Undergoing Percutaneous Coronary Intervention (RECLOSE-3 study). Reference: Valenti R, et al. JACC Cardiovasc Interv. 2015 Oct;8(12):1563-70. Clopidogrel Nonresponders have higher risk of adverse events (cardiovascular death and stent thrombosis) compared to responders. Studies published so far have failed to demonstrate the use of platelet function tests in ACS patient…
SPRINT: lower blood pressure targets for many hypertensive
Original Title: A randomized trial of intensive versus standard blood-pressure control. Presenter: Wright JR Jr. A systolic blood-pressure target lower than 120 over the standard 140 mm Hg reduces adverse events rates in non-diabetic patients at high cardiovascular risk, according to the SPRINT trial, but only at the expense of increased adverse events that include hypotension,…
PEGASUS-TIMI 54 Subanalysis: Discontinuation of Ticagrelor Mostly Due to Dyspnea or Bleeding
Original Title: Long-term tolerability of ticagrelor for secondary prevention: insights from PEGASUS-TIMI 54 trial. Presenter: Bonaca MP. The higher rate of premature discontinuation of ticagrelor vs placebo in the PEGASUS-TIMI 54 of stable outpatients with prior MI is attributed to more frequent dyspnea and bleeding, according to a new study. Among patients who tolerated therapy for…