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…
Bivalirudin, effective in the pre-hospitalization phase of infarction
Original title: Bivalirudin Started during Emergency Transport for Primary PCI. Reference: Philippe G. Steg, et;al. NEJM 2013; Octubre 30:1-11 Primary PCI is the preferred treatment for AMI within the first 12 hours of symptom onset and outcomes have been improving with the incorporation of new strategies and technology. This study randomized 2218 STEMI patients started with bivalirudin during…
Low cardiac mortality with bivalirudin beyond the reduction in major bleeding
Original title: Reduction in Cardiac Mortality with Bivalirudin in Patients With and Without Major Bleeding: The HORIZONS-AMI Trial. Reference: Gregg W. Stone et al. J Am Coll Cardiol. Epub ahead of print The HORIZONS -AMI study included 3602 patients experiencing ST segment elevation myocardial infarction received primary angioplasty, resulting in lower mortality at 30 days and three years…
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…
Ticagrelor effective in venous bridges
Original title: Effect of ticagrelor on the outcomes of patients with prior coronary artery bypass grafo surgery: Inssights from th PLATelet inhibition and patients outcomes (PLATO) trial. Reference: Emmanouil S. Brilakis, et al. Am Heart J 2013;166:474-80 The bridge venous occlusion is a common finding in patients with previous CABG presenting with acute coronary syndrome without ST…
Enoxaparin appears superior to unfractionated heparin in patients undergoing primary angioplasty
Original title: A direct comparison of intravenous enoxaparin with unfractionated heparin in primary percutaneous coronary intervention (from the ATOLL trial). Reference: Collet et al. Am J Cardiol. 2013; Epub ahead of print. ATOLL study analysis suggests that enoxaparin is superior to unfractionated heparin in reducing ischemic events and mortality in patients suffering ST elevation acute myocardial infarction (STEMI)…
Ticagrelor reduces in-stent thrombosis in patients with acute coronary syndromes
Original title: Stent thrombosis with ticagrelor versus clopidogrel in patients with acute coronary syndromes: An analysis from the prospective randomized PLATO trial. Reference: Steg PG et al. Circulation. 2013; Epub ahead of print The PLATO study randomized 18624 patients with acute coronary syndrome to receive ticagrelor (180 mg loading dose followed by 90 mg twice daily )…
Rivaroxaban reduces in-stent thrombosis in patients with acute coronary syndromes
Original title: Reduction of Stent Thrombosis in Patients With Acute Coronary Syndromes Treated With Rivaroxaban in ATLAS-ACS 2 TIMI 51. Reference: C. Michael Gibson et al. J Am Coll Cardiol 2013;62:286–90. There are few contemporary studies that investigated oral anticoagulation utility in patients with acute coronary syndromes and coronary angioplasty. Rivaroxaban is an oral anticoagulant that directly and…
Transradial access plus bivalirudin, the best combination to reduce bleeding
Original title: Comparison of bivalirudin and radial access across a spectrum of preprocedural risk of bleeding in percutaneous coronary intervention: Analysis from the National Cardiovascular Data Registry. Reference: Baklanov DV et al. Circ Cardiovasc Interv. 2013, article in press. Bleeding complications are clearly associated to mortality increase and two of the current best strategies to reduce bleeding are…