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…
Riociguat, a new drug for pulmonary arterial hypertension
Título original: Riociguat for the Treatment of Pulmonary Arterial Hypertension. Referencia: Hossein-Ardeschir Ghofrani et al. N Engl J Med 2013;369:330-40. Many drugs have been tested for pulmonary arterial hypertension (PAH) including PDE5 inhibitors, prostanoids and endothelin receptor antagonists, however there are still missed targets in the treatment of this disease. Riociguat is a drug belonging to a…
Ticagrelor similar to clopidogrel in terms of coronary flow and myocardial perfusion
Título original: Angiographic Outcomes in the PLATO Trial (Platelet Inhibition and Patient Outcomes). Referencia: Vijay Kunadian et al. J Am Coll Cardiol Intv 2013;6:671–83. In the PLATO (Platelet Inhibition and Patient Outcomes) trial, treatment with ticagrelor compared with clopidogrel resulted in a significant reduction in the combined endpoint of cardiac death, heart attack or stroke in patients undergoing…
High doses of statins may reduce the lipid content in severe injury
Original title: Changes in Plaque Lipid Content After Short-Term Intensive Versus Standard Statin Therapy. The YELLOW Trial (Reduction in Yellow Plaque by Aggressive Lipid-Lowering Therapy). Reference: Annapoorna S. Kini et al. J Am Coll Cardiol 2013;62:21–9. Multiple studies have shown the benefits of statins in reducing all events, stabilize plaques and improve endothelial function. Coronary intravascular ultrasound (IVUS)…
Monoclonal antibodies to decrease peri-procedural myocardial damage
Original title: Effects of the P-Selectin Antagonist Inclacumab on Myocardial Damage After Percutaneous Coronary Intervention for Non–ST-Segment Elevation Myocardial Infarction Results of the SELECT-ACS Trial. Reference: Jean-Claude Tardif et al. J Am Coll Cardiol 2013;61:2048–55. The pathophysiology of myocardial injury after angioplasty is multifactorial but it is clear that inflammation and platelet activation play a major role. P-selectin…
Rational use of bivalirudin, less bleeding and less costs using risk score
Original title: Pre-Procedural Estimate of Individualized Bleeding Risk Impacts Physicians’ Utilization of Bivalirudin During Percutaneous Coronary Intervention. Reference: Seshu C. Rao et al. J Am Coll Cardiol 2013;61:1847–52 While safety of coronary angioplasty has improved over time, post-procedure bleeding is still frequent with a large variability between centers. Bleeding is associated with increased mortality, myocardial infarction, stroke, increased…
High doses of Rosuvastatin in acute coronary syndromes
Original title: Rosuvastatin calcium in acute coronary sydromes Reference: Aggarwal, R. et al, Expert Opinion on Pharmacotherapy , Volume 14, Number 9, June 2013 , pp. 1215-1227(13). Lowering cholesterol of low density lipoproteins (LDL-C) by reducing inhibitors of 3-hydroxy-3-metilgutaril coenzyme A (HMGCoA) statins has proven advantageous for the survival of patients with acute coronary syndrome (ACS). These patients…
Gastric bypass puts type 2 diabetes into remission
Original title: Effects of Ingestion Routes on Hormonal and Metabolic Profiles in Gastric-Bypassed Humans. Reference: Andreas Lindqvist, Peter Spégel, Mikael Ekelund, Hindrik Mulder, Leif Groop, Jan Hedenbro and Nils Wierup. . JCEM, 2013 DOI: 10.1210/jc.2012-3996. A team of researchers at Lund University has explained why gastric bypass often sends diabetes to fast remission, which could be a step…
Aspirin, Clopidogrel and Warfarin. Is it safe or is a triple scheme necessary?
Original title: Use of clopidogrel with or without aspirin in patients taking oral anticoagulant therapy and undergoing percutaneous coronary intervention: an open-label, randomised, controlled trial Reference: Dewilde WJ et al. Lancet. 2013 Mar 30;381(9872):1107-15 The question to answer was simple, relevant, and is increasingly frequent in everyday practice: what to do when a patient who is anticoagulated has…
Improved efficacy and also increased bleeding with Rivaroxaban in Acute Myocardial Infarction
Original title: Rivaroxaban in Patients Stabilized After a ST-Segment Elevation Myocardial Infarction. Results From the ATLAS ACS-2–TIMI-51 Trial. Anti-Xa Therapy to Lower Cardiovascular Events in Addition to Standard Therapy in Subjects with Acute Coronary Syndrome Thrombolysis In Myocardial Infarction-51. Reference: Jessica L. Mega et al. J Am Coll Cardiol 2013;61:1853–9. Morbidity and mortality rates following AMI have progressively…