Original Title: Optimal P2Y12 inhibitor in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention: a network meta-analysis. Reference: Rafique AM et al. J Am Coll Cardiol Intv 2016;9:1036–46. Courtesy of Dr. Alejandro Lakowsky. Researchers drew up a network meta-analysis incorporating 37 trials with more than 88,000 patients undergoing ST elevation...
Conservative Management of MI risk in ACS
Original Title: Spontaneous MI after Non–ST-Segment Elevation Acute Coronary Syndrome Managed without Revascularization. The TRILOGY ACS Trial. Reference: Renato D. Lopes et al. J Am Coll Cardiol. 2016;67(11):1289-1297. Patients admitted with acute coronary syndromes (ACS) and especially those managed conservatively without revascularization, are at high risk of a new spontaneous infarction. However, MI risk rate...
Optimal Duration of Dual Antiplatelet Therapy: New ACC-AHA Guidelines
Original Title: 2016 ACC/AHA Guideline Focused Update on Duration of Dual Antiplatelet Therapy in Patients with Coronary Artery Disease. Reference: Levine GN et al. Circulation. 2016 Mar 29. [Epub ahead of print]. Courtesy of Dr. Alejandro Lakowsky. The new ACC-AHAGuidelines on the optimal duration of dual antiplatelet therapy(DAPT) in patients with coronary artery disease have just been...
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...
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...
REGULATE-PCI: REG1 with an unacceptable rate of severe allergic reactions
The aim of this study was to assess treatment with the new anticoagulant Pegnivacogin and its specific antidote Anivamersen compared with bivalirudin in patients undergoing coronary angioplasty. The Pegnivacogin has an affinity for factor IXa with a longer shelf life to 24 hours and Anivamersen only has an affinity for Pegnivacogin. The combination of these...
TRILOGY Trial: First large scale test evaluating platelet function in acute coronary syndromes.
TRILOGY ACS which was presented at the ESC 2012 is a randomized, double blind study that included 10,300 patients and compared aspirin + cloplidogrel versus aspirin + prasugrel in patients admitted with acute coronary syndromes without ST-segment elevation and initially treated with a conservative strategy. The study concluded that the administration of prasugrel did not...
Artic Study: Bedside Platelet Function Monitoring to Reduce Events after DES Implantation .
Given the individual variability of response to antiplatelet therapies, measuring platelet function and designing tailored therapies could be beneficial. The ARTIC study tested the superiority of bedside platelet function monitoring with drug adjustment vs. the conventional post DES therapy without monitoring and drug adjustment. It included 2466 patients with stable coronary disease or Non-ST Elevation...
TRANSLATE-POPS: Routine measurement of platelet aggregation generates a minimal impact on the treatment setting
The high platelet reactivity is associated with adverse events after stent implantation. Current guidelines consider the measurement of aggregability as a class IIB and there is no information about the routine performance of these measurements. This was a multicenter, prospective, randomized study that included 3800 patients with myocardial infarction. The primary study end point was...
Validation of the Bleeding Academic Research Consortium
Reference: Circulation. 2012; 125:1424–143 Abstract: For many years all efforts applied to the optimization of percutaneous coronary intervention (PCI) were aimed specifically at reducing ischemic events risk through the advent of: 1) new devices (medicated stents), reducing restenosis rates, revascularization and 2) development of new drugs with a potent anti-platelet or anticoagulant such as clopidogrel or,...