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Risks and benefits of extending dual antiplatelet therapy in patients with and without MI

Original title: Benefits and Risks of Extended Duration Dual Antiplatelet Therapy after PCI in Patients With and Without Acute Myocardial Infarction. The DAPT Study. Reference: Robert W. Yeh et al. J Am Coll Cardiol. 2015, online before print. The risks and benefits of prolonged antiplatelet therapy after PCI could be different in patients presenting with AMI compared to...

Net clinical benefit of bivalirudin in STEMI patients

Original title: Bivalirudin Versus Heparin With or Without Glycoprotein IIb/IIIa Inhibitors in Patients With STEMI Undergoing Primary Percutaneous Coronary Intervention: Pooled Patient-Level Analysis From the HORIZONS-AMI and EUROMAX Trials. Reference: Stone GW et al. J Am CollCardiol. 2015 Jan 6;65(1):27-38. The HORIZONS-AMI (Harmonizing Outcomes with RevasculariZatiON and Stents in Acute Myocardial Infarction) that included 3602 STEMI patients undergoing...

Risks and benefits of Dual Antiplatelet beyond the year of a drug-eluting stent

Original title: Twelve or 30 Months of Dual Antiplatelet Therapy after Drug-Eluting Stents. Reference: Laura Mauri et al. N Engl J Med 2014;371:2155-66.   Dual antiplatelet therapy is recommended after a drug-eluting stent to prevent thrombotic complications. The clinical benefit of this scheme it is not clear beyond one year. Patients were registered to receive a...

Thienopyridine Pretreatment in Non ST Elevation ACS syndrome

Original title: Reappraisal of thienopyridine pretreatment in patients with non-ST elevation acute coronary syndrome: a systematic review and meta-analysis. Reference: Bellemain-Appaix A. et al. BMJ. 2014;Epub ahead of print. This meta-analysis included 7 studies that included a total 32383 patients admitted with non ST elevation ACS; 17545 (54.5%) underwent PCI. These studies were published between 2001 and 2013:...

Thrombosis with bioresorbable scaffolds: the story of DES all over again?

Original title: Percutaneous coronary intervention with everolimus-eluting bioresorbable vascular scaffolds in routine clinical practice: early and midterm outcomes from the European multicentre GHOST-EU registry. Reference: Capodanno D et al. EuroIntervention. 2014 Jul 18. Epub ahead of print   The GHOST-EU registry, that included 1189 patients from 10 European centers between 2011 and 2014, is now the largest registry...

Higher event rate in those with non-ST elevation ACS who received revascularization at PLATO study. Beyond this, ticagrelor reduced mortality.

Original title: Ticagrelor vs. clopidogrel in patients with non-ST-elevation acute coronary syndrome with or without revascularization: results from the PLATO trial. Reference: Lindholm D et al. Eur Heart J. 2014; Epub ahead of print. The PLATO study randomized 18624 patients with ACS to aspirin and ticagrelor (180 mg loading dose followed by 90 mg every 12 hours) versus...

Stent reestenosis, the only subgroup that benefits from longer double antiaggregation

Original title: Short vs. Long Term Duration of Dual Antiplatelet Therapy in Patients treated for InstentRestenosis. A PRODIGY Trial substudy. Reference: Gianluca Campo el al. J Am CollCardiol, article in press.   In the study PRODIGY (Prolonging Dual Antiplatelet Treatment After Grading Stent- Induced Intimal Hyperplasia) we found that the 24 months ratio of dual antiaggregation was not...

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...

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...

Outpatient coronary angioplasty, is it possible?

Original title: Assessment of Clinical Outcomes related to Early Discharge alter elective Percutaneous Coronary Intervention: COED PCI Reference: Purushothaman Muthusamy MD, et al. Catheterization and Cardiovascular Intervention 81:6-13 (2013) The standard procedure in most institutions is that after angioplasty (PTCA) patients are discharged the next morning. There are some reports in which they were ambulatory but the safety...

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