Patients treated with A9 biolimus eluting stent with biodegradable polymer (Nobori, Terumo) can receive only six months of dual antiplatelet therapy (DAPT) with no increase in adverse events, compared against more prolonged treatments. The net adverse clinical and cerebrovascular events that included all cause death, MI, cerebrovascular events and major bleeding was: 1.92% for...
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...
The use of morphine in patients undergoing ST elevation acute coronary syndromes is associated to higher platelet reactivity and lower thrombolysiscapacity, according to this small study. The negative effects seem to resolve 2 days after administration. This transient effect is believed to be the result of the inhibition of the normal muscular activity of the...
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...
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...
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...
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...
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,...
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...
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...