In patients undergoing transcatheter aortic valve replacement (TAVR) that also required anticoagulation for another indication (mostly atrial fibrillation), the incidence of major bleeding between month 1 and 12 was lower in those receiving only anticoagulation instead of anticoagulation + clopidogrel. The present study presented as part of the scientific sessions at the virtual ACC 2020,...
This very interesting work leaves us with a sour taste in our mouth, as it failed to meet its primary endpoint. Using genotype to individualize treatment with a P2Y12 inhibitor in patients with acute coronary syndrome or stable patients after a scheduled angioplasty compared with conventional treatment with clopidogrel does not reduce the risk of...
According to this study, presented during the ESC 2019 scientific sessions, non-ST acute coronary syndrome (NSTE-ACS) patients treated with ticagrelor presented a significantly higher risk of bleeding than patients treated with clopidogrel, with no counterbalance by higher benefit in thrombotic events. Researchers suggest clopidogrel might be the gold standard for this elderly NSTE-ACS population, though...
Elderly patients are at elevated risk of both ischemic and bleeding complications after an acute coronary syndrome (ACS), and display higher platelet reactivity under clopidogrel when compared to younger patients. A 5-mg dose of prasugrel would provide more predictable platelet inhibition than clopidogrel in elderly populations, without the risk of bleeding entailed by the full...
Courtesy of Dr. Pablo Baglioni. This is a prospective observational study with a 1-year follow-up analyzing 2062 patients with acute coronary syndrome (ACS) who have been treated with coronary angioplasty using new-generation drug-eluting stents (DES). Patients were included between December 21, 2012 and August 25, 2015. On May, 2014, due to changes in international guidelines, clopidogrel...
Courtesy of SBHCI. This study presented at Euro PCR and simultaneously published by JACC Cardiovascular Interventions poses a question that has remained unanswered since the start of TAVR. There is little information on the optimal antithrombotic therapy after transcatheter aortic valve replacement (TAVR). In general, patients receive between 1 and 6 months of dual...
Peripheral vascular disease is considered as a manifestation of systemic atherosclerosis associated with adverse events, both cardiovascular and related to the lower limbs. Previous studies showed that clopidogrel monotherapy is associated with lower risk of events when compared to low doses of aspirin. Such is the rationale behind this article comparing clopidogrel and ticagrelor...
Cangrelor is an intravenous P2Y12 inhibitor approved to reduce peri-procedural ischemic events in patients undergoing PCI that have not previously received any other P2Y12 inhibitor. The CHAMPION PHOENIX trial randomized a total of 11,145 patients to cangrelor vs. clopidogrel. The study sought to explore the effect of cangrelor on peri-procedural acute myocardial infarction...
Original Title: Effects of Ticagrelor versus Clopidogrel in Troponin-Negative Patients With Low-Risk ACS Undergoing Ad Hoc PCI. Reference: Dominick J et al. J Am Coll Cardiol. 2016;67(6):603-613. Many patients admitted with low-risk acute coronary syndrome (ACS) are not pre-treated with a P2Y12 receptor inhibitors despite the invasive strategy in place, with angiography and PCI in the...
Original Title: Clopidogrel versus Aspirin as an Antiplatelet Monotherapy after 12-Month Dual-Antiplatelet Therapy in the Era of Drug-Eluting Stents. Reference: Taek Kyu Park et al. Circ Cardiovasc Interv. 2016 Jan;9(1):e002816. Courtesy of Dr. José Amadeo Guillermo Álvarez. The use of dual antiplatelet therapy (DAPT) over 12 months after hospitalization for acute myocardial infarction (AMI) or drug...