Currently the recommendation is 12 months of dual antiplatelet after a drug-eluting stent angioplasty. This study compared the 3 – months versus 12 months of dual antiplatelet after angioplasty with zotarolimus-eluting stent in real-world patients. This was a prospective, multicenter study randomized 1563 patients to receive aspirin and clopidogrel for 3 months and 1556 to...
Bivalirudin reduced mortality and bleeding compared to heparin and glycoprotein IIbIIIa in HORIZONS- AMI study. However there was a higher rate of acute stent thrombosis in patients receiving bivalirudin. This randomized study (> 90 % randomized in the ambulance) enrolled 2218 patients with ASTEMIto prolonged infusion of bivalirudin compared with heparin -associated glycoprotein inhibitors. The...
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: Duration of Triple Therapy in Patients Requiring Oral Anticoagulation After Drug-Eluting Stent ImplantationThe ISAR-TRIPLE Trial. Reference: Katrin A. Fiedler et al. J Am Coll Cardiol. 2015;65(16):1619-1629. Patients with oral anticoagulation indication after drug eluting stenting require aspirin and clopidogrel; however, the triple scheme has high bleeding risk and optimal duration is yet to be determined. The...
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...
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:...
Original title: Aspirin Treatment and Outcomes After Percutaneous Coronary InterventionResults of the ISAR-ASPI Registry. Reference: Katharina Mayer et al. J Am CollCardiol. 2014;64(9):863-871. Aspirin administration, as part of the double antiagregation scheme, is essential in the context of PCI. The correlation between high platelet reactivity to on-clopidogrel treatment and higher events rates has been well established, while data...
Original title: Impact of hemodialysis on local vessel healing and thrombus formation after drug-eluting stent implantation. Reference: Akihide Konishi, et al. Journal of Cardiology 2014;64:25-31 Even though the benefit of DES implantation to the general population is undeniable, it has been proved lower in hemodialysis patients (HD); the reason behind this phenomenon remains unclear. 121 patients received...
Original title: Evaluation of proximal protection devices during carotid artery stenting as the first choice for embolic protection. Reference: Hornung M et al. EuroIntervention. 2014; Epub ahead of print. This series of the Frankfurt CardioVascular Center included 124 consecutive patients undergoing carotid angioplasty with proximal protection. The first 92 patients received the Gore Flow Reversal System (WL Gore;...