Newer P2Y12 blockers are the front-line treatment and dual antiplatelet therapy is indicated for 1 year after acute coronary syndrome (ACS). Both prasugrel and ticagrelor offer more ischemic benefit than clopidogrel during the initial phase; however, bleeding complications could increase in the long term. The objective of this study was to assess the safety and efficacy...
Courtesy of Dr. Agustín Vecchia. Currently, the duration of dual antiplatelet therapy (DAPT) after stent placement is one of the most highly debated topics in Cardiology. On the one hand, women are usually underrepresented in trials in our specialty; on the other, the fact that symptoms of coronary disease are different in women is well-known. The aim...
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: Benefits and Risks of Extended Dual Antiplatelet Therapy after Everolimus-Eluting Stents. For the Dual Antiplatelet Therapy (DAPT) Study Investigators. Reference: James B. Hermiller et al. JACC: Cardiovascular Interventions 2015, online before print. The DAPT study had shown that continued aspirin plus thienopyridine beyond a year reduces ischemic events. Given the fairly low rate of thrombosis...
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...
The cessation of dual antiplatelet treatment increased the risk of post coronary intervention adverse events. It is unclear whether the risk varies through time or if it depends on the reason for the interruption or both. The PARIS (patterns of non-adherence to anti-platelet regimens in stented patients) register is a prospective, observational study in patients...
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: Zotarolimus-Eluting Versus Bare-Metal Stents in Uncertain Drug-Eluting Stent Candidates. Reference: Marco Valgimigli et al. J Am Coll Cardiol. 2015;65(8):805-815. The use of drug eluting stents (DES) in patients at high risk of bleeding or thrombosis has not been studied prospectively. Data on patients at high risk of bleeding and low restenosis are limited. This study compared...
Original title: Second Generation Drug-Eluting Stents Implantation Followed by Six Versus Twelve-Month – Dual Antiplatelet Therapy- The SECURITY Randomized Clinical Trial. Reference: Antonio Colombo et al. J Am CollCardiol. 2014 Nov 18;64(20):2086-97. The optimal duration of dual antiplatelet therapy after second-generation DES implantation is still debated and apparently will remain controversial for some time. The aim of this...
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...