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...
Triple Antithrombotic Scheme in AMI Patients undergoing PCI
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...
Bleeding Events after Left Atrial Appendage Closure vs. Long Term Warfarin
Original Title: Bleeding Outcomes After Left Atrial Appendage Closure Compared With Long-Term Warfarin A Pooled, Patient-Level Analysis of the WATCHMAN Randomized Trial Experience. Reference: Matthew J. Price et al. J Am Coll Cardiol Intv. 2015. Online before print. The aim of this trial was to compare the relative risk of major bleeding after left atrial appendage closure...
DAPT Substudy: Score to Personalize Optimal Dual Antiaggregation Therapy Duration
Original Title: Individualizing Treatment Duration of Dual Antiplatelet Therapy after Percutaneous Coronary Intervention: An Analysis from the DAPT Study. Presenter: Yeh RW. Optimal dual antiplatelet therapy duration for patients receiving stents has started to become clearer, but a new scoring method (DAPT Score) may help single out patients who could either benefit or suffer from extended...
Polymer Free Drug Coated Stent in High Bleeding Risk Patients with Only One Month DAPT
Original Title: Polymer-free Drug-Coated Coronary Stents in Patients at High Bleeding Risk Reference: Philip Urban et al. N Engl J Med. 2015 Oct 14. [Epub ahead of print]. High bleeding risk patients undergoing PCI usually receive conventional bare metal stents (BMS) to allow the shortest possible DAPT (dual antiplatelet therapy), usually a month long. This...
ISAR-SAFE: 6 vs. 12 month clopidogrel administration after DES implantation
The aim of this randomized double blind control trial was to validate the safety and efficacy of 6 months vs. 12 months clopidogrel treatment in patients receiving DES. Primary end point was a combination of death, infarction, in-stent thrombosis, stroke and major bleeding. Secondary end point was the individual analysis of each one of the...
DAPT TRIAL: double antiaggregation remains controversial
Article This multicenter randomized control study with placebo was designed to determine the risks and benefits of double antiaggregation for longer than 12 months post DES stenting. 9961 patients were randomized to continue on placebo or thienopyridine after 12 months. Thienopyridine reduces the incidence of in-stent thrombosis (0.4% vs 1.4%; p<0,001) and cardiovascular events (4.3%...
OPTIMIZE: 3 months versus 12 months of dual anti-aggregation with zotarolimus-eluting stents
The current recommendation for dual anti-aggregation post-DES implantation is 12 months. However, the ideal length for specific types of stents is unclear. This study aimed to evaluate the clinical non-inferiority at 3 months versus 12 months of dual anti-platelet therapy in patients undergoing coronary angioplasty with zotarolimus-eluting stents. The study randomized 1:1 to 3 months...
SECURITY: 6 months versus 12 months of dual anti-aggregation using 2nd generation DES
This multicenter noninferiority design work included 1399 patients randomized to receive 6 months (n = 682) versus 1 year (n = 717) dual anti-aggregation after implantation of 2nd generation drug-eluting stent. The primary end point was a composite of cardiac death, myocardial infarction, stroke, definite or probable thrombosis, and major bleeding. At 12 months follow-up...
ZEUS Trial: Patients with increased risk of bleeding may benefit from eluting stents Zotarolimus
The use of drug-eluting stents versus bare metal stents is controversial in some clinical situations in patients at high risk of bleeding.This study randomized 1606 patients considered at low risk of restenosis but with high risk of bleeding receiving Zotarolimus eluting stent (Endeavor) or conventional stent.The clinical characteristics were similar between the two groups with...