antiplatelet

IVUS improves outcomes in long lesions with DES

Original title: Randomized Comparison of Clinical Outcomes between Intravascular Ultrasound and Angiography-Guided Drug-Eluting Stent Implantation for Long Coronary Artery Stenosis. Reference: Jung-Sun Kim et al. J Am Coll Cardiol Intv 2013. Article in press. Treating long lesions is difficult and the chance of instant thrombosis may be higher in these lesions. Coronary intravascular ultrasound (IVUS) can help in...

Prasugrel is not as effective as Ticagrelor in acute myocardial infarction. 

Original title: Comparison of Prasugrel and Ticagrelor loading doses in STEMI patients: The Rapid Activity of Platelet Inhibitor Drugs (RAPID) primary PCI Study. Reference: Guido Parodi et al. J Am Coll Cardiol 2013. Article in press. Current guidelines recommend the use of prasugrel or ticagrelor in patients with ST elevation acute coronary syndromes who are due to receive...

Appendage trans-catheter closure is equivalent to anticoagulation in fibrillated patients.

Original title: Percutaneous Left Atrial Appendage Closure for Stroke Prophylaxis in Patients With Atrial Fibrillation: 2.3-Year Follow-up of the PROTECT AF (Watchman Left Atrial Appendage System for Embolic Protection in Patients With Atrial Fibrillation) Trial. Reference: Vivek Y. Reddy et al. Circulation. 2013;127:720-729. Atrial fibrillation is the most common sustained arrhythmia in the world and its importance lies...

Radial Approach, 1st choice in Acute Coronary Syndromes

Original title: Radial Versus Femoral Randomized Investigation in ST-Segment Elevation Acute Coronary síndrome. The RIFLE-STEACS (Radial Versus Femoral Randomized Investigation in ST-Elevation Acute Coronary Syndrome) Study. Reference: Enrico Romagnoli et al. J Am Coll Cardiol 2012;60:2481–9. Bleeding in patients with acute coronary syndromes (ACS) is an independent predictor of morbidity and mortality. Until today, evidence supporting the radial...

Future strategies to prevent restenosis and stent thrombosis

Original title: Endothelial cell repopulation after stenting determines in-stent neointima formation: effects of bare-metal vs. drug-eluting stents and genetic endothelial cell modification. Reference: Douglas G et al. European Heart Journal doi:10.1093/eurheartj/ehs240 Experimental models of vascular injury have shown that the rate of endothelial cell repopulation post-injury is a critical factor in determining subsequent neointima formation as well as...

Bleeding risk in ACS. Do the scores we have work?

Original title: Comparing the predictive validity of three contemporary bleeding risk scores in acute coronary syndrome Reference: European Heart Journal: Acute Cardiovascular Care 2012 1: 222 DOI: 10.1177/2048872612453924 The aim of this study was to compare the validity of the three most widely used scores to predict the risk of bleeding in patients who are hospitalized for acute...

A new paradigm in the treatment of in-stent restenosis?

Original title: ISAR DESIRE 3: Drug-eluting balloon is best option for restenosis of limus-eluting stents Reference: Dr Robert Byrne. TCT 2012. Miami, Fl. The first of the ISAR DESIRE trials showed that drug-eluting stents (DES) were the best strategy for treating restenosis of a bare metal stent, the second ISAR DESIRE trial tested the hypothesis of changing or...

Diabetics with multivessel, must keep waiting.

Original title: Strategies for Multivessel Revascularization in Patients with Diabetes. The FREEDOM Trial. Reference: Michael E. Farkouh et al. N Engl J Med 2012. DOI: 10.1056/NEJMoa1211585 This study was designed to determine the best revascularization strategy in diabetic patients with multivessel using current techniques of angioplasty (PCI) and surgery (CABG). Randomized 1:1 diabetic patients with injuries > 70%...

Drug-Eluting Stents: device without polymers overcomes limitations of first generations stents

The NEXT randomized trial showed the superiority of a polymer-free amphilimus-eluting stent compared to paclitaxel-eluting stents with permanent polymers The NEXT clinical trial (International Randomized Comparison Between DES Limus Carbostent and Taxus Drug-Eluting Stents in the Treatment of De Novo Coronary Lesions), is a multicenter randomized trial (n=296) comparing coronary amphilimus eluting stent Cre8 (CID,...

To discontinue clopidogrel after a year of infarction can be risky

Reference: Charlot et al. European Heart Journal 2012 (in press). International guideline recommendations approve giving dual antiplatelet therapy for a period of not less than 12 months after acute myocardial infarction. However, the benefit is unknown if the therapy is extended beyond 12 months. Perhaps its extension could be particularly useful in patients receiving pharmacological...

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