dual antiplatelet

3 to 6 months of dual antiplatelet after DES reduced bleeding and did not raise mortality or infarction.

Original title: Meta-analysis of randomized clinical trials comparing short term -vs- long term dual antiplatelet therapy following drug eluting stents. Reference: El-Hayek G et al. Am J Cardiol. 2014; Epub ahead of print. This meta-analysis examined the data of four randomized and controlled studies (EXCELLENT, PRODIGY, RESET y OPTIMIZE) including 8157 patients receiving sirolimus, paclitaxel, everolimus or zotarolimus...

Six Months Sufficient for Dual Antiplatelet Therapy

Reference: Kandzari DE, Barrer CS, Leon MB, et al. Dual antiplatelet therapy duration and clinical outcomes following treatment with zotarolimus-eluting stents. JACC Cardiovasc Interv 2011; 4: 1119-28.2011; 4: 1119-28. Patients treated with zotarolimus-eluting stents (ZES) suffer no excess late ischemic events if they take dual antiplatelet therapy for 6 months instead of 12 months or longer,...

Cierre de orejuela izquierda

Single Antiplatelet Therapy Following Percutaneous Left Atrial Appendage Occlusion

Percutaneous left atrial appendage occlusion (LAAO) has surged as an effective alternative to treat patients with atrial fibrillation (AF) presenting counterindications for oral anticoagulants. However, the optimal antithrombotic treatment after LAAO is still debated, seeing as it should prevent device related thrombosis (DRT) while minimizing bleeding risk.  The aim of this retrospective study carried out...

Trombosis y riesgo de sangrado

WOEST 2 | Dual Versus Triple Antithrombotic Scheme in the Real World.

The WOEST study found a significant reduction in bleeding complications post PCI with oral anticoagulation indication (OAC) when treating patients with dual antiplatelet therapy (DAPT) vs. the triple antithrombotic scheme. Several randomized studies have shown these results. At present, the guidelines recommend using the triple antithrombotic scheme in patients according to ischemic and bleeding risk. ...

Fentanilo en la angioplatia: ¿Cuál es el precio de un mayor confort en el procedimiento?

TICO: Age Impacts the Effect of Antiplatelet Monotherapy

The higher the age, the greater the benefit of ticagrelor monotherapy vs. dual antiplatelet therapy (DAPT) in patients with acute coronary syndrome. This post hoc sub-analysis of the TICO study goes along the same lines as the TWILIGHT study (which we recently discussed), given that age is the most common reason for considering that a...

ARTE: ¿AsEl fin de la aspirina para los pacientes anticoagulados que reciben angioplastiapirina o aspirina más clopidogrel post TAVI?

HOST-EXAM: The Study that Challenges Aspirin as Long-Term Antiplatelet Therapy

The HOST-EXAM study (which was prospective, randomized, and open-label, with the participation of 37 Korean sites) was specifically designed to determine the role of aspirin as the long-term antiplatelet therapy of choice after angioplasty with current drug-eluting stents. To this end, the study compared aspirin head-to-head with clopidogrel. Over the course of four years, 5438 patients (mean...

¿Desescalar la doble antiagregación es el nuevo paradigma?

Dual Antiaggregation De-Escalation: A New Paradigm?

De-escalating dual antiaggregation could be the most effective strategy after acute coronary syndrome seeing as it prevents bleeding and cut down costs with no increase of ischemic events.  Balancing the effects of dual antiaggregation therapy (DAPT) in the era of potent P2Y12 inhibitors has become the cornerstone of acute coronary syndrome (ACS) management.  This meta-analysis...

Tasa de stroke post cirugía vs angioplastia coronaria en un análisis de más de 10.000 pacientes

How to Discontinue Antiplatelet Therapy Prior Non-Cardiac Surgery

Both the indication and discontinuation of antiplatelet therapy to balance ischemic-bleeding risks has been left to physician criterion.  However, leaving the decision to one single specialist might not be the best. This is when the team’s role becomes essential.  This study looked at the advantages consensus decision-making amongst clinicians, surgeons and anesthesiologists to continue or...

Esquema corto y monoterapia, una práctica llena de evidencia

Antiplatelet Therapy in Elderly Population: Are the New P2Y12 Inhibitors Safe?

Should elderly patients stick to clopidogrel? The first large study on prasugrel showed an unacceptable increase of bleeding in elderly patients, suggesting the use of 5 mg (although the sample size was small, which hindered the determination of dose efficacy). Later, ticagrelor showed better efficacy than clopidogrel without apparent safety concerns. However, specific evidence on elderly...

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