Original Title: Long-term tolerability of ticagrelor for secondary prevention: insights from PEGASUS-TIMI 54 trial. Presenter: Bonaca MP. The higher rate of premature discontinuation of ticagrelor vs placebo in the PEGASUS-TIMI 54 of stable outpatients with prior MI is attributed to more frequent dyspnea and bleeding, according to a new study. Among patients who tolerated therapy for...
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...
Bleeding Risk Estimation and the New (BARC) Definition of Bleeding Events Dr. Franz Weidinger
Bleeding Risk Estimation and the New (BARC) Definition of Bleeding Events Dr. Franz Weidinger
ACCOAST: pretreatment with prasugrel in non-ST elevation acute coronary syndrome (NSTE-ACS) offers no benefit and increased bleeding
P2Y12 receptor inhibitors are effective in patients experiencing NSTE-ACS, however, the administration timing is not clear. This study evaluated the administration of prasugrel at the time of diagnosis of ACS or after performing coronary angiography when angioplasty was already decided. 4033 patients were included experiencing an NSTE-ACS troponin positive who had planned angiography between 2...
POISE -2: Aspirin before a noncardiac surgery does not reduce the risk of death or myocardial infarction and increased bleeding.
There is great variability in the perioperative administration of aspirin (ASA) in patients undergoing noncardiac surgery, both those who had been receiving and those who not. This work included 10010 patients who planned to undergo noncardiac surgery and were randomized to aspirin versus placebo and clonidine versus placebo. Stratified according to whether they were receiving...
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...
HEAT PPCI: Bivalirudin raises major cardiac events and does not reduce bleeding. The most controversial and criticized study at the ACC 14.
This randomized trial of a single center with consent obtained after randomization compared the use of bivalirudin versus heparin with the use of glycoprotein inhibitors arescue only in patients having ST segment elevation myocardial infarction.The primary efficacy endpoint was a composite of death, stroke, and myocardial revascularization of the target lesion and the primary safety...
CHAMPION PHOENIX: Cangrelor compared with clopidogrel improves efficiency without increasing bleeding in patients undergoing angioplasty
Background: Oral antiplatelet agents have a limitation in their duration of action and bioavailability. Cangrelor is an intravenous adenosine diphosphate (ADP) inhibitor that has a powerful effect, is rapid and reversible within one hour and with the advantage of intravenous administration that reduces variability in the bioavailability of the drug. The study was designed to...
PRAGUE 14: Anti-thrombotic therapy before non-cardiac surgery may be associated with a higher incidence of bleeding.
The majority of coronary patients are under anti-thrombotic therapy and its interruption may increase cardiovascular risk, while on the other hand, continuation during a surgical procedure may increase the risk of bleeding. This study, which included 1211 patients who underwent non-cardiac surgery, compared the interruption of anti-thrombotic therapy at least 7 days prior vs continuing...
ACCOAST: Pretreatment with prasugrel showed no benefits and increased bleeding in patients with non-ST segment myocardial infarction.
This study evaluated the administration of prasugrel at the time of diagnosis of non-ST segment acute coronary syndrome vs administration at the time of the coronary angiography without indication of angioplasty. 4033 enrolled patients with non-ST segment acute coronary syndrome and positive troponin levels were randomized and who would undergo the angiography between 2 and...