Short dual antiplatelet therapy (DAPT) has shown benefits in patients receiving drug eluting stents (DES), reducing bleeding with no concomitant increase in major adverse cardiovascular events (MACE). Traditionally, the therapeutic window was limited to monotherapy with P2Y12 inhibitors during the first year and there are few data on short DAPT followed by long term monotherapy...
While the rate of stroke has decreased since the early days of transcatheter aortic valve replacement (TAVR), it remains non-negligible, reaching up to 1%-3% at 30 days. As TAVR progressively expands to low-risk populations and younger patients, identifying risk factors for patient selection and management in stroke prevention becomes crucial. While researchers have identified predictors...
The use of drug-coated balloons (DCB) offers the advantage of avoiding permanent stent implants, thus reducing the incidence of in-stent restenosis (ISR), neoatherosclerosis, and late in-stent thrombosis. Additionally, the use of DCB reduces the duration of dual antiplatelet therapy. Current evidence supports the use of DCB for ISR treatment (Class I) compared with drug-eluting stents...
While the benefits of dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 inhibitor are recognized, its primary complication is the occurrence of bleeding events, which negatively impact patient morbidity and mortality. Additionally, about 10% of patients undergoing percutaneous coronary intervention (PCI) are on oral anticoagulant therapy, which significantly increases the risk of bleeding when...
This was a randomized study including patients at high risk of bleeding treated with short dual antiplatelet therapy (DAPT). A total 747 patients were recruited, 368 received PCI with the ultrathin Superflex stent with 60 µm struts (SUF), and 364 received the Terumo Tansei with 89 µm struts (SF). Primary end point was NACE at...
This is a multicenter randomized study including 2,850 patients with acute coronary syndrome. Patients were randomized to: dual antiplatelet therapy (DAPT) with ASA and ticagrelor during one month (1,426 patients), followed by ticagrelor monotherapy for 12 months, while the other group received DAPT with ASA and ticagrelor during 12 months (1,424 patients). This study was...
In the TVT registry, around 40% of the patients eligible for transcatheter aortic valve replacement (TAVR) had atrial fibrillation, and there were high levels of adverse events after starting anticoagulant treatment, especially with oral anticoagulants (VKAs), primarily due to bleeding. The purpose of this study was to assess the feasibility, safety, and efficacy of combined...
Despite stroke rate has declined since the early days of transcatheter aortic valve replacement (TAVR), it remains significant, reaching 1% to 3% 30 days after procedure. Since TAVR has seen a progressive expansion to the low risk and young populations, identifying risk factors in patient selection and management is crucial for us to prevent stroke. ...
The transcatheter treatment of patent foramen ovale (PFO) has been shown to reduce thromboembolic events in patients with cryptogenic stroke. However, most of large randomized studies have failed to include patients with thrombophilia, either inherited or acquired. For instance, the RESPECT study excluded patients with antiphospholipid antibodies (AFA) or hyperhomocysteinemia, while the REDUCE screened for...
An increasing number of patients currently present both an elevated ischemic risk and hemorrhagic risk. This means that the selection of the optimal antiplatelet treatment is a clinical challenge. Several studies have shown that P2Y12 monotherapy after minimum dual antiplatelet therapy (DAPT) is a novel strategy to reduce bleeding risk without increasing ischemic risk. Furthermore,...