The PARIS registry was a prospective observational study in 5018 patients undergoing coronary angioplasty with stent implantation in 15 centers. Three categories were prespecified in the discontinuation of dual antiplatelet therapy: 1) discontinuation for medical guidance, 2) transient discontinuation for less than 15 days for surgery and 3) permanent abandonment of it by non-adherence or...
Bivalirudin superior than heparin beyond the use or not of Glycoprotein inhibitors
Bivalirudin benefits in bleeding events versus heparin plus glycoprotein IIbIIIa inhibitors is clear even though this benefit has not been fully studied at the point whether persists when glycoprotein inhibitors are used only for rescue and not routinely. This is an EUROMAX sub-analysis that included 2198 patients experiencing AMI analyzing events at 30 days. Bivalirudin...
Safety and efficacy of Cardiobrand device for percutaneous mitral annuloplasty
The Cadiobrand device is implanted through a transseptal approach and makes a reduction in the mitral annulus area. The study included 24 patients with moderate mitral regurgitation (functional class III- IV) and high surgical risk. The device was successfully implanted in all cases reducing the annular size by 92 % and to the same extent...
BLESS: assessment of platelet reactivity in patients undergoing angioplasty receiving prasugrel.
The aim of this study was to evaluate the modification in residual platelet reactivity by adjusting the prasugrel dose from 10 mg to 5 mg after the acute phase (1 month) of ACS. 450 patients were included receiving a loading dose of 60 mg followed by a month of 10 mg of prasugrel and randomized...
ALECARDIO Trial: Aleglitazar associated with severe adverse events in diabetic patients with acute coronary syndrome
This randomized, double-blind, placebo-controlled, multicenter work evaluated the potential cardiovascular reduction risk and the long-term safety profile of Aleglitazar, compared with placebo in patients with type 2 diabetes experiencing an acute coronary syndrome. A total of 7226 patients were randomized at 12 weeks post-acute coronary event to receive Aleglitazar 150 ug or placebo. The study...
COAG Trial: Dose of warfarin and Pharmacogenetics
Observational studies identified two genes that influence the dose of warfarin (CYP2C9 and VKORC1). The clinical utility of dose adjustment by genetics has been tested only in small studies with conflicting results. In this multicenter, double-blind randomized 1015 patients comparing strategy initiation of therapy using only clinical information versus using patient’s genotype. The primary endpoint...
CoreValve superior to surgical aortic valve replacement in high-risk patients
The aim of this study was to compare percutaneous aortic valve replacement (TAVR) with the self-expanding Valve Core with conventional surgery in patients at high surgical risk. Patients with a valve area < 0.8 cm2 , valvular index ≤ 0.5 cm2 , a mean gradient of > 40 mmHg or peak speeds above 4m /s...
CHOICE Trial: Same mortality, less aortic regurgitation and need for a second prosthetic for Edwards Sapien XT valve versus Medtronic CoreValve
So far, there had been no published randomized studies comparing balloon-expandable Edwards’s prosthesis and self-expandingCoreValve. The aim of this study was to compare the results between the two thin aortic prosthesis in high-risk surgical patients with severe symptomatic aortic stenosis undergoing valve replacement by percutaneous transfemoral access. This was a multicenter work (five centers in...
STREAM Trial: Pharmacological-invasive strategy versus primary angioplasty
The STREAM study (Strategic Reperfusion Early After Myocardial Infarction) that included 1891 patients gave support to the fibrinolytic infusion strategy in the ambulance in patients treated within 3 hours of stroke and who cannot receive primary angioplasty within the hour versus primary angioplasty. The primary end point was a composite of death from any cause,...
ENGAGE AF-TIMI 48: Endoxaban versus warfarin in atrial fibrillation
The endoxaban is an oral direct inhibitor of factor Xa with a rapid onset of action and a half-life of 8-10 hours. Endoxaban efficacy and safety for long-term versus warfarinin patients with atrial fibrillation was not studied. This was a randomized, double-blind study that compares two different regimes of endoxaban with warfarin in 21105 patients...