The use of vitamin K antagonists provides excellent protection against thromboembolic complications in patients with mechanical valves, however long-term INR monitoring is needed. Dabigatran is an oral direct thrombin inhibitor which was shown to be effective in patients with atrial fibrillation. Based on these promising results this study was designed to evaluate its use in...
Reference: Circulation. 2012; 125:1424–143 Abstract: For many years all efforts applied to the optimization of percutaneous coronary intervention (PCI) were aimed specifically at reducing ischemic events risk through the advent of: 1) new devices (medicated stents), reducing restenosis rates, revascularization and 2) development of new drugs with a potent anti-platelet or anticoagulant such as clopidogrel or,...
Original title: Baseline bleeding risk and arterial access site practice in relation to procedural outcomes after percutaneous coronary intervention. Presenter: Mamas A. Mamas et al. J Am Coll Cardiol. 2014;64:1554-1564. The transradial approach has been associated with reduced access site related bleeding complications as well as a reduced mortality in the context of PCI. It seems...
Original title: Bivalirudin versus heparin in patients treated with percutaneous coronary Intervention: a meta-analysis of randomised trials. Reference: Salvatore Cassese et al. EuroIntervention 2014;10-online publish-ahead-of-print August 2014. Current recommendations for the use of bivalirudin in PCI patients are mostly based on studies comparing bivalirudin vs. heparin combined with glycoprotein IIb/IIIa inhibitors. Whether bivalirudin is superior to heparin alone...
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...
Original title: Bivalirudin or heparin in primary angioplasty performed through the transradial approach: results from a multicentre registry. Reference: Sciahbasi A et al. Eur Heart J: Acute Cardiovasc Care. Epub ahead of print. Bivalirudin benefit has been demonstrated in terms of bleeding; however when primary angioplasty is performed by radial access this information is not clear. To get...
Original title: Reduction in Cardiac Mortality with Bivalirudin in Patients With and Without Major Bleeding: The HORIZONS-AMI Trial. Reference: Gregg W. Stone et al. J Am Coll Cardiol. Epub ahead of print The HORIZONS -AMI study included 3602 patients experiencing ST segment elevation myocardial infarction received primary angioplasty, resulting in lower mortality at 30 days and three years...
Original title: Impact of Periprocedural Bleeding on Incidente of Constrast-Induced Acute Kidney Injury in patients treated with Percutaneous Coronary Intervention. Reference: Yohei Ohno, et al. J Am Coll Cardiol 2013;62:1260-6 Contrast induced acute kidney injury (CI-AKI) is a serious complication associated to higher morbimortality rates and higher costs, but its correlation to bleeding remains controversial. This study included...
Original title: Comparison of bivalirudin and radial access across a spectrum of preprocedural risk of bleeding in percutaneous coronary intervention: Analysis from the National Cardiovascular Data Registry. Reference: Baklanov DV et al. Circ Cardiovasc Interv. 2013, article in press. Bleeding complications are clearly associated to mortality increase and two of the current best strategies to reduce bleeding are...
Original title: Pre-Procedural Estimate of Individualized Bleeding Risk Impacts Physicians’ Utilization of Bivalirudin During Percutaneous Coronary Intervention. Reference: Seshu C. Rao et al. J Am Coll Cardiol 2013;61:1847–52 While safety of coronary angioplasty has improved over time, post-procedure bleeding is still frequent with a large variability between centers. Bleeding is associated with increased mortality, myocardial infarction, stroke, increased...