A multicenter randomized study, (n = 573), that evaluated the role of aspirin in anticoagulated patients undergoing angioplasty. The primary endpoint was the rate of total bleeding, (TIMI), at 12 months follow-up. The administration of a dual therapy, (warfarin + clopidogrel), showed a significant reduction compared with the triple therapy, (19.5% vs. 44.9%, P <0.001)....
XIMA: Randomized prospective study comparing everolimus eluting stents versus conventional stent implantation in octogenarians.
Background: Octogenarian patients represent an increasingly growing population. In addition, this age group has a higher proportion of co-morbidities with more extensive and complex coronary disease. However, they have often been excluded from major studies, whose average age is usually 60 years. Despite having a more complex coronary anatomy, the role of pharmacological stent (DES)...
ADAPT-DES: Results at 1 year of the clinical impact of hypo-responders to aspirin and clopidogrel.
Background: The ADAPT-DES registry showed a strong correlation between hypo-responders to clopidogrel and the likelihood of stent thrombosis at 30 days, while the impact of aspirin response has not been evaluated so far. This presentation focuses on the aspirin response impact in the clinical course of one year. Methods and Results: A total of 8,583...
PC Trial: Clinical treatment or closure of patent foramen oval in cryptogenic stroke patients?
Background: The association between paradoxical embolism, including cryptogenic stroke, and the presence of patent foramen oval (PFO) has been found in previous clinical studies. However, the benefit of percutaneous PFO closure versus medical treatment is not clear, especially after the negative results of the randomized CLOSURE I trial. This study included patients with PFO and...
STEMI RADIAL A prospective, randomized trial which compares radial versus femoral access in patients with ST- segment elevation acute myocardial infarction.
Fundamentals: Previous studies have shown the benefits of a transradial approach in the context of coronary syndromes with ST-segment elevation. The aim of this study was to evaluate these benefits in AMI patients with ST-segment elevation within a window of up to 12 hours from the onset of symptoms. Methods: A randomized study conducted in...
AIDA STEMI MRI: Intracoronary versus intravenous abciximab in primary angioplasty. MRI analysis in AIDA study
Basics: Recent meta-analysis showed benefits of intracoronary abciximab administration compared with intravenous (A-EV). Although the AIDA study showed no such benefit when analyzing the combined endpoints of death, reinfarction and congestive heart failure, it did show a decrease of CHF in isolation over the group receiving intracoronary abciximab. This time, the study authors of AIDA...
TRILOGY ACS. Prasugrel versus clopidogrel in patients with acute coronary syndromes with non – ST segment elevation treated clinically after angiographic evaluation
Insides : 40%-60% of patients with acute coronary syndrome with non ST elevation (ACS) are treated clinically. Prasugrel proved superior to clopidogrel in patients with ACS undergoing invasive treatment (TRITON-TIMI 38). The TRILOGY ACS randomized multicenter trial assessed prasugrel and clopidogrel in patients with ACS treated clinically. Study results were neutral and have already been...
TRILOGY Trial: First large scale test evaluating platelet function in acute coronary syndromes.
TRILOGY ACS which was presented at the ESC 2012 is a randomized, double blind study that included 10,300 patients and compared aspirin + cloplidogrel versus aspirin + prasugrel in patients admitted with acute coronary syndromes without ST-segment elevation and initially treated with a conservative strategy. The study concluded that the administration of prasugrel did not...
Artic Study: Bedside Platelet Function Monitoring to Reduce Events after DES Implantation .
Given the individual variability of response to antiplatelet therapies, measuring platelet function and designing tailored therapies could be beneficial. The ARTIC study tested the superiority of bedside platelet function monitoring with drug adjustment vs. the conventional post DES therapy without monitoring and drug adjustment. It included 2466 patients with stable coronary disease or Non-ST Elevation...
CABG off-pump, same results at one year-pump surgery.
The relative benefits and risks of off-pump coronary artery bypass grafting (CABG) as compared with the use of CBP are not clearly defined. The CORONARY trial in 79 centers randomized 4,752 patients in whom CABG was planned with or without CBP. There was no significant difference in the primary end point which was a composite...