Most patients with atrial fibrillation require anticoagulation to reduce the risk of stroke or systemic embolization. Today, this is achieved with the new direct oral anticoagulants, which present lower intracranial bleeding risk compared against the old vitamin K antagonists. On the other hand, approximately between 5% to 10% of patients receiving PCI also present atrial...
Several clinical guidelines differ in their recommendation regarding the prescription of proton pump inhibitors to patients being treated with dual antiplatelet therapy after infarction. In 2015, the European Society of Cardiology (ESC) recommended their use in patients with high bleeding risk; however, in the 2017 update that recommendation became general after the assumption that, for...
This study attempts to test drug PB2452 for use in cases of catastrophic bleeding and, then, its potential use in other scenarios involving patients receiving ticagrelor. This specific ticagrelor reversal agent stops immediately and substantially the effect of the aforementioned P2Y12 receptor antagonist according to several test measurements conducted during this phase 1 trial in...
Aspirin is against the ropes: first, it was primary prevention; now, its use is being reconsidered even in relation to angioplasty. There might be paradigm changes as regards antiplatelet therapy after angioplasty. These two studies presented at the American College of Cardiology (ACC) 2019 Scientific Session can really change what we have been doing unquestioningly...
This work (presented during the same American College of Cardiology [ACC] 2019 Scientific Session as the STOPDAPT-2 trial) enrolled 2993 patients who underwent angioplasty with current-generation stents Xience, Promus, Synergy, or Orsiro at 33 Korean sites. Patients were randomized to 12 months of dual antiplatelet therapy or dropping aspirin at 3 months. There was no difference between the short-...
1- What Antiplatelet Therapy Should We Use in Patients with Stroke/TIA? Interesting Results for the POINT Trial The New England Journal of Medicine (NEJM) recently published an article about the POINT trial (simultaneously presented at the European Stroke Organisation Conference), a long-awaited randomized clinical trial to assess the efficacy and safety of dual antiplatelet therapy...
1- New High Blood Pressure Guidelines The wait is finally over: the high blood pressure guidelines that have been in the works for the past 3 years saw the light of day at the American Heart Association (AHA) 2017 Scientific Sessions. Read more 2- New European Hypertension Guidelines Contrast with American Recommendations The European...
Courtesy of Dr. Carlos Fava. PCI to saphenous vein grafts is one the greatest challenges these days because, as opposed to native arteries, they present important thrombolytic material, diffuse and long lesions, and abundant macrophage and inflammatory cells, which makes the procedure more complex. At present, we have not yet agreed on the best antiplatelet...
Transcatheter aortic valve replacement (TAVR) is more and more frequent in lower risk populations that had previously been treated with surgical valve replacement (SAVR). A small difference in neurological events could have significant consequences when it comes to deciding a course of action. This study is a sub-analysis of the randomized study SURTAVI (Surgical Replacement...
Polymer persistence in 1st and 2nd generation DES meant to allow drug release has been associated with a chronic inflammatory response that might be associated to restenosis, neo atherosclerosis and stent thrombosis. This is the rationale behind the development of polymer free and bioresorbable polymer-based DES. They have both been compared against permanent polymer DES,...