Editorial Read article William Weintraub.2012-03-26
WOEST: Randomized trial that compared dual therapy versus triple therapy on anticoagulated patients.
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)....
POST trial: Post-conditioning effect in myocardial reperfusion with primary angioplasty.
Ischemic postconditioning obtained through reversible ischemia and reproduced during reperfusion after a prolonged ischemic injury has shown comparable effects to ischemic preconditioning in preclinical phase. A study in humans showed a reduction in serum markers of AMI thanks to Ischemic postconditioning in the context of primary angioplasty. Different MRI studies showed conflicting results regarding the...
SWISS AMI: Stem cells infusion after primary angioplasty
The trial enrolled 200 patients post AMI treated with successful PCI, with LVEF ≤45% randomized to placebo, to receive early (before 7 days) or late (after 7 days) stem cells infusion. Primary end point was LVEF at 4 months. At follow up, stem cells infusion, both early and late, did not improve LVEF, compared to...
FAME 2: Cost-effectiveness of FFR-guided angioplasty in patients with stable angina
Introduction: FAME study 2, presented at the European Congress of Cardiology 2012, is a multicenter study that randomized patients with stable angina FFR-guided angioplasty and optimal medical therapy versus optimal medical therapy alone. The study was stopped early due to a significantly higher rate of primary endpoints, (death, MI, or urgent revascularization), in the conservative...
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...
CHAMPION PHOENIX: Cangrelor compared with clopidogrel improves efficiency without increasing bleeding in patients undergoing angioplasty
Background: Oral antiplatelet agents have a limitation in their duration of action and bioavailability. Cangrelor is an intravenous adenosine diphosphate (ADP) inhibitor that has a powerful effect, is rapid and reversible within one hour and with the advantage of intravenous administration that reduces variability in the bioavailability of the drug. The study was designed to...
SELECT ACS: The Inclacumab seems to reduce myocardial injury post angioplasty
P-selectin is an adhesion molecule involved in the interactions between endothelial cells, platelets and leukocytes. Inclacumab is a recombinant monoclonal antibody against P-selectin, a potential anti-inflammatory, anti-thrombotic and anti-atherogenic. The objective of the SELECT-ACS was to evaluate whether Inclacumab could reduce myocardial damage during percutaneous coronary intervention (PCI) in patients with non-ST elevation myocardial infarction...
STREAM trial: It is time to check out facilitated angioplasty?
It is not clear so far whether pre-hospital fibrinolysis with early angiography could provide a clinical outcome similar to primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI). This study included 1,892 patients who presented within three hours of symptom onset and who could not undergo primary angioplasty within the first hour. Patients were...
SCAAR: Heparin versus bivalirudin in patients with myocardial infarction without ST segment elevation.
We evaluated 41,537 patients admitted with myocardial infarction without ST elevation on the SCAAR register and who had not received IIBIIIB glycoprotein inhibitors and divided them into two groups: 31,351 patients who received heparin versus 10,186 who received bivalirudin. We adjusted baseline characteristics of the two groups using the Propensity score with the exception of...