Short Dual antiplatelet therapy (DAPT), one to three months, followed by P2Y12 inhibitor monotherapy has been shown to reduce bleeding events without increased cardiovascular events vs. standard DAPT, according to guidelines. However, the rate of major bleeding within the first month after procedure remains significant when using these strategies. The use of aspirin-free therapies (ASA)…
Safety and Efficacy of Ticagrelor Monotherapy According to BMI
Obesity is growing dramatically around the world, regardless of income. For instance, 53% of US adults are obese, and 53% of people in the EU are overweight. The actual impact of elevated body mass index (BMI) in antiaggregation safety and efficacy, being it DAPT or SAPT, has not yet been properly looked at. This is…
Heparin Pretreatment in STEACS Treatment: A New Old Ally?
The treatment of ST-segment elevation acute coronary syndromes (STEACS) is undoubtedly reperfusion therapy with primary percutaneous coronary intervention. Similarly, nobody doubts that the pretreatment with more stronger antiplatelet agents has a role in such a treatment. In certain sites, unfractionated heparin (UFH) pretreatment is also administered before the patient enters the cath lab; its aim…
Dr. Marco Valgimigli Presented the Outcomes of MASTER-DAPT in a New SOLACI Webinar
Re-watch our webinar on “New Evidence in the Treatment of HBR Patients: Balance of Ischemic and Bleeding Risks” on our YouTube channel. During the event, Dr. Marco Valgimigli, principal investigator of the MASTER DAPT trial, shared the main outcomes of that study and had an interesting academic debate with Drs. Anibal Damonte (ARG), Mario Araya…
XIENCE SHORT DAPT | Ideal DAPT Period for Patients at High Risk of Bleeding
In patients at high risk of bleeding undergoing coronary stenting with a Xience stent, 1-to-3-month DAPT period resulted non-inferior to a 6-to-12-month period in terms of ischemic events, and this could be associated to a lower rate of major bleeding and lower stent thrombosis incidence. There is no longer an indication for conventional stents in…
How to Discontinue Antiplatelet Therapy Prior Non-Cardiac Surgery
Both the indication and discontinuation of antiplatelet therapy to balance ischemic-bleeding risks has been left to physician criterion. However, leaving the decision to one single specialist might not be the best. This is when the team’s role becomes essential. This study looked at the advantages consensus decision-making amongst clinicians, surgeons and anesthesiologists to continue or…
The FDA Approves Ticagrelor for Primary Prevention in High Risk Patients
The FDA has approved the indication of ticagrelor as primary prevention in high risk CAD patients with no history of MI or stroke. The lab producing ticagrelor has informed the FDA has based this decision on the THEMIS study, which included nearly 20,000 patients with stable CAD and type 2 diabetes. This decision has come…
AHA 2019 | TWILIGHT: Discontinue Aspirin after Acute Coronary Syndrome
This study findings confirm less bleeding at no extra cost of thrombotic events when aspirin is discontinued after an acute coronary syndrome (ACS). In the same line as the original TWILIGHT, this study focused on ACS patients alone (excluding STEMI) and confirmed that aspirin discontinuation after 3-month DAPT to continue with ticagrelor alone, reduced the…
TCT 2019 | TWILIGHT: Minimal DAPT in High Bleeding Risk Patients
Courtesy of the SBHCI. Monotherapy with a P2Y12 inhibitor after a minimum period (3 months) of dual antiplatelet antiaggregation (DAPT) is a valid treatment option to reduce bleeding in patients at high risk of bleeding complications. The present double-blind study presented at TCT 2019 simultaneously published in NEJM analyzed ticagrelor monotherapy (prior 3 months DAPT)…
ESC 2019 | ISAR-REACT 5 | Which Is Better in ACS, Prasugrel or Ticagrelor?
Courtesy of Dr. Carlos Fava. The benefit of dual antiplatelet therapy in acute coronary syndromes (ACS) has been proven long ago, and both prasugrel and ticagrelor have offered best results than clopidogrel. However, nowadays, it is unclear which of them is superior in the long term, taking into account the fact that one starts to…
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