Differences in patient characteristics, changes in treatment algorithms, and advances in device technology, together or separately, might limit the applicability of older randomized trials to contemporary clinical practice. In this case, we look at patients and devices used in the contemporary clinical practice vs. those in the EXTEND DAPT. These differences were associated with attenuated…
TICO: Age Impacts the Effect of Antiplatelet Monotherapy
The higher the age, the greater the benefit of ticagrelor monotherapy vs. dual antiplatelet therapy (DAPT) in patients with acute coronary syndrome. This post hoc sub-analysis of the TICO study goes along the same lines as the TWILIGHT study (which we recently discussed), given that age is the most common reason for considering that a…
ESC 2019 | POPULAR AGE: Good Old Clopidogrel Still Valid
According to this study, presented during the ESC 2019 scientific sessions, non-ST acute coronary syndrome (NSTE-ACS) patients treated with ticagrelor presented a significantly higher risk of bleeding than patients treated with clopidogrel, with no counterbalance by higher benefit in thrombotic events. Researchers suggest clopidogrel might be the gold standard for this elderly NSTE-ACS population, though…
Permanent Carotid Coil Filters in Patients with Atrial Fibrillation
This new strategy to reduce the risk of stroke in patients with atrial fibrillation is technically feasible and safe, even though long-term outcomes are yet to be seen and despite the evidence available, for instance, left atrial appendage closure devices. It is true that they could be used simultaneously, but its synergy and cost have…
New Percutaneous Devices to Prevent Embolism in Atrial Fibrillation
Patients with atrial fibrillation (AF) unsuitable for anticoagulation because of bleeding risk, require other strategies to prevent stroke. For some years, there have been in the market (limited to some places; not as part of the regular agenda of cardiologists and hematologists) devices to occlude the atrium that have been proved safe and effective. These…
Balancing Bleeding Risk vs. Thrombotic Risk to Define Dual Antiplatelet Therapy Duration
Patients who undergo complex angioplasty are at higher ischemic risk, but only benefit from extended dual antiplatelet therapy if there are no factors for high bleeding risk. These data suggest that the bleeding risk must weigh more than the ischemic risk on the determination of dual antiplatelet therapy duration. Complex angioplasty is associated with higher…