The 1-month outcomes of dual antiplatelet therapy (DAPT) followed by clopidogrel monotherapy were comparable to 12-month DAPT in patients with both simple and complex PCI. There was no significant interaction between DAPT period and procedure difficulty. This is a post hoc study of the STOPDAPT-2 that looked at the complex PCI patient subgroup. It is…
ACC 2021 | HOST-EXAM: Clopidogrel vs ASA monotherapy post DAPT in PCI patients
Clopidogrel monotherapy after dual antiplatelet therapy (DAPT) was associated with reduced mortality, MI, stroke, and other events in patients receiving PCI compared against aspirin monotherapy (ASA). This information was provided by the Korean HOST-EXAM study, presented at ACC 2021 scientific sessions, and simultaneously published in the Lancet. Researchers followed patients for 2 years and observed…
ACC 2021 | TALOS-AMI: De-escalating from Ticagrelor to Clopidogrel after One Month
After one-month dual antiplatelet therapy (DAPT) with aspirin and ticagrelor, a net clinical benefit was observed when de-escalating to clopidogrel in acute myocardial infarction (AMI) patients treated with PCI. We have discussed the pros and cons of de-escalating from a potent antiplatelets Such as ticagrelor to clopidogrel since the TOPIC presented at EuroPCR in 2017. What…
Back to Basics: Ticagrelor Questioned and Clopidogrel in the Limelight
Yet another observational study has come to question the antiaggregation power of ticagrelor when it comes to death or MI reduction, pointing at its higher risk of bleeding vs. clopidogrel. This new analysis recently published in JAHA includes a large number of patients undergoing acute coronary syndrome (ACS) in the clinical practice. Ticagrelor has been…
Ticagrelor: Yet Another Pleiotropic Effect?
Studies in animals have shown ticagrelor offers better myocardial protection against reperfusion injury after ST elevation MI than clopidogrel. This had to be tested in the clinical arena, which is the aim of this study (published in JACC Intv): to assess left ventricular remodeling after reperfusion. The study included patients undergoing their first ST elevation…
Diabetes and Peripheral Vascular Disease: Old Drugs, New Evidence
This paper, recently published in JAHA, showed that patients with type 2 diabetes mellitus exhibiting lower-limb vascular disease benefit from combining cilostazol and clopidogrel. Treatment for at least 6 months with clopidogrel (75 mg/QD) plus cilostazol (100 mg/BID) significantly reduces ischemic events—including stroke, infarction, and death from vascular causes—compared with clopidogrel monotherapy. Adding cilostazol reduces ischemic events, but that…
The most relevant articles in pharmacology in 2020
In this selection, we summarize for you the most important scientific news of 2020 in the field of pharmacology. 01- Virtual ACC 2020 | Colchicine After Infarction: Good Results and Cost-Effectiveness Low doses of colchicine reduce the risk of ischemic events after an acute myocardial infarction, according to the COLCOT trial, originally presented at the…
AHA 2020 | Clopidogrel Resists as the Best Option in Elective Patients
High risk patients undergoing elective PCI treated with a more potent antiplatelet scheme (ticagrelor) vs. the classic clopidogrel do not see a benefit in protection against periprocedural events and instead see increased costs and minor bleeding rate. These are the outcomes of the ALPHEUS study presented at AHA 2020 simultaneously published in the Lancet. Ticagrelor…
Antiplatelet Therapy in Elderly Population: Are the New P2Y12 Inhibitors Safe?
Should elderly patients stick to clopidogrel? The first large study on prasugrel showed an unacceptable increase of bleeding in elderly patients, suggesting the use of 5 mg (although the sample size was small, which hindered the determination of dose efficacy). Later, ticagrelor showed better efficacy than clopidogrel without apparent safety concerns. However, specific evidence on elderly…
Virtual ACC 2020 | POPULAR TAVR: Post TAVR Anticoagulation without Clopidogrel?
In patients undergoing transcatheter aortic valve replacement (TAVR) that also required anticoagulation for another indication (mostly atrial fibrillation), the incidence of major bleeding between month 1 and 12 was lower in those receiving only anticoagulation instead of anticoagulation + clopidogrel. The present study presented as part of the scientific sessions at the virtual ACC 2020,…