Cangrelor is an intravenous P2Y12 inhibitor approved to reduce peri-procedural ischemic events in patients undergoing PCI that have not previously received any other P2Y12 inhibitor. The CHAMPION PHOENIX trial randomized a total of 11,145 patients to cangrelor vs. clopidogrel. The study sought to explore the effect of cangrelor on peri-procedural acute myocardial infarction…
STEMI: Best P2Y12 inhibitor according to network meta-analysis
Original Title: Optimal P2Y12 inhibitor in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention: a network meta-analysis. Reference: Rafique AM et al. J Am Coll Cardiol Intv 2016;9:1036–46. Courtesy of Dr. Alejandro Lakowsky. Researchers drew up a network meta-analysis incorporating 37 trials with more than 88,000 patients undergoing ST elevation…
Optimal Duration of Dual Antiplatelet Therapy: New ACC-AHA Guidelines
Original Title: 2016 ACC/AHA Guideline Focused Update on Duration of Dual Antiplatelet Therapy in Patients with Coronary Artery Disease. Reference: Levine GN et al. Circulation. 2016 Mar 29. [Epub ahead of print]. Courtesy of Dr. Alejandro Lakowsky. The new ACC-AHAGuidelines on the optimal duration of dual antiplatelet therapy(DAPT) in patients with coronary artery disease have just been…
Ticagrelor vs Clopidogrel in low risk coronary syndrome
Original Title: Effects of Ticagrelor versus Clopidogrel in Troponin-Negative Patients With Low-Risk ACS Undergoing Ad Hoc PCI. Reference: Dominick J et al. J Am Coll Cardiol. 2016;67(6):603-613. Many patients admitted with low-risk acute coronary syndrome (ACS) are not pre-treated with a P2Y12 receptor inhibitors despite the invasive strategy in place, with angiography and PCI in the…
Different Thienopyridine Loading Strategies to Get the Fastest Effect
Original Title: Randomized Comparison of Different Thienopyridine Loading Strategies in Patients Undergoing Elective Coronary Intervention. The Excelsior LOAD Trial. Reference: Willibald Hochholzer et al. J Am Coll Cardiol Intv. 2016, online before print. This study assesses how to provide a more rapid antiaggregant effect. It compares the effect of a prasugrel load vs. a 600…
Aspirin or Clopidogrel as Monotherapy after 12 month DAPT
Original Title: Clopidogrel versus Aspirin as an Antiplatelet Monotherapy after 12-Month Dual-Antiplatelet Therapy in the Era of Drug-Eluting Stents. Reference: Taek Kyu Park et al. Circ Cardiovasc Interv. 2016 Jan;9(1):e002816. Courtesy of Dr. José Amadeo Guillermo Álvarez. The use of dual antiplatelet therapy (DAPT) over 12 months after hospitalization for acute myocardial infarction (AMI) or drug…
Triple Antithrombotic Scheme in AMI Patients undergoing PCI
Original Title: Outcomes of Patients with Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention Receiving an Oral Anticoagulant and Dual Antiplatelet Therapy, a Comparison of Clopidogrel vs. Prasugrel from the TRANSLATE-ACS Study. Reference: Jackson L.R. et al. JACC Cardiovasc Interv. 2015 Dec 21;8(14):1880-9. Courtesy of Dr Agustín Vecchia. In these last years, new and more powerful antiaggregants have…
ADAPT-DES: Proton Pump Inhibitors and Clopidogrel in Patients with DES
Original Title: Proton Pump Inhibitors, Platelet Reactivity, and Cardiovascular Outcomes After Drug-Eluting Stents in Clopidogrel-Treated Patients. The ADAPT-DES Study. Some proton pump inhibitors interfere with clopidogrel metabolism and could attenuate P2Y12 reception. Prior observational and randomized studies have reported contradicting results on the clinical significance of this drug interaction. The aim of this trial was…
Prasugrel in the Treatment of Clopidogrel Nonresponders Undergoing PCI
Original Title: Prasugrel in Clopidogrel Nonresponders Undergoing Percutaneous Coronary Intervention (RECLOSE-3 study). Reference: Valenti R, et al. JACC Cardiovasc Interv. 2015 Oct;8(12):1563-70. Clopidogrel Nonresponders have higher risk of adverse events (cardiovascular death and stent thrombosis) compared to responders. Studies published so far have failed to demonstrate the use of platelet function tests in ACS patient…
Meta-analysis of prolonged DAT after DES
Extending the antiaggregation therapy over a year reduces adverse events in patients with a history of AMI, according to this meta-analysis simultaneously published in the European Heart Journal. They analyzed data from 33.435 patients (mean age 64; 24% women) with a history of infarction included in one of the following clinical trials: CHARISMA, PRODIGY, ARCTIC-Interruption,…