Association of diabetes with outcomes in patients undergoing contemporary percutaneous coronary intervention: Pre-specified subgroup analysis from the randomized GLOBAL LEADERS study

Diabetes has been well recognized as a strong predictor for adverse outcomes after percutaneous coronary intervention (PCI), however, studies in the era of drug-eluting stent and potent P2Y12 inhibitors have shown conflicting results. We aimed to assess ischemic and bleeding outcomes after contemporary PCI according to diabetic status.
Source: Atherosclerosis - Category: Cardiology Authors: Source Type: research

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Publication date: Available online 22 January 2020Source: Nutrition, Metabolism and Cardiovascular DiseasesAuthor(s): Giuseppe De Luca, Monica Verdoia, Stefano Savonitto, Luca A. Ferri, Luigi Piatti, Daniele Grosseto, Nuccia Morici, Irene Bossi, Paolo Sganzerla, Giovanni Tortorella, Michele Cacucci, Maurizio Ferrario, Ernesto Murena, Girolamo Sibilio, Stefano Tondi, Anna Toso, Sergio Bongioanni, Amelia Ravera, Elena Corrada, Matteo MarianiAbstractBackgroundElderly patients are at increased risk of hemorrhagic and thrombotic complications after an acute coronary syndrome (ACS). Frailty, comorbilities and low body weight hav...
Source: Nutrition, Metabolism and Cardiovascular Diseases - Category: Nutrition Source Type: research
Authors: Parker WAE, Storey RF Abstract Aspirin and P2Y12 inhibitors remain commonly prescribed antiplatelet drugs in the treatment of atherothrombotic conditions. Despite established benefits of dual antiplatelet therapy (DAPT) in the setting of acute coronary syndromes, there remains residual ischemic risk in this group and the problem of bleeding complications is an ongoing issue. DAPT with aspirin and ticagrelor has now been studied in other patient groups such as those with concurrent diabetes and stable coronary artery disease, and those undergoing elective percutaneous coronary intervention (PCI). Recent tri...
Source: Platelets - Category: Hematology Tags: Platelets Source Type: research
ConclusionsIn this observational analysis of STEMI patients who underwent primary percutaneous coronary intervention, ticagrelor was associated with improved outcomes compared with clopidogrel and prasugrel. An appropriately powered randomized trial is needed to confirm these findings.RésuméContexteIl n’existe pas d’analyse robuste comparant les inhibiteurs P2Y12 à prise orale (clopidogrel, prasugrel et ticagrélor) chez les patients ayant subi un infarctus du myocarde avec élévation du segment ST (STEMI) traités par une intervention coronaire percutanée (I...
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
AbstractDirect oral anticoagulants (DOACs) include dabigatran, which inhibits thrombin, and apixaban, edoxaban, and rivaroxaban, which inhibit factor Xa. They have been extensively studied in large trials involving patients affected by the most common cardiovascular diseases. As the presence of diabetes leads to peculiar changes in primary and secondary hemostasis, in this review we highlight the current evidence regarding DOAC use in diabetic patients included in the majority of recently conducted studies. Overall, in trials involving patients with atrial fibrillation, data seem to confirm at least a similar efficacy and ...
Source: Acta Diabetologica - Category: Endocrinology Source Type: research
Publication date: Available online 1 September 2019Source: The LancetAuthor(s): Deepak L Bhatt, Philippe Gabriel Steg, Shamir R Mehta, Lawrence A Leiter, Tabassome Simon, Kim Fox, Claes Held, Marielle Andersson, Anders Himmelmann, Wilhelm Ridderstråle, Jersey Chen, Yang Song, Rafael Diaz, Shinya Goto, Stefan K James, Kausik K Ray, Alexander N Parkhomenko, Mikhail N Kosiborod, Darren K McGuire, Robert A HarringtonSummaryBackgroundPatients with stable coronary artery disease and diabetes with previous percutaneous coronary intervention (PCI), particularly those with previous stenting, are at high risk of ischaemic even...
Source: The Lancet - Category: General Medicine Source Type: research
Authors: Liu Y, Ding LY, Li XZ Abstract OBJECTIVE: To investigate the protective effect of ticagrelor on the myocardium of patients with ST-elevated acute coronary syndrome accompanied by diabetes mellitus. PATIENTS AND METHODS: 210 patients with diabetes mellitus receiving emergency percutaneous coronary intervention (PCI) due to ST-elevated acute coronary syndrome from December 2014 to June 2018 in the Hospital were selected and randomly divided into ticagrelor group and clopidogrel group. The myocardial microcirculation perfusion was evaluated via ST-segment elevation resolution (STR) in electrocardiogram (E...
Source: European Review for Medical and Pharmacological Sciences - Category: Drugs & Pharmacology Tags: Eur Rev Med Pharmacol Sci Source Type: research
Publication date: August 2019Source: Canadian Journal of Cardiology, Volume 35, Issue 8Author(s): Lucas C. Godoy, Patrick R. Lawler, Michael E. Farkouh, Bronwyn Hersen, José C. Nicolau, Vivek RaoAbstractThe prevalence of diabetes mellitus (DM) is rising globally and in Canada. Besides being a risk factor for the development of coronary artery disease, DM is also a marker of poor prognosis in patients with acute coronary syndrome (ACS), increasing the risks for ischemic and bleeding complications. Patients with DM have a high prevalence of multivessel coronary artery disease (MVD) and robust evidence has supported co...
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
Publication date: Available online 31 May 2019Source: Journal of the Saudi Heart AssociationAuthor(s): Leia Hee, Oliver J. Gibbs, Joseph G. Assad, Lokesh D. Sharma, Andrew Hopkins, Craig P. Juergens, Sidney Lo, Christian J. MussapAbstractObjectivesThe primary aim was to investigate the efficacy and safety of dual antiplatelet therapy (DAPT) using ticagrelor (T-DAPT) versus clopidogrel (C-DAPT) in a real-world ST-elevation myocardial infarction (STEMI) population.MethodsWe retrospectively analyzed 655 consecutive patients having primary percutaneous coronary intervention (PCI) for STEMI at Liverpool Hospital, Sydney, Austra...
Source: Journal of the Saudi Heart Association - Category: Cardiology Source Type: research
CONCLUSION: Thirty days post PCI, IC tirofiban was more efficient in ameliorating blood flow in the coronary arteries and myocardial tissue perfusion in DM patients after STEMI despite bleeding events, and MACE rates showed no significant difference between the groups. The IC group showed better improvement in LVEF. PMID: 31194213 [PubMed - as supplied by publisher]
Source: Cardiovascular Journal of Africa - Category: Cardiology Authors: Tags: Cardiovasc J Afr Source Type: research
Purpose of review The purpose of this review is to summarize the existing evidence for use of long-term antiplatelet therapies for primary and secondary prevention of adverse cardiovascular events. Recent findings In the setting of primary prevention, several contemporary trials have shown a lack of net clinical benefit with use of aspirin across different patient groups, including those with diabetes mellitus, older age or high estimated cardiac risk. For secondary prevention, the addition of either ticagrelor or low-dose rivaroxaban to aspirin monotherapy significantly lowered recurrent vascular events, albeit with ...
Source: Current Opinion in Cardiology - Category: Cardiology Tags: CLINICAL TRIALS: Edited by Neal S. Kleiman Source Type: research
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