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An Open-label, 2 x 2 Factorial, Randomized Controlled Trial to Evaluate the Safety of Apixaban vs. Vitamin K Antagonist and Aspirin vs. Placebo in Patients with Atrial Fibrillation and Acute Coronary Syndrome and/or Percutaneous Coronary Intervention: Rationale and Design of the AUGUSTUS Trial
Publication date: Available online 9 March 2018 Source:American Heart Journal Author(s): Renato D. Lopes, Amit N. Vora, Danny Liaw, Christopher B. Granger, Harald Darius, Shaun G. Goodman, Roxana Mehran, Stephan Windecker, John H. Alexander The optimal antithrombotic strategy for patients with atrial fibrillation (AF) who develop acute coronary syndrome (ACS) and/or the need for percutaneous coronary intervention (PCI) is uncertain. The risk of bleeding is a major concern when oral anticoagulation is required to prevent stroke and concomitant therapy with antiplatelet agents is required to minimize recurrent ischemic even...
Source: American Heart Journal - March 10, 2018 Category: Cardiology Source Type: research

An open-Label, 2 × 2 factorial, randomized controlled trial to evaluate the safety of apixaban vs. vitamin K antagonist and aspirin vs. placebo in patients with atrial fibrillation and acute coronary syndrome and/or percutaneous coronary intervention: Rationale and design of the AUGUSTUS trial
Publication date: June 2018 Source:American Heart Journal, Volume 200 Author(s): Renato D. Lopes, Amit N. Vora, Danny Liaw, Christopher B. Granger, Harald Darius, Shaun G. Goodman, Roxana Mehran, Stephan Windecker, John H. Alexander Background The optimal antithrombotic strategy for patients with atrial fibrillation (AF) who develop acute coronary syndrome (ACS) and/or the need for percutaneous coronary intervention (PCI) is uncertain. The risk of bleeding is a major concern when oral anticoagulation is required to prevent stroke, and concomitant therapy with antiplatelet agents is required to minimize recurrent ischemic ...
Source: American Heart Journal - April 6, 2018 Category: Cardiology Source Type: research

Rationale and design of the EVOLVE short DAPT study to assess 3-month dual antiplatelet therapy in subjects at high risk for bleeding undergoing percutaneous coronary intervention
ConclusionThe EVOLVE Short DAPT study will prospectively define the safety of DAPT discontinuation at 3 months in high bleeding risk patients treated with the SYNERGY stent.
Source: American Heart Journal - August 17, 2018 Category: Cardiology Source Type: research

Addition of cilostazol to aspirin therapy for secondary prevention of cardiovascular and cerebrovascular disease in patients undergoing percutaneous coronary intervention: A randomized, open-label trial
Conclusions In patients who underwent coronary stent implantation, the addition of cilostazol to aspirin therapy was associated with lower rates of cardiovascular and cerebrovascular events at 2 years compared with aspirin monotherapy.
Source: American Heart Journal - January 12, 2016 Category: Cardiology Source Type: research

A randomized clinical trial comparing long-term clopidogrel versus aspirin monotherapy beyond dual antiplatelet therapy after drug-eluting coronary stent implantation: Design and rationale of the HOST-EXAM trial
Conclusions The HOST-EXAM will be the first large-scale randomized controlled study to directly compare the efficacy and safety of long-term antiplatelet monotherapy beyond DAPT after DES implantation. This study will provide clinical evidence to establish optimal regimen for long-term antiplatelet therapy after DES implantation.
Source: American Heart Journal - December 9, 2016 Category: Cardiology Source Type: research

A randomized clinical trial comparing long-term clopidogrel vs aspirin monotherapy beyond dual antiplatelet therapy after drug-eluting coronary stent implantation: Design and rationale of the Harmonizing Optimal Strategy for Treatment of coronary artery stenosis-Extended Antiplatelet Monotherapy (HOST-EXAM) trial
Conclusions The HOST-EXAM will be the first large-scale randomized controlled study to directly compare the efficacy and safety of long-term antiplatelet monotherapy beyond DAPT after DES implantation. This study will provide clinical evidence to establish optimal regimen for long-term antiplatelet therapy after DES implantation.
Source: American Heart Journal - December 20, 2016 Category: Cardiology Source Type: research

A Prospective, Randomized, Open Label Trial of 6Months vs. 12Months Dual Antiplatelet Therapy After Drug-Eluting Stent Implantation In ST-elevation Myocardial Infarction: Rationale and design of the “DAPT-STEMI trial”
Publication date: Available online 20 February 2017 Source:American Heart Journal Author(s): Elvin Kedhi, Enrico Fabris, Martin van der Ent, Mark Kennedy, Pawel Buszman, Clemens von Birgelen, Stéphane Cook, Hans Wedel, Felix Zijlstra Abstract. Background The optimal duration of dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) with second-generation drug eluting stents (DES) is unclear. Because prolonged DAPT is associated with higher bleeding risk and health care costs, establishing optimal DAPT duration is of paramount importance. No other randomized controlled trials have evaluated the sa...
Source: American Heart Journal - February 20, 2017 Category: Cardiology Source Type: research

A prospective, randomized, open-label trial of 6-month versus 12-month dual antiplatelet therapy after drug-eluting stent implantation in ST-elevation myocardial infarction: Rationale and design of the “DAPT-STEMI trial”
Publication date: June 2017 Source:American Heart Journal, Volume 188 Author(s): Elvin Kedhi, Enrico Fabris, Martin van der Ent, Mark W. Kennedy, Pawel Buszman, Clemens von Birgelen, Stéphane Cook, Hans Wedel, Felix Zijlstra Background The optimal duration of dual antiplatelet therapy (DAPT) after percutaneous coronary intervention with second-generation drug eluting stents (DESs) is unclear. Because prolonged DAPT is associated with higher bleeding risk and health care costs, establishing optimal DAPT duration is of paramount importance. No other randomized controlled trials have evaluated the safety of shorter DAPT dur...
Source: American Heart Journal - March 20, 2017 Category: Cardiology Source Type: research

Dual Antiplatelet Therapy in Patients with Diabetes and Acute Coronary Syndromes Managed without Revascularization
Conclusions Among NSTE ACS patients managed medically without revascularization, patients with DM had a higher risk of ischemic events that was amplified among those treated with insulin. There was no differential treatment effect with a more potent DAPT regimen of aspirin + prasugrel vs. aspirin + clopidogrel.
Source: American Heart Journal - March 28, 2017 Category: Cardiology Source Type: research

Percutaneous Coronary Intervention and Antiplatelet Therapy in Patients with Atrial Fibrillation Receiving Apixaban or Warfarin: Insights from the ARISTOTLE Trial
Conclusions PCI occurred infrequently during follow-up. The majority of patients on study drug at the time of PCI remained on study drug in the peri-PCI period; 19% continued the study drug without interruption. Antiplatelet therapy use post-PCI was variable, though the majority of patients received DAPT. Additional data are needed to guide the use of antithrombotics in patients undergoing PCI.
Source: American Heart Journal - November 10, 2017 Category: Cardiology Source Type: research

Safety and efficacy of non-vitamin K oral anticoagulant for atrial fibrillation patients following percutaneous coronary intervention: A bivariate analysis of the PIONEER AF-PCI and RE-DUAL PCI trial
Conclusions A bivariate analysis that simultaneously characterizes both risk and benefit demonstrates that rivaroxaban- and dabigatran-based regimens were both favorable over VKA plus dual antiplatelet therapy among patients with AF undergoing PCI.
Source: American Heart Journal - June 13, 2018 Category: Cardiology Source Type: research

Safety and efficacy of non –vitamin K oral anticoagulant for atrial fibrillation patients after percutaneous coronary intervention: A bivariate analysis of the PIONEER AF-PCI and RE-DUAL PCI trial
Conclusions A bivariate analysis that simultaneously characterizes both risk and benefit demonstrates that riva- and dabi-based regimens were both favorable over VKA plus dual antiplatelet therapy among patients with atrial fibrillation undergoing PCI.
Source: American Heart Journal - July 4, 2018 Category: Cardiology Source Type: research

Safety and efficacy of non–vitamin K oral anticoagulant for atrial fibrillation patients after percutaneous coronary intervention: A bivariate analysis of the PIONEER AF-PCI and RE-DUAL PCI trial
ConclusionsA bivariate analysis that simultaneously characterizes both risk and benefit demonstrates that riva- and dabi-based regimens were both favorable over VKA plus dual antiplatelet therapy among patients with atrial fibrillation undergoing PCI.
Source: American Heart Journal - July 5, 2018 Category: Cardiology Source Type: research

Randomized evaluation of ticagrelor monotherapy after 3-month dual-antiplatelet therapy in patients with acute coronary syndrome treated with new-generation sirolimus-eluting stents: TICO trial rationale and design
ConclusionsThe TICO trial is an ongoing trial evaluating the efficacy and safety of ticagrelor monotherapy following 3-month DAPT exclusively in ACS patients treated with uniform BP-SES. It may provide novel insights regarding the need for adjusted use of DAPT for rebalancing risk–benefit in current practice and changing from the conventional concept of aspirin maintenance to a ticagrelor-based regimen in the management of ACS.
Source: American Heart Journal - March 9, 2019 Category: Cardiology Source Type: research