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Aspirin for Primary Prevention of Cardiovascular Disease in the 21st Century: A Review of the Evidence
Aspirin (ASA) is the most commonly prescribed antiplatelet agent. Although the evidence for efficacy of aspirin for secondary prevention of ischemic events in patients with established cardiovascular disease is strong, its role in primary prevention has been subject of controversies over the past decades. In fact, historical trials have shown only modest benefit in terms of reduction of ischemic events, mostly myocardial infarction and to a lesser extent stroke, and only at the expense of an increased risk of bleeding.
Source: The American Journal of Cardiology - March 9, 2021 Category: Cardiology Authors: Dominick J Angiolillo, Davide Capodanno Source Type: research

Benefit of Single Antiplatelet Therapy Over Dual Antiplatelet Therapy After Transcatheter Aortic Valve Implantation
Current practice guidelines recommend dual antiplatelet therapy with aspirin and clopidogrel for 3-6 months followed by lifelong aspirin after transcatheter aortic valve implantation (TAVI). However, recently published POPular TAVI trial1 and other trials2 –4 that have compared dual antiplatelet therapy (DAPT) with single antiplatelet therapy (SAPT) have shown decreased bleeding events and non-inferiority with respect to ischemic stroke, all-cause mortality, and myocardial infarction (MI) amongst patients receiving SAPT.
Source: The American Journal of Cardiology - December 8, 2020 Category: Cardiology Authors: Agam Bansal, Ashish Kumar, Vardhmaan Jain, Grant W Reed, Amar Krishnaswamy, Ankur Kalra, Rishi Puri, Samir R. Kapadia Source Type: research

Meta-Regression to Identify Patients Deriving the Greatest Benefit from Dual Antiplatelet Therapy After Stroke or Transient Ischemic Attack Without Thrombolytic or Thrombectomy Treatment
The patient's profile drawing the greatest benefit from dual antiplatelet therapy (DAPT) after a non-cardioembolic, ischemic cerebrovascular event is not well characterized. Aim of this meta-regression analysis was to compare DAPT versus single antiplatelet therapy (SAPT) in patients with stroke or transient ischemic attack (TIA). We searched randomized trials evaluating clinical outcome with aspirin plus a P2Y12 inhibitor versus SAPT in patients with non-cardioembolic stroke or TIA. Primary endpoint was the incidence of recurrent stroke; safety outcome measure was major bleeding.
Source: The American Journal of Cardiology - May 24, 2019 Category: Cardiology Authors: Giuseppe Patti, Alessandro Sticchi, Antonio Bisignani, Francesco Pelliccia, Vincenzo Pasceri, Giulio Speciale, Maria Penco Source Type: research

Bleeding Risk and Antithrombotic Strategy in Patients With Sinus Rhythm and Heart Failure With Reduced Ejection Fraction Treated With Warfarin or Aspirin
We sought to assess the performance of existing bleeding risk scores, such as the Hypertension, Abnormal Renal/Liver Function, Stroke, Bleeding History or Predisposition, Labile INR, Elderly, Drugs/Alcohol Concomitantly (HAS-BLED) score or the Outpatient Bleeding Risk Index (OBRI), in patients with heart failure with reduced ejection fraction (HFrEF) in sinus rhythm (SR) treated with warfarin or aspirin. We calculated HAS-BLED and OBRI risk scores for 2,305 patients with HFrEF in SR enrolled in the Warfarin versus Aspirin in Reduced Cardiac Ejection Fraction trial.
Source: The American Journal of Cardiology - June 24, 2015 Category: Cardiology Authors: Siqin Ye, Bin Cheng, Gregory Y.H. Lip, Richard Buchsbaum, Ralph L. Sacco, Bruce Levin, Marco R. Di Tullio, Min Qian, Douglas L. Mann, Patrick M. Pullicino, Ronald S. Freudenberger, John R. Teerlink, J.P. Mohr, Susan Graham, Arthur J. Labovitz, Conrado J. Tags: Heart Failure Source Type: research

Meta-analysis Of Randomized Controlled Trials and Adjusted Observational Results Of Use Of Clopidogrel, Aspirin and Oral Anti-coagulants In Patients Undergoing Percutaneous Coronary Intervention
The optimal antiaggregant therapy after coronary stenting in patients receiving oral anticoagulation (OAC) is currently debated. Medline and Cochrane Library were searched for studies reporting outcomes of patients undergoing PCI and who were on triple therapy (TT)or dual antiplatelet therapy (DAPT) with aspirin and clopidogrel or dual therapy(DT) with OAC and clopidogrel. Major bleeding was the primary end point, while all-cause death, myocardial infarction (MI), stent thrombosis and stroke were secondary ones.
Source: The American Journal of Cardiology - February 11, 2015 Category: Cardiology Authors: Fabrizio D’Ascenzo, Salma Taha, Claudio Moretti, Pierluigi Omedè, Walter Grossomarra, Jonas Persson, Morten Lamberts, Willem Dewilde, Andrea Rubboli, Sergio Fernández, Enrico Cerrato, Ilaria Meynet, Flavia Ballocca, Umberto Barbero, Giorgio Quadri, Fr Source Type: research

Impact of Dual Antiplatelet Therapy on Outcomes Among Aspirin-Resistant Patients Following Coronary Artery Bypass Grafting
This study was designed to define the impact of dual antiplatelet therapy (dAPT) on clinical outcomes among aspirin-resistant patients who underwent coronary artery surgery. We randomly assigned 219 aspirin-resistant patients according to multiple electrode aggregometry to receive clopidogrel (75 mg) plus aspirin (300 mg) or aspirin-monotherapy (300 mg). The primary end point was a composite outcome of all-cause death, nonfatal myocardial infarction, stroke, or cardiovascular hospitalization assessed at 6 months postoperatively. The primary end point occurred in 6% of patients assigned to dAPT and 10% of patients rando...
Source: The American Journal of Cardiology - March 3, 2014 Category: Cardiology Authors: Hrvoje Gasparovic, Mate Petricevic, Tomislav Kopjar, Zeljko Djuric, Lucija Svetina, Bojan Biocina Tags: Coronary Artery Disease Source Type: research

Association of Aspirin Dose and Vorapaxar Safety and Efficacy in Patients With Non–ST-Segment Elevation Acute Coronary Syndrome (from the TRACER Trial)
In conclusion, most TRACER participants were treated with low-dose ASA, although a high dose was common in North America. High-dose participants tended to have higher rates of ischemic and bleeding outcomes. Although formal statistical testing did not reveal heterogeneity in vorapaxar's effect across dose subgroups, consistent trends support use of low-dose ASA with other antiplatelet therapies.
Source: The American Journal of Cardiology - December 26, 2013 Category: Cardiology Authors: Kenneth W. Mahaffey, Zhen Huang, Lars Wallentin, Robert F. Storey, Lisa K. Jennings, Pierluigi Tricoci, Harvey D. White, Paul W. Armstrong, Philip E. Aylward, David J. Moliterno, Frans Van de Werf, Edmond Chen, Sergio Leonardi, Tyrus Rorick, Claes Held, J Tags: Coronary Artery Disease Source Type: research

Comparison of the Efficacy and Safety of Two Rivaroxaban Doses in Acute Coronary Syndrome (from ATLAS ACS 2–TIMI 51)
In conclusion, the 2 doses of rivaroxaban reduced cardiovascular events in patients with recent acute coronary syndromes treated with antiplatelet therapies; however, the 2.5-mg dose was associated with lower mortality and fewer bleeding complications than the 5-mg dose. Thus, the addition of rivaroxaban 2.5 mg twice daily offers a more favorable balance of efficacy and safety in patients with recent acute coronary syndromes.
Source: The American Journal of Cardiology - May 28, 2013 Category: Cardiology Authors: Jessica L. Mega, Eugene Braunwald, Stephen D. Wiviott, Sabina A. Murphy, Alexei Plotnikov, Nina Gotcheva, Mikhail Ruda, C. Michael Gibson Tags: Coronary Artery Disease Source Type: research