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Finding the right balance
Patients with an indication for oral anticoagulation (OAC) that receive antiplatelet therapy after percutaneous coronary intervention (PCI) are challenging for the treating physician. It is of importance to balance their antithrombotic treatment to protect them from ischemic events, such as stent thrombosis as well as ischemic stroke without exposing them to an excess in bleeding. The current guidelines recommend a so-called triple therapy consisting of aspirin, clopidogrel and OAC for 1 –6 months after PCI depending on the patient's ischemic risk [1].
Source: International Journal of Cardiology - September 27, 2018 Category: Cardiology Authors: Alexander Goedel, Nikolaus Sarafoff Tags: Editorial Source Type: research

Risk stratification for secondary prevention with ticagrelor and aspirin: A closer look to patient subsets from the PEGASUS-TIMI 54 trial
In the PEGASUS trial, 21,162 patients with a history of myocardial infarction within 1 to 3years earlier were randomized to ticagrelor 90mg twice daily, ticagrelor 60mg twice daily or placebo on a background of low-dose aspirin, and were followed for a median of 33months [1]. Both doses of ticagrelor significantly reduced the primary efficacy endpoint (a composite of cardiovascular death, myocardial infarction, or stroke) but also increased the primary safety endpoint (TIMI major bleeding), compared with placebo [1].
Source: International Journal of Cardiology - August 5, 2015 Category: Cardiology Authors: Davide Capodanno, Piera Capranzano, Sergio Buccheri, Corrado Tamburino Tags: Letter to the Editor Source Type: research

Dual antiplatelet therapy versus warfarin anticoagulation in patients undergoing catheter ablation of atrial fibrillation
Radio frequency catheter ablation (RFCA) has become a standard treatment for patients with atrial fibrillation (AF) . Anticoagulation in patients undergoing AF ablation is crucial to minimize the risk of thromboembolic complications. Although warfarin is effective in reducing stroke, its chronic use has many disadvantages including frequent international normalized ratio (INR)/prothrombin, attention to numerous dietary and medication interactions, and risk of serious bleeding including intracranial hemorrhage . Novel oral anticoagulants provide a reasonable alternative; however, they cannot yet be reversed, are expensive, ...
Source: International Journal of Cardiology - March 28, 2014 Category: Cardiology Authors: Zhiyu Ling, Fengpeng Jia, Yanping Xu, Li Su, Zengzhang Liu, Huaan Du, Xiaoyu Yang, Xianbin Lan, Peilin Xiao, Weijie Chen, Jinqi Fan, Suxin Luo, Yuehui Yin, Saman Nazarian Tags: Letters to the Editor Source Type: research

Apixaban in patients with atrial fibrillation and prior coronary artery disease: Insights from the ARISTOTLE trial
Conclusions: In patients with AF, apixaban more often prevented stroke or systemic embolism and death and caused less bleeding than warfarin, regardless of the presence of prior CAD. Given the common occurrence of AF and CAD and the higher rates of cardiovascular events and death, our results indicate that apixaban may be a better treatment option than warfarin for these high-risk patients.
Source: International Journal of Cardiology - November 4, 2013 Category: Cardiology Authors: Maria Cecilia Bahit, Renato D. Lopes, Daniel M. Wojdyla, Stefan H. Hohnloser, John H. Alexander, Basil S. Lewis, Philip E. Aylward, Freek W.A. Verheugt, Matyas Keltai, Rafael Diaz, Michael Hanna, Christopher B. Granger, Lars Wallentin Tags: Original Articles Source Type: research

Stroke risk and suboptimal thromboprophylaxis in Chinese patients with atrial fibrillation: Would the novel oral anticoagulants have an impact?
Abstract: Background: The risk of stroke associated with atrial fibrillation (AF) is higher in Far Eastern population than in Western population, and warfarin use suboptimal. There is uncertainty whether the novel oral anticoagulants (NOACs) would have a major impact on stroke prevention in Far Eastern populations with AF.Objectives: We investigated current antithrombotic therapy use on stroke and bleeding risk, determinants of warfarin use and performed a modeling analysis of the net clinical benefit of the NOACs (apixaban, dabigatran) in a large cohort of Chinese patients with AF.Methods: We studied 1034 Chinese patients...
Source: International Journal of Cardiology - October 24, 2012 Category: Cardiology Authors: Yutao Guo, Ron Pisters, Stavros Apostolakis, Andrew D. Blann, Haijun Wang, Xiaoning Zhao, Yu Zhang, Dexian Zhang, Jingling Ma, Yutang Wang, Gregory Y.H. Lip Tags: Original Articles Source Type: research

Impact of non-steroidal anti-inflammatory drugs (NSAIDs) on cardiovascular outcomes in patients with stable atherothrombosis or multiple risk factors
Abstract: Background: We aimed to assess whether the use of non-steroidal anti-inflammatory drugs (NSAIDs) is associated with an increased risk of cardiovascular (CV) events in stable patients with established atherothrombosis or multiple risk factors.Methods: We analysed the 23,728 European patients of the REACH Registry; 20,588 (86.8%) had established atherothrombotic disease and 3140 (13.2%) had multiple risk factors only. Aspirin (ASA) and/or NSAIDs use was determined at enrolment and ischemic events were recorded over two years of follow-up. cMACCE was defined as the composite of CV death, MI or stroke. Bleeding was d...
Source: International Journal of Cardiology - June 30, 2011 Category: Cardiology Authors: Olivier Barthélémy, Tobias Limbourg, Jean Philippe Collet, Farzin Beygui, Johanne Silvain, Anne Bellemain-Appaix, Guillaume Cayla, Thomas Chastre, Iris Baumgartner, Joachim Röther, Uwe Zeymer, Deepak L. Bhatt, Gabriel Steg, Gilles Montalescot, On behal Tags: Original Articles Source Type: research