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Longer dual antiplatelet therapy (DAPT) after percutaneous coronary intervention has higher anti-ischaemic efficacy than shorter DAPT but is associated with more frequent bleeding
Commentary on: Spencer FA, Prasad M, Vandvik PO, et al.. Longer- versus shorter-duration dual-antiplatelet therapy after drug-eluting stent placement: a systematic review and meta-analysis. Ann Intern Med 2015;163:118–26. Context Dual antiplatelet therapy (DAPT) with aspirin plus a P2Y12 receptor antagonist is recommended after drug eluting stent implantation (DES) for at least 12 months by the American College of Cardiology/American Heart Association1 and for 6–12 months by European guidelines. Recent randomised controlled trials (RCT) suggested comparable efficacy of short-term DAPT versus therapy o...
Source: Evidence-Based Medicine - January 22, 2016 Category: Internal Medicine Authors: Navarese, E. P. Tags: Journalology, Clinical trials (epidemiology), Epidemiologic studies, Drugs: cardiovascular system, Stroke, Interventional cardiology, Ischaemic heart disease, Venous thromboembolism, Radiology, Clinical diagnostic tests, Ethics Therapeutics/Prevention Source Type: research

Coronary artery bypass surgery continues to remain the treatment of choice for multivessel coronary artery disease even in the era of new-generation drug-eluting stents
Commentary on: Park SJ, Ahn JM, Kim YH, et al; BEST Trial Investigators. Trial of everolimus-eluting stents or bypass surgery for coronary disease. N Engl J Med 2015;372:1204–12. Context Multivessel coronary artery disease (MVCAD) may be found in patients subjected to coronary angiography. It is treated with coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI). The expanded use of PCI, following development of drug-eluting stents (DES), necessitated comparison of its outcomes with CABG (gold standard therapy). The SYNTAX (SYNergy between PCI with TAXUS and Cardiac Surgery) trial favoured...
Source: Evidence-Based Medicine - July 24, 2015 Category: Internal Medicine Authors: Mohr, F. W., Davierwala, P. M. Tags: Clinical trials (epidemiology), Drugs: cardiovascular system, Stroke, Interventional cardiology, Ischaemic heart disease, Venous thromboembolism, Radiology, Clinical diagnostic tests, Radiology (diagnostics) Therapeutics/Prevention Source Type: research

Meta-analysis compares anticoagulant strategies in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention
Commentary on: Bangalore S, Toklu B, Kotwal A, et al. Anticoagulant therapy during primary percutaneous coronary intervention for acute myocardial infarction: a meta-analysis of randomised trials in the era of stents and P2Y12 inhibitors. BMJ 2014;349:g6419 Context Optimal anticoagulant therapy in patients receiving primary intervention for acute myocardial infarction (MI) is widely debated. Prior studies have been heterogeneous in doses and concomitant treatments such that it has been unclear whether effects have been those of newer medication or a result of changes in these co-interventions. A meta-analytic approach can ...
Source: Evidence-Based Medicine - March 17, 2015 Category: Internal Medicine Authors: Patti, G. Tags: Clinical trials (epidemiology), Drugs: cardiovascular system, Stroke, Interventional cardiology, Ischaemic heart disease, Venous thromboembolism, Radiology, Clinical diagnostic tests Therapeutics/Prevention Source Type: research