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Benefit of switching dual antiplatelet therapy after acute coronary syndrome: the TOPIC (timing of platelet inhibition after acute coronary syndrome) randomized study
ConclusionA switched DAPT is superior to an unchanged DAPT strategy to prevent bleeding complications without increase in ischaemic events following ACS.
Source: European Heart Journal - May 16, 2017 Category: Cardiology Source Type: research

Ticagrelor, but not clopidogrel active metabolite, displays antithrombotic properties in the left atrial endocardium
Conclusion</div>Ticagrelor, but not CAM, reduces expression and activity of TF and PAI-1 in LAA endocardial cells isolated from patients with AF, indicating possible local antithrombotic effects. Such pleiotropic properties of ticagrelor may contribute to a reduction in thromboembolic complications in patients with AF.</span>
Source: European Heart Journal - January 8, 2017 Category: Cardiology Source Type: research

Outcomes in patients treated with ticagrelor or clopidogrel after acute myocardial infarction: experiences from SWEDEHEART registry
Conclusion Ticagrelor vs. clopidogrel post-ACS was associated with a lower risk of death, MI, or stroke, as well as death alone. Risk of bleeding was higher with ticagrelor. These real-world outcomes are consistent with randomized trial results.
Source: European Heart Journal - December 21, 2016 Category: Cardiology Authors: Sahlen, A., Varenhorst, C., Lagerqvist, B., Renlund, H., Omerovic, E., Erlinge, D., Wallentin, L., James, S. K., Jernberg, T. Tags: Acute coronary syndromes Source Type: research

Growth differentiation factor-15 level predicts major bleeding and cardiovascular events in patients with acute coronary syndromes: results from the PLATO study
Conclusions In patients with ACS, higher levels of GDF-15 are associated with raised risks of all types of major non-CABG-related bleeding, spontaneous MI, and stroke as well as CV and total mortality and seem to improve risk stratification for CV-mortality and major bleeding beyond established risk factors. Clinical Trial Registration www.clinicaltrials.gov; NCT00391872.
Source: European Heart Journal - April 20, 2016 Category: Cardiology Authors: Hagström, E., James, S. K., Bertilsson, M., Becker, R. C., Himmelmann, A., Husted, S., Katus, H. A., Steg, P. G., Storey, R. F., Siegbahn, A., Wallentin, L., for the PLATO Investigators Tags: Acute coronary syndromes Source Type: research

Stopping or continuing clopidogrel 12 months after drug-eluting stent placement: the OPTIDUAL randomized trial
Conclusions Extended DAPT did not achieve superiority in reducing net adverse clinical events compared to 12 months of DAPT after DES placement. The power of the OPTIDUAL trial was however low and reduced by premature termination of enrolment. ClinicalTrials.gov number NCT00822536.
Source: European Heart Journal - January 21, 2016 Category: Cardiology Authors: Helft, G., Steg, P. G., Le Feuvre, C., Georges, J.-L., Carrie, D., Dreyfus, X., Furber, A., Leclercq, F., Eltchaninoff, H., Falquier, J.-F., Henry, P., Cattan, S., Sebagh, L., Michel, P.-L., Tuambilangana, A., Hammoudi, N., Boccara, F., Cayla, G., Douard, Tags: ESC Hot Line Source Type: research

Ascertainment, classification, and impact of neoplasm detection during prolonged treatment with dual antiplatelet therapy with prasugrel vs. clopidogrel following acute coronary syndrome
Conclusions Neoplasm events were infrequent during long-term DAPT after ACS, were associated with differential cancer-screening practices across regions, and the frequency of neoplasm detection was similar with prasugrel vs. clopidogrel. Trial registration ClinicalTrials.gov identifier: NCT00699998.
Source: European Heart Journal - January 21, 2016 Category: Cardiology Authors: Roe, M. T., Cyr, D. D., Eckart, D., Schulte, P. J., Morse, M. A., Blackwell, K. L., Ready, N. E., Zafar, S. Y., Beaven, A. W., Strickler, J. H., Onken, J. E., Winters, K. J., Houterloot, L., Zamoryakhin, D., Wiviott, S. D., White, H. D., Prabhakaran, D., Tags: Acute coronary syndromes Source Type: research

ISAR-SAFE: a randomized, double-blind, placebo-controlled trial of 6 vs. 12 months of clopidogrel therapy after drug-eluting stenting
Conclusions In the present trial, characterized by low event rates, we did not observe a significant difference in net clinical outcome between 6 and 12 months of clopidogrel therapy after DES implantation. However, the results of the trial must be considered in view of its premature termination and lower than expected event rates. The trial is registered with ClinicalTrials.gov, Identifier: NCT00661206.
Source: European Heart Journal - May 21, 2015 Category: Cardiology Authors: Schulz-Schupke, S., Byrne, R. A., ten Berg, J. M., Neumann, F.-J., Han, Y., Adriaenssens, T., Tolg, R., Seyfarth, M., Maeng, M., Zrenner, B., Jacobshagen, C., Mudra, H., von Hodenberg, E., Wohrle, J., Angiolillo, D. J., von Merzljak, B., Rifatov, N., Kufn Tags: Thrombosis and antithrombotic therapy Source Type: research

Prasugrel plus bivalirudin vs. clopidogrel plus heparin in patients with ST-segment elevation myocardial infarction
Conclusion In this randomized trial of STEMI patients, we were unable to demonstrate significant differences in net clinical outcome between prasugrel plus bivalirudin and clopidogrel plus heparin. Neither the composite of ischaemic complications nor bleeding were favourably affected by prasugrel plus bivalirudin compared with a regimen of clopidogrel plus unfractionated heparin. However, the results must be interpreted in view of the premature termination of the trial. Clinical trial registration information Unique identifier NCT00976092 (www.clinicaltrials.gov).
Source: European Heart Journal - September 7, 2014 Category: Cardiology Authors: Schulz, S., Richardt, G., Laugwitz, K.-L., Morath, T., Neudecker, J., Hoppmann, P., Mehran, R., Gershlick, A. H., Tolg, R., Anette Fiedler, K., Abdel-Wahab, M., Kufner, S., Schneider, S., Schunkert, H., Ibrahim, T., Mehilli, J., Kastrati, A., and for the Tags: FASTTRACK CLINICAL RESEARCH Source Type: research

Ticagrelor vs. clopidogrel in patients with non-ST-elevation acute coronary syndrome with or without revascularization: results from the PLATO trial
Conclusion In patients with NSTE-ACS, benefit of ticagrelor over clopidogrel in reducing ischaemic events and total mortality was consistent with the overall PLATO trial, independent of actually performed revascularization during the initial 10 days.
Source: European Heart Journal - August 14, 2014 Category: Cardiology Authors: Lindholm, D., Varenhorst, C., Cannon, C. P., Harrington, R. A., Himmelmann, A., Maya, J., Husted, S., Steg, P. G., Cornel, J. H., Storey, R. F., Stevens, S. R., Wallentin, L., James, S. K. Tags: Acute coronary syndromes Source Type: research

Duration of dual antiplatelet treatment with clopidogrel and aspirin in patients with acute coronary syndrome
Conclusion In this contemporary, large real-life ACS population, DAPT for more than 3 months compared with a shorter duration was associated with a lower risk of death, stroke, or re-infarction. Trial Registration Clinicaltrials.gov (NCT01623700).
Source: European Heart Journal - April 14, 2014 Category: Cardiology Authors: Varenhorst, C., Jensevik, K., Jernberg, T., Sundstrom, A., Hasvold, P., Held, C., Lagerqvist, B., James, S. Tags: FASTTRACK CLINICAL RESEARCH Source Type: research

New oral anticoagulants in addition to single or dual antiplatelet therapy after an acute coronary syndrome: a systematic review and meta-analysis
Conclusion In patients with a recent acute coronary syndrome, the addition of a new oral anticoagulant to antiplatelet therapy results in a modest reduction in cardiovascular events but a substantial increase in bleeding, most pronounced when new oral anticoagulants are combined with dual antiplatelet therapy.
Source: European Heart Journal - June 7, 2013 Category: Cardiology Authors: Oldgren, J., Wallentin, L., Alexander, J. H., James, S., Jonelid, B., Steg, G., Sundstrom, J. Tags: Acute coronary syndromes Source Type: research

The CHA2DS2-VASc score identifies those patients with atrial fibrillation and a CHADS2 score of 1 who are unlikely to benefit from oral anticoagulant therapy
Conclusion The CHA2DS2-VASc score reclassifies 26% of patients with a CHADS2 score of 1 to a low annual risk of SSE of 1%. This risk seems low enough to consider withholding anticoagulant treatment.
Source: European Heart Journal - January 14, 2013 Category: Cardiology Authors: Coppens, M., Eikelboom, J. W., Hart, R. G., Yusuf, S., Lip, G. Y. H., Dorian, P., Shestakovska, O., Connolly, S. J. Tags: Arrhythmia/electrophysiology Source Type: research

Cost-effectiveness of treating acute coronary syndrome patients with ticagrelor for 12 months: results from the PLATO study
Conclusion Based on clinical and health-economic evidence from the PLATO study, treating ACS patients with ticagrelor for 12 months is associated with a cost per QALY below generally accepted thresholds for cost-effectiveness. ClinicalTrials.gov Identifier: NCT00391872.
Source: European Heart Journal - January 14, 2013 Category: Cardiology Authors: Nikolic, E., Janzon, M., Hauch, O., Wallentin, L., Henriksson, M., for the PLATO Health Economic Substudy Group Tags: Coronary artery disease Source Type: research