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Short dual antiplatelet therapy followed by P2Y12 inhibitor monotherapy vs. prolonged dual antiplatelet therapy after percutaneous coronary intervention with second-generation drug-eluting stents: a systematic review and meta-analysis of randomized clinical trials
ConclusionAfter second-generation DES implantation, 1 –3 months of DAPT followed by P2Y12 inhibitor SAPT is associated with lower major bleeding and similar stent thrombosis, all-cause death, myocardial infarction, and stroke compared with prolonged DAPT. Whether P2Y12 inhibitor SAPT is preferable to aspirin SAPT needs further investigation.
Source: European Heart Journal - December 7, 2020 Category: Cardiology Source Type: research

Ticagrelor alone vs. ticagrelor plus aspirin following percutaneous coronary intervention in patients with non-ST-segment elevation acute coronary syndromes: TWILIGHT-ACS
Conclusion  Among patients with or without NSTE-ACS who have completed an initial 3-month course of DAPT following PCI with DES, ticagrelor monotherapy reduced clinically meaningful bleeding events without increasing ischaemic risk as compared with ticagrelor plus aspirin. The benefits of ticagrelor monotherapy with respect to bleeding events were more pronounced in patients with NSTE-ACS.Trial registrationClinicaltrials.gov identifier: NCT02270242.
Source: European Heart Journal - October 20, 2020 Category: Cardiology Source Type: research

Edoxaban in atrial fibrillation patients with percutaneous coronary intervention by acute or chronic coronary syndrome presentation: a pre-specified analysis of the ENTRUST-AF PCI trial
Conclusions  In patients with AF who underwent PCI, the edoxaban-based regimen, as compared with VKA-based regimen, provides consistent safety and similar efficacy for ischaemic events in patients with AF regardless of their clinical presentation.
Source: European Heart Journal - August 29, 2020 Category: Cardiology Source Type: research

Prediction of individual life-years gained without cardiovascular events from lipid, blood pressure, glucose, and aspirin treatment based on data of more than 500  000 patients with Type 2 diabetes mellitus
ConclusionCardiovascular disease-free life expectancy and effects of lifelong prevention in terms of CVD-free life-years gained can be estimated for people with T2DM using readily available clinical characteristics. Predictions of individual-level treatment effects facilitate translation of trial results to individual patients.
Source: European Heart Journal - January 9, 2019 Category: Cardiology Source Type: research

External applicability of the COMPASS trial: an analysis of the reduction of atherothrombosis for continued health (REACH) registry
ConclusionCOMPASS-Eligible patients represent a substantial fraction of stable CAD/PAD patients encountered in routine clinical practice in the large international REACH registry suggesting good external applicability. COMPASS-Eligible patients experienced a higher rate of the primary outcome compared with COMPASS participants in the aspirin alone treatment arm.
Source: European Heart Journal - November 23, 2017 Category: Cardiology Source Type: research

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

Outcomes and costs of left atrial appendage closure from randomized controlled trial and real-world experience relative to oral anticoagulation
Conclusion Left atrial appendage closure in NVAF in a real-world setting may result in lower stroke and major bleeding rates than reported in LAAC clinical trials. Left atrial appendage closure in both settings achieves cost parity in a relatively short period of time and may offer substantial savings compared with current therapies. Savings are most pronounced among higher risk patients and those unsuitable for anticoagulation.
Source: European Heart Journal - December 29, 2016 Category: Cardiology Authors: Panikker, S., Lord, J., Jarman, J. W. E., Armstrong, S., Jones, D. G., Haldar, S., Butcher, C., Khan, H., Mantziari, L., Nicol, E., Hussain, W., Clague, J. R., Foran, J. P., Markides, V., Wong, T. Tags: Thrombosis and antithrombotic therapy 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

Long-term dual antiplatelet therapy for secondary prevention of cardiovascular events in the subgroup of patients with previous myocardial infarction: a collaborative meta-analysis of randomized trials
Conclusion Compared with aspirin alone, DAPT beyond 1 year among stabilized high-risk patients with prior MI decreases ischaemic events, including significant reductions in the individual endpoints of cardiovascular death, recurrent MI, and stroke. Dual antiplatelet therapy beyond 1 year increases major bleeding, but not fatal bleeding or non-cardiovascular death.
Source: European Heart Journal - January 21, 2016 Category: Cardiology Authors: Udell, J. A., Bonaca, M. P., Collet, J.-P., Lincoff, A. M., Kereiakes, D. J., Costa, F., Lee, C. W., Mauri, L., Valgimigli, M., Park, S.-J., Montalescot, G., Sabatine, M. S., Braunwald, E., Bhatt, D. L. Tags: Coronary artery disease 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

Risk of ischaemic stroke according to pattern of atrial fibrillation: analysis of 6563 aspirin-treated patients in ACTIVE-A and AVERROES
Conclusion In a large population of non-anticoagulated AF patients, pattern of AF was a strong independent predictor of stroke risk and may be helpful to assess the risk/benefit for anticoagulant therapy, especially in lower risk patients.
Source: European Heart Journal - February 2, 2015 Category: Cardiology Authors: Vanassche, T., Lauw, M. N., Eikelboom, J. W., Healey, J. S., Hart, R. G., Alings, M., Avezum, A., Diaz, R., Hohnloser, S. H., Lewis, B. S., Shestakovska, O., Wang, J., Connolly, S. J. Tags: Atrial fibrillation Source Type: research

Efficacy and safety of apixaban compared with aspirin in patients who previously tried but failed treatment with vitamin K antagonists: results from the AVERROES trial
Conclusion The efficacy and safety of apixaban compared with aspirin is consistent in subgroups of patients who have previously attempted but failed VKA therapy, irrespective of the reason for discontinuation.
Source: European Heart Journal - July 21, 2014 Category: Cardiology Authors: Coppens, M., Synhorst, D., Eikelboom, J. W., Yusuf, S., Shestakovska, O., Connolly, S. J. Tags: Atrial fibrillation Source Type: research

Cost-effectiveness of apixaban vs. current standard of care for stroke prevention in patients with atrial fibrillation
Conclusions Based on randomized trial data, apixaban is a cost-effective alternative to warfarin and aspirin, in VKA suitable and VKA unsuitable patients with AF, respectively.
Source: European Heart Journal - July 21, 2014 Category: Cardiology Authors: Dorian, P., Kongnakorn, T., Phatak, H., Rublee, D. A., Kuznik, A., Lanitis, T., Liu, L. Z., Iloeje, U., Hernandez, L., Lip, G. Y. H. Tags: BASIC SCIENCE Source Type: research

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