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Long-term outcomes for women versus men with unstable angina/non–ST-segment elevation myocardial infarction managed medically without revascularization: Insights from the TaRgeted platelet Inhibition to cLarify the Optimal strateGy to medicallY manage Acute Coronary Syndromes trial
Conclusions Long-term ischemic and bleeding outcomes in medically managed ACS patients were similar for women versus men, as was treatment-related platelet reactivity. Women had a higher baseline risk profile and, after adjustment, significantly lower risk of the primary composite end point and all-cause death through 30 months.
Source: American Heart Journal - September 19, 2015 Category: Cardiology Source Type: research

Ticagrelor or prasugrel versus clopidogrel in elderly patients with an acute coronary syndrome: optimization of antiplatelet treatment in patients aged 70years and older – Rationale and design of the POPular AGE-study
Conclusion The POPular AGE is the first randomized controlled trial that will assess whether the treatment strategy with clopidogrel will result in fewer bleeding events without compromising the net clinical benefit in patients≥70years of age with NSTE-ACS, when compared with a treatment strategy with ticagrelor or prasugrel.
Source: American Heart Journal - August 5, 2015 Category: Cardiology Source Type: research

Long-term outcomes for women vs. men with unstable angina/non-ST-segment elevation myocardial infarction managed medically without revascularization: Insights from the TRILOGY ACS trial
Conclusions : Long-term ischemic and bleeding outcomes for in medically managed ACS patients were similar for women vs. men, as was treatment-related platelet reactivity. Women had a higher baseline risk profile and, after adjustment, significantly lower risk of the primary composite endpoint and all-cause death through 30 months.
Source: American Heart Journal - June 20, 2015 Category: Cardiology Source Type: research

Concomitant proton-pump inhibitor use, platelet activity, and clinical outcomes in patients with acute coronary syndromes treated with prasugrel vs. clopidogrel and managed without revascularization: Insights from the TRILOGY ACS Trial
Conclusions Among ACS patients managed without revascularization, use of PPIs did not result in a differential antiplatelet response between prasugrel vs. clopidogrel but was associated with a lower incidence of MI with prasugrel. These hypothesis-generating findings suggest that factors besides platelet reactivity may underlie the differential risk of MI observed by treatment assignment with PPI use.
Source: American Heart Journal - June 11, 2015 Category: Cardiology Source Type: research

Ticagrelor versus clopidogrel in Asian patients with acute coronary syndrome: A retrospective analysis from the Platelet Inhibition and Patient Outcomes (PLATO) Trial
Conclusions We observed consistency of effects in Asian patients receiving ticagrelor and clopidogrel in the PLATO study. The relatively modest number of Asian patients in this analysis supports further investigation of larger cohorts to confirm our observations.
Source: American Heart Journal - April 3, 2015 Category: Cardiology Source Type: research

Vorapaxar with or without clopidogrel after non–ST-segment elevation acute coronary syndromes: Results from the Thrombin Receptor Antagonist for Clinical Event Reduction in Acute Coronary Syndrome trial
Conclusions We observed no interaction between vorapaxar and clopidogrel after non–ST-segment elevation acute coronary syndromes on efficacy or safety outcomes, supporting a complementary role of protease-activated receptor 1 and P2Y12 antagonism.
Source: American Heart Journal - November 25, 2014 Category: Cardiology Source Type: research

Antithrombotic therapy for atrial fibrillation and coronary artery disease in older patients
Conclusions Among older patients with AF and CAD, overall warfarin use was low. Patients ≥80 years old at highest stroke risk received warfarin in similar proportions to the overall cohort. Further investigation into optimizing antithrombotic strategies in this population is warranted.
Source: American Heart Journal - October 20, 2014 Category: Cardiology Source Type: research

Extent of coronary artery disease and outcomes after ticagrelor administration in patients with an acute coronary syndrome: Insights from the PLATelet inhibition and patient Outcomes (PLATO) trial
Background: Extensive coronary artery disease (CAD) is associated with higher risk. In this substudy of the PLATO trial, we examined the effects of randomized treatment on outcome events and safety in relation to the extent of CAD.Methods: Patients were classified according to presence of extensive CAD (defined as 3-vessel disease, left main disease, or prior coronary artery bypass graft surgery). The trial's primary and secondary end points were compared using Cox proportional hazards regression.Results: Among 15,388 study patients for whom the extent of CAD was known, 4,646 (30%) had extensive CAD. Patients with extensiv...
Source: American Heart Journal - April 14, 2014 Category: Cardiology Authors: Anna Kotsia, Emmanouil S. Brilakis, Claes Held, Christopher Cannon, Gabriel P. Steg, Bernhard Meier, Frank Cools, Marc J. Claeys, Jan H. Cornel, Philip Aylward, Basil S. Lewis, Douglas Weaver, Gunnar Brandrup-Wognsen, Susanna R. Stevens, Anders Himmelmann Tags: Acute Ischemic Heart Disease Source Type: research

CYP2C19 genotype–guided antiplatelet therapy in ST-segment elevation myocardial infarction patients—Rationale and design of the Patient Outcome after primary PCI (POPular) Genetics study
Conclusion: The POPular Genetics study is the first large-scale trial comparing CYP2C19 genotype–guided antiplatelet therapy to a nontailored strategy in terms of net clinical benefit, safety, and cost-effectiveness.
Source: American Heart Journal - March 24, 2014 Category: Cardiology Authors: Thomas O. Bergmeijer, Paul W.A. Janssen, Jurjan C. Schipper, Khalid Qaderdan, Maycel Ishak, Rianne S. Ruitenbeek, Folkert W. Asselbergs, Arnoud W.J. van ‘t Hof, Willem J.M. Dewilde, Fabrizio Spanó, Jean-Paul R. Herrman, Johannes C. Kelder, Maarten J. P Tags: Trial Design Source Type: research

Rationale and design of The Intracoronary Stenting and Antithrombotic Regimen—Testing of a six-week versus a six-month clopidogrel treatment Regimen In Patients with concomitant aspirin and oraL anticoagulant therapy following drug-Eluting stenting (ISAR-TRIPLE) study
Background: An increasing number of patients undergoing coronary stenting need lifelong anticoagulation and therefore require a triple therapy typically consisting of aspirin, clopidogrel, and a vitamin K antagonist. Triple therapy confers an elevated bleeding risk as compared with dual therapy; however, omission of either antiplatelet or anticoagulation therapy might increase the risk of stent thrombosis or thrombembolic events. Although guidelines recommend a duration of dual antiplatelet therapy of 6 to 12months after drug-eluting stent (DES) implantation, the optimal duration of dual antiplatelet therapy in patients re...
Source: American Heart Journal - January 16, 2014 Category: Cardiology Authors: K. Anette Fiedler, Robert A. Byrne, Stefanie Schulz, Dirk Sibbing, Julinda Mehilli, Tareq Ibrahim, Michael Maeng, Karl-Ludwig Laugwitz, Adnan Kastrati, Nikolaus Sarafoff Tags: Trial Design Source Type: research

Design and rationale for the Prevention of Cardiovascular Events in Patients With Prior Heart Attack Using Ticagrelor Compared to Placebo on a Background of Aspirin–Thrombolysis in Myocardial Infarction 54 (PEGASUS-TIMI 54) trial
Conclusions: PEGASUS-TIMI 54 is investigating whether the addition of intensive antiplatelet therapy with ticagrelor to low-dose aspirin reduces major adverse cardiovascular events in high-risk patients with a history of myocardial infarction.
Source: American Heart Journal - January 8, 2014 Category: Cardiology Authors: Marc P. Bonaca, Deepak L. Bhatt, Eugene Braunwald, Marc Cohen, Philippe Gabriel Steg, Robert F. Storey, Peter Held, Eva C. Jensen, Marc S. Sabatine Tags: Trial Design Source Type: research

Effect of ticagrelor on the outcomes of patients with prior coronary artery bypass graft surgery: Insights from the PLATelet inhibition and patient outcomes (PLATO) trial
Conclusions: Prior-CABG patients presenting with acute coronary syndrome are a high-risk cohort for death and recurrent cardiovascular events but have a lower risk for major bleeding. Similar to the results in no-prior-CABG patients, ticagrelor was associated with a reduction in ischemic events without an increase in major bleeding.
Source: American Heart Journal - July 29, 2013 Category: Cardiology Authors: Emmanouil S. Brilakis, Claes Held, Bernhard Meier, Frank Cools, Marc J. Claeys, Jan H. Cornel, Philip Aylward, Basil S. Lewis, Douglas Weaver, Gunnar Brandrup-Wognsen, Susanna R. Stevens, Anders Himmelmann, Lars Wallentin, Stefan K. James Tags: Acute Ischemic Heart Disease Source Type: research

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