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Use of prasugrel vs clopidogrel and outcomes in patients with acute coronary syndrome undergoing percutaneous coronary intervention in contemporary clinical practice: Results from the PROMETHEUS study
Conclusions In contemporary clinical practice, patients receiving prasugrel tend to have a lower-risk profile compared with those receiving clopidogrel. The lower ischemic and bleeding events associated with prasugrel use were no longer evident after accounting for these baseline differences.
Source: American Heart Journal - April 1, 2017 Category: Cardiology Source Type: research

Dual Antiplatelet Therapy in Patients with Diabetes and Acute Coronary Syndromes Managed without Revascularization
Conclusions Among NSTE ACS patients managed medically without revascularization, patients with DM had a higher risk of ischemic events that was amplified among those treated with insulin. There was no differential treatment effect with a more potent DAPT regimen of aspirin + prasugrel vs. aspirin + clopidogrel.
Source: American Heart Journal - March 28, 2017 Category: Cardiology Source Type: research

A prospective, randomized, open-label trial of 6-month versus 12-month dual antiplatelet therapy after drug-eluting stent implantation in ST-elevation myocardial infarction: Rationale and design of the “DAPT-STEMI trial”
Publication date: June 2017 Source:American Heart Journal, Volume 188 Author(s): Elvin Kedhi, Enrico Fabris, Martin van der Ent, Mark W. Kennedy, Pawel Buszman, Clemens von Birgelen, Stéphane Cook, Hans Wedel, Felix Zijlstra Background The optimal duration of dual antiplatelet therapy (DAPT) after percutaneous coronary intervention with second-generation drug eluting stents (DESs) is unclear. Because prolonged DAPT is associated with higher bleeding risk and health care costs, establishing optimal DAPT duration is of paramount importance. No other randomized controlled trials have evaluated the safety of shorter DAPT dur...
Source: American Heart Journal - March 20, 2017 Category: Cardiology Source Type: research

Use of Prasugrel versus Clopidogrel and Outcomes in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention in Contemporary Clinical Practice: Results from the PROMETHEUS Study
Conclusions In contemporary clinical practice, patients receiving prasugrel tend to have a lower-risk profile compared with those receiving clopidogrel. The lower ischemic and bleeding events associated with prasugrel use were no longer evident after accounting for these baseline differences.
Source: American Heart Journal - February 20, 2017 Category: Cardiology Source Type: research

Differential Occurrence, Profile, and Impact of First Recurrent Cardiovascular Events After an Acute Coronary Syndrome
Conclusions Approximately 9% of patients experienced a first cardiovascular event in the post-ACS setting during a median follow-up of 1year. While the profile and prognostic implications of stroke versus MI as the first nonfatal event differ substantially, approximately one-third of these patients experienced a second event, typically soon after the first event. These findings have implications for improving post-ACS care and influencing the design of future cardiovascular trials.
Source: American Heart Journal - February 20, 2017 Category: Cardiology Source Type: research

A Prospective, Randomized, Open Label Trial of 6Months vs. 12Months Dual Antiplatelet Therapy After Drug-Eluting Stent Implantation In ST-elevation Myocardial Infarction: Rationale and design of the “DAPT-STEMI trial”
Publication date: Available online 20 February 2017 Source:American Heart Journal Author(s): Elvin Kedhi, Enrico Fabris, Martin van der Ent, Mark Kennedy, Pawel Buszman, Clemens von Birgelen, Stéphane Cook, Hans Wedel, Felix Zijlstra Abstract. Background The optimal duration of dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) with second-generation drug eluting stents (DES) is unclear. Because prolonged DAPT is associated with higher bleeding risk and health care costs, establishing optimal DAPT duration is of paramount importance. No other randomized controlled trials have evaluated the sa...
Source: American Heart Journal - February 20, 2017 Category: Cardiology Source Type: research

Association of Measured Platelet Reactivity with Changes in P2Y12 Receptor Inhibitor Therapy and Outcomes Following Myocardial Infarction: Insights into Routine Clinical Practice from the TRANSLATE-ACS Study
Conclusions Only one-third of PCI-treated MI patients with high on-clopidogrel platelet reactivity were switched to a more potent P2Y12 receptor inhibitor. Intensification of antiplatelet therapy was associated with lower risk of ischemic events at 1year among HPR patients.
Source: American Heart Journal - February 10, 2017 Category: Cardiology Source Type: research

A randomized clinical trial comparing long-term clopidogrel vs aspirin monotherapy beyond dual antiplatelet therapy after drug-eluting coronary stent implantation: Design and rationale of the Harmonizing Optimal Strategy for Treatment of coronary artery stenosis-Extended Antiplatelet Monotherapy (HOST-EXAM) trial
Conclusions The HOST-EXAM will be the first large-scale randomized controlled study to directly compare the efficacy and safety of long-term antiplatelet monotherapy beyond DAPT after DES implantation. This study will provide clinical evidence to establish optimal regimen for long-term antiplatelet therapy after DES implantation.
Source: American Heart Journal - December 20, 2016 Category: Cardiology Source Type: research

A randomized clinical trial comparing long-term clopidogrel versus aspirin monotherapy beyond dual antiplatelet therapy after drug-eluting coronary stent implantation: Design and rationale of the HOST-EXAM trial
Conclusions The HOST-EXAM will be the first large-scale randomized controlled study to directly compare the efficacy and safety of long-term antiplatelet monotherapy beyond DAPT after DES implantation. This study will provide clinical evidence to establish optimal regimen for long-term antiplatelet therapy after DES implantation.
Source: American Heart Journal - December 9, 2016 Category: Cardiology Source Type: research

A comparison of reduced-dose prasugrel and standard-dose clopidogrel in elderly patients with acute coronary syndromes undergoing early percutaneous revascularization: design and rationale of the randomized Elderly-ACS 2 Study
Conclusion The Elderly-ACS 2 study is a multicenter, randomized trial comparing a strategy of dual antiplatelet therapy with a reduced dose of prasugrel with a standard dose of clopidogrel in elderly patients with ACS undergoing percutaneous revascularization. (The Elderly ACS 2 trial: NCT01777503)
Source: American Heart Journal - August 26, 2016 Category: Cardiology Source Type: research

Complete Versus Incomplete Revascularization in Patients with Multivessel Coronary Artery Disease Treated With Drug-Eluting Stents
Conclusions Among patients with multivessel CAD treated with DES, as compared with CR, IR was associated with similar risk of death. However, IR was associated with a higher risk of MI during follow-up.
Source: American Heart Journal - July 7, 2016 Category: Cardiology Source Type: research

Impact of glycoprotein IIb/IIIa inhibitors on the efficacy and safety of ticagrelor compared with clopidogrel in patients with acute coronary syndromes: Analysis from the Platelet Inhibition and Patient Outcomes (PLATO) Trial
Conclusions In patients with acute coronary syndrome undergoing early PCI, the efficacy and safety of ticagrelor as compared with clopidogrel were not modified by GPI use according to the primary efficacy and safety end point of the trial, although there were indications of greater benefit on definite stent thrombosis and more major or minor bleeding with ticagrelor in patients without (vs with) GPI treatment.
Source: American Heart Journal - May 7, 2016 Category: Cardiology Source Type: research

Impact of Glycoprotein IIb/IIIa Inhibitors on the Efficacy and Safety of Ticagrelor Compared to Clopidogrel in Patients with Acute Coronary Syndromes - Analysis from the PLATO (Platelet Inhibition and Patient Outcomes) Trial
Conclusions In patients with ACS undergoing early PCI the efficacy and safety of ticagrelor as compared with clopidogrel was not modified by GPI use according to the primary efficacy and safety endpoint of the trial, although there were indications of greater benefit on definite stent thrombosis and more major or minor bleeding with ticagrelor in patients without (vs. with) GPI treatment.
Source: American Heart Journal - April 13, 2016 Category: Cardiology Source Type: research

Non-eligibility for reperfusion therapy in patients presenting with ST-segment elevation myocardial infarction: Contemporary insights from the National Cardiovascular Data Registry (NCDR)
Conclusion Most patients with STEMI not receiving reperfusion therapy had a documented reason. Coronary anatomy not suitable for PCI was the major contributor to ineligibility. In-hospital mortality was higher in patients not receiving reperfusion therapy.
Source: American Heart Journal - January 12, 2016 Category: Cardiology Source Type: research

Addition of cilostazol to aspirin therapy for secondary prevention of cardiovascular and cerebrovascular disease in patients undergoing percutaneous coronary intervention: A randomized, open-label trial
Conclusions In patients who underwent coronary stent implantation, the addition of cilostazol to aspirin therapy was associated with lower rates of cardiovascular and cerebrovascular events at 2 years compared with aspirin monotherapy.
Source: American Heart Journal - January 12, 2016 Category: Cardiology Source Type: research

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