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Outcomes Among Clopidogrel, Prasugrel, and Ticagrelor in ST-Elevation Myocardial Infarction Patients Who Underwent Primary Percutaneous Coronary Intervention From the TOTAL Trial
ConclusionsIn this observational analysis of STEMI patients who underwent primary percutaneous coronary intervention, ticagrelor was associated with improved outcomes compared with clopidogrel and prasugrel. An appropriately powered randomized trial is needed to confirm these findings.RésuméContexteIl n’existe pas d’analyse robuste comparant les inhibiteurs P2Y12 à prise orale (clopidogrel, prasugrel et ticagrélor) chez les patients ayant subi un infarctus du myocarde avec élévation du segment ST (STEMI) traités par une intervention coronaire percutanée (ICP) primaire. Nous avons entrepris d’évaluer les rés...
Source: Canadian Journal of Cardiology - October 9, 2019 Category: Cardiology Source Type: research

Outcomes Among Clopidogrel, Prasugrel, And Ticagrelor In Stemi Patients Undergoing Primary Percutaneous Coronary Intervention From The Total Trial
ConclusionsIn this observational analysis of STEMI patients undergoing PPCI, ticagrelor was associated with improved outcomes compared to clopidogrel and prasugrel. An appropriately powered randomized trial is needed to confirm these findings.
Source: Canadian Journal of Cardiology - May 8, 2019 Category: Cardiology Source Type: research

Associations between Complex PCI and Prasugrel or Clopidogrel use in Patients with Acute Coronary Syndromes undergoing PCI: From the PROMETHEUS Study
Conclusions Despite the use of contemporary techniques, ACS patients undergoing complex PCI had significantly higher rates of 1-year MACE. Adjusted magnitude of treatment effects with prasugrel versus clopidogrel were consistent in complex and non-complex PCI without evidence of interaction. Teaser In this analysis from the PROMETHEUS ACS registry (n = 19,914), complex PCI (PCI of left main/ bifurcation/ moderate-severely calcified lesion/ stent length ≥30mm) was associated with greater risk of 1-year MACE (death, myocardial infarction, stroke or unplanned revascularization; HR 1.29 [1.20-1.39]). Treatment effects with p...
Source: Canadian Journal of Cardiology - December 27, 2017 Category: Cardiology Source Type: research

A risk assessment tool incorporating new biomarkers for cardiovascular events in acute coronary syndromes: the Organization to Assess Strategies in Ischemic Syndromes (OASIS) risk score
Conclusions The addition of NT-proBNP and hemoglobin A1C to 5 standard variables creates a 7-variable risk score that improves prediction of cardiovascular events at 1 year and aids in risk-based selection of NSTEACS patients for dual antiplatelet therapy. Teaser Several new biomarkers improve risk stratification in non-ST-segment elevation ACS, however they are not integrated into risk prediction tools. A risk score to predict CV death/MI/stroke was developed by incorporating new biomarkers with standard variables. The addition of NT-proBNP and hemoglobin A1C to 5 standard variables (age, prior MI/stroke, sex, ST-segment ...
Source: Canadian Journal of Cardiology - February 3, 2016 Category: Cardiology Source Type: research

Comparison of Dual-antiplatelet Therapy to Mono-antiplatelet Therapy After Transcatheter Aortic Valve Implantation: Systematic Review and Meta-analysis
Conclusions DAPT in patients who have undergone TAVI demonstrated no benefit over MAPT in reduction of ischemic events, with a trend toward increased harm because of bleeding. Future considerations should be given to MAPT with clopidogrel alone, as well as the omission of clopidogrel loading before the procedure.
Source: Canadian Journal of Cardiology - June 1, 2015 Category: Cardiology Source Type: research

Comparison of Dual Antiplatelet Therapy to Mono-antiplatelet Therapy Post-transcatheter Aortic Valve Implantation: Systematic review and Meta-analysis
Conclusion DAPT in comparison to MAPT in patients who have undergone TAVI demonstrated no benefit in reduction of ischemic events, with a trend towards increased harm due to bleeding. Future considerations should be given to MAPT with clopidogrel alone, as well as the omission of clopidogrel loading prior to the procedure. Teaser Post-TAVI dual antiplatelet therapy (DAPT) with ASA and clopidogrel is common practice despite the lack of clinical trial evidence demonstrating superiority over mono-antiplatelet therapy (MAPT) alone. The results of our meta-analysis demonstrate DAPT in comparison to MAPT showed no benefit in red...
Source: Canadian Journal of Cardiology - January 24, 2015 Category: Cardiology Source Type: research