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The COMPASS trial: practical considerations for application after coronary artery bypass surgery
Purpose of review We review the cardiovascular outcomes for people using anticoagulation strategies (COMPASS) trial with particular emphasis on patients with a history of remote coronary artery bypass grafting (CABG) and those who were enrolled 4–14 days after CABG. We provide practical guidance for selecting patients with the greatest potential to benefit who have acceptable bleeding risk. In particular, we address concerns about postoperative bleeding and discuss the relative merits of rivaroxaban and aspirin versus P2Y12 inhibition and aspirin. Recent findings The COMPASS trial demonstrated that rivaroxaban and a...
Source: Current Opinion in Cardiology - August 13, 2020 Category: Cardiology Tags: COMPLEX ISSUES IN CORONARY REVASCULARIZATION: Edited by Bobby Yanagawa and Subodh Verma Source Type: research

Net Adverse Clinical Events With Antiplatelet Therapy in Acute Coronary Syndromes
Clopidogrel, prasugrel, and ticagrelor are oral platelet P2Y12 receptor inhibitors that decrease the risk of platelet-mediated coronary artery thrombosis. Clinical guidelines have recommended ticagrelor or prasugrel over clopidogrel in combination with aspirin as dual antiplatelet therapy (DAPT) for 1 year after acute coronary syndrome (ACS), whether or not percutaneous coronary intervention (PCI) is performed. The ticagrelor recommendation was based on the Study of Platelet Inhibition and Patient Outcomes (PLATO) trial, which enrolled 18  624 patients with ACS and randomized them to receive DAPT with either clopidogrel ...
Source: JAMA - October 27, 2020 Category: General Medicine Source Type: research

Risks and benefits of concurrent treatment with antiplatelet and anticoagulation therapy in post ‐op bioprosthetic aortic valve replacement patients
ConclusionPatients who underwent bAVR and were discharged on concurrent therapy compared to aspirin only had a significantly increased risk of bleeding without a significant difference in thromboembolic events.
Source: Journal of Cardiac Surgery - January 13, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Carma Yaghi, Rajeev Masson, Kyoko Yamada, Shiyun Zhu, Christine Fong, Aida Shirazi, Paul LaPunzina, Kenny Mok Tags: ORIGINAL ARTICLE Source Type: research

Ticagrelor or aspirin after coronary artery bypass in patients with chronic kidney disease
CONCLUSIONS: In patients with CKD and CABG, those who received ticagrelor had a higher incidence of MACCE but a similar incidence of major bleeding compared to those who received aspirin.PMID:33819474 | DOI:10.1016/j.athoracsur.2021.03.061
Source: The Annals of Thoracic Surgery - April 5, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Sigrid E Sandner Heribert Schunkert Adnan Kastrati Milan Milojevic Andreas B öning Daniel Zimpfer Stephan Zellmer Dominik Wiedemann G ünther Laufer Moritz von Scheidt TiCAB Investigators Source Type: research

Ticagrelor: clinical development and future potential
Rev Cardiovasc Med. 2021 Jun 30;22(2):373-394. doi: 10.31083/j.rcm2202044.ABSTRACTPlatelets participate centrally in atherothrombosis, resulting in vessel occlusion and ischaemia. Consequently, optimisation of antiplatelet regimens has the potential to further reduce the residual burden of morbidity and mortality associated with atherosclerosis. Ticagrelor is a potent oral platelet P2Y12 receptor antagonist that (1) inhibits a central amplification pathway of platelet activation directly as well as via an active metabolite, (2) has a rapid onset and offset of antiplatelet action that remains consistent in the circulation d...
Source: Reviews in Cardiovascular Medicine - July 14, 2021 Category: Cardiology Authors: Nicholas C Sanderson William A E Parker Robert F Storey Source Type: research

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