Ticagrelor is a reversible, direct-acting, oral P2Y12-receptor antagonist that provides greater and more consistent platelet inhibition than clopidogrel. In the PLATO (PLATelet inhibition and patient Outcomes) trial, ticagrelor was found to be superior to clopidogrel for the treatment of a broad spectrum of patients admitted to hospital with an acute coronary syndrome. In this paper, […]
Category: Interventional cardiology
PLATO-Invasive: further evidence for benefit from ticagrelor
Ticagrelor is a reversible, direct-acting, oral P2Y12-receptor antagonist that provides greater and more consistent platelet inhibition than clopidogrel. In the PLATO (PLATelet inhibition and patient Outcomes) trial, ticagrelor was found to be superior to clopidogrel for the treatment of a broad spectrum of patients admitted to hospital with an acute coronary syndrome. In this paper, […]
Cangrelor fails to show benefit in Phase III trials
Cangrelor fails to show benefit in Phase III trialsCangrelor, a novel anti-platelet agent, is an intravenously administered P2Y12 antagonist with an almost instantaneous onset of action that produces profound and stable platelet inhibition in over 95% of individuals. Furthermore, the effect of the drug is quickly reversible and platelet responses approach baseline within 60 minutes […]
Dialysis Patients Undergoing PCI Frequently Receive Contraindicated Medications
Several antithrombotic agents commonly used by cardiologists during percutaneous coronary intervention (PCI) are not recommended for use in dialysis patients. Specifically, eptifibatide and enoxaparin are renally excreted and therefore not recommended for use in dialysis patients due to an increased risk of bleeding complications. Tsai and colleagues investigated the use of these agents amongst dialysis […]
HORIZONS-AMI reports 1 year results
In the HORIZONS-AMI (Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction) trial, the direct thrombin inhibitor bivalirudin was found to lower 30-day rates of net adverse clinical events and and haemorrhagic complications in AMI when compared to treatment with heparin and a glycoprotein IIb/IIIa inhibitor (GPI). The trial investigators examined whether these initial […]
Kidney disease triples bleeding risk post PCI
The need for dual antiplatelet therapy following percutaneous coronary intervention (PCI) also imposes a significant bleeding risk. Chronic kidney disease (CKD) is associated with poorer outcomes following PCI, and in addition a detrimental effect on platelet function is well described. In this study the authors investigated the outcomes of patients with chronic renal impairment (defined […]
Stent or Surgery? It depends on the SYNTAX
As percutaneous coronary intervention (PCI) continues to evolve, its ability to treat complex coronary artery disease (CAD) continues to improve.The SYNTAX (Synergy between PCI with Taxus and Cardiac Surgery) trial was designed to assess whether modern percutaneous techniques have assumed parity with coronary artery bypass surgery (CABG) for the treatment of complex (3 vessel or […]
No Benefit from Late Invasive Therapy for Occluded Arteries
A third of patients hospitalized with an acute myocardial infarction (MI) have persistent occlusion of the infarct related artery at 72 hours, despite the availability of several effective reperfusion strategies. This has led to interest as to whether some of the benefits seen with early opening of the artery could be achieved with later opening, […]
Prasugrel proves powerful in STEMI
Prasugrel is novel third-generation thienopyridine which is a more potent blocker of the platelet P2Y12 receptor than clopidogrel.The TRITON-TIMI 38 (Trial to assess Improvement in Therapeutic Outcomes by optimizing platelet inhibition with prasugrel – Thrombolysis in Myocardial Infarction 38) study compared clopidogrel with prasugrel in the setting of ST elevation myocardial infarction (STEMI). […]
Fractional Flow Reserve achieves FAME at last
Fractional flow reserve (FFR), calculated using a coronary presure wire, is an index of the physiological significance of a coronary stenosis and is defined as the ratio of maximal blood flow in a stenotic artery to normal maximal flow. FFR in a normal artery is 1.0 – a value <0.80 identifies ischaemia causing lesions with […]