Dual antiplatelet therapy may be beneficial post-CABG

Perioperative aspirin therapy in CABG improves graft patency, prevents ischemic events, and prolongs survival.  However, Aspirin resistance is common after CABG, particularly in the immediate post-operative period, in part due to cardiopulmonary bypass causing a pro-inflammatory, pro-thrombotic state.  Clopidogrel has revolutionised the practice of interventional cardiology but it remains unknown whether more aggressive antiplatelet treatment […]

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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 […]

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Increased use of antithrombotics increases hospital admissions for bleeding

The safety of multiple antithrombotic drug regimes has not been investigated in clinical trials.  Specifically, guidelines for the management of patients with myocardial infarction who also have an indication for warfarin are currently unclear; some recommend the use of clopidogrel and warfarin in combination following coronary stent implantation.  As bleeding episodes following myocardial infarction are […]

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New molecular switch linked to hypertrophy

Myocardial hypertrophy is a response to environmental stress that allows augmentation of pump function and reduces wall stress.  Importantly, the transition from hypertrophy to heart failure is associated with a decrease in cardiac contractility, ventricular remodeling and fibrosis, and myocyte loss. One of the most highly characterized hypertrophic signaling cascades involves the calcium dependent serine/threonine […]

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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 […]

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ACE and ARB in combination give no added benefits

Both angiotensin-converting enzyme (ACE) inhibitors and angiotensin II-receptor blockers (ARBs) have been shown to be of benefit in patients with heart failure, and in patients who have reduced ventricular function following a myocardial infarction.  However, it is less well known whether they provide benefit in patients with ischaemic heart disease (IHD) and preserved ventricular function.  […]

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