CardioExchange Archive

December 27th, 2011

Clopidogrel Testing Comes Under Fire

Larry Husten, PHD

The phenomenon of clopidogrel resistance has been much discussed, but no consensus has emerged about the best, or any, response to the problem. Now a review published in JAMA finds no clinically relevant relationship between the CYP2C19 genotype  and cardiovascular events. Michael Holmes and colleagues performed a meta-analysis of 32 studies involving CYP 2C19 genotyping and more than […]

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November 16th, 2011

ELEVATE-TIMI 56: One New Piece of the Clopidogrel Puzzle

Larry Husten, PHD

Tripling the maintenance dose of clopidogrel in most but not all patients with a common genetic variation will lower platelet reactivity to levels achieved in patients without the variation.

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October 25th, 2011

Genetic and Clinical Factors Linked to Stent Thrombosis

Larry Husten, PHD

French researchers have identified several genetic and clinical factors independently tied to early stent thrombosis. Writing in the Journal of the American Medical Association, Guillaume Cayla and colleagues report on their case-control study comparing 123 patients with definite early stent thrombosis with 246 matched controls without stent thrombosis. The researchers found three genes with variants that […]

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September 21st, 2011

More Data but No Answers About Platelet Function Testing

Larry Husten, PHD

The RECLOSE 2–ACS (Responsiveness to Clopidogrel and Stent Thrombosis 2–ACS) trial from Italy provides new information about platelet reactivity but doesn’t answer any of the key questions about the possible role of platelet function testing in clinical practice. In a paper published in JAMA, Guido Parodi and colleagues report on 1,789 ACS patients who underwent PCI and who […]

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August 29th, 2011

ESC: A Closure Device and a Warfarin Substitute for High-Risk AFib Patients

Stephen Fleet, MD

How can we manage a patient with atrial fibrillation and contraindications to warfarin therapy such as recurrent severe bleeding — a common scenario in clinical practice? Data from the manufacturer-sponsored ASAP study (ASA Plavix Feasibility Study with WATCHMAN Left Atrial Appendage Closure Technology) provides some hope, beyond what we had learned from the Protect AF […]

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July 28th, 2011

AstraZeneca Sets Premium Price for Ticagrelor

Larry Husten, PHD

AstraZeneca will be charging a premium price for its new antiplatelet drug ticagrelor (Brilinta). Wall Street analyst Timothy Anderson reports that the daily treatment cost for the drug will be $7.24 on a wholesaler acquisition cost (WAC) basis, which is approximately 20% higher than the daily cost of $6.08 for clopidogrel (Plavix) and about 25% […]

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July 25th, 2011

Panel: Will You Prescribe Ticagrelor (Brilinta)?

CardioExchange Editors, Staff

Three experts discuss whether — and with which patients — they will use ticagrelor in clinical practice.

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June 27th, 2011

Asprin Dosage in U.S. May Explain Disparity in Ticagrelor Results in PLATO

Larry Husten, PHD

Although the PLATO trial demonstrated the overall superiority of ticagrelor (Brilinta, AstraZeneca) to clopidogrel in more than 18,000 acute coronary syndrome patients worldwide, approval of the drug in the U.S. has been delayed because of ticagrelor’s lack of effect in the prespecified subgroup of patients from North America. Now, two analyses of the trial, presented […]

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June 2nd, 2011

Small Study Suggests Possible Benefits of Fish-Oil Supplements for PCI Patients

Larry Husten, PHD

A small study from Poland raises the possibility that supplements containing omega-3 fatty acids may have beneficial effects when given to PCI patients already taking aspirin and clopidogrel. The investigator-initiated study randomized 54 PCI patients to either 1 g per day of n-3 PUFA daily or placebo for one month. The results have been published […]

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May 13th, 2011

Simultaneous TIA and ACS After Aspirin Cessation for Palpebral Surgery

Jean-Pierre Usdin, MD and James Fang, MD

A 77-year-old man with metformin-treated type 2 diabetes, high blood pressure, moderate renal insufficiency, stable angina, and a history of phlebitis stopped taking aspirin in preparation for palpebral surgery. A day after the surgery, he presented to the ER with two transient ischemic attacks (TIAs) affecting the left arm. The patient complained to the examining neurologist of […]

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