CardioExchange Archive

March 14th, 2015

DAPT ‘Approaching the Point of Diminishing Returns’?

Larry Husten, PHD

After a myocardial infarction (MI), patients remain at high risk for recurrent events. The precise role of dual antiplatelet therapy (DAPT) to lower this risk has been the subject of considerable disagreement.  Now a new study offers fresh evidence that prolonged DAPT can lower risk over a long period, but only at the cost of […]

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February 24th, 2015

Increased Risk with NSAIDs Following Myocardial Infarction

Larry Husten, PHD

The cardiovascular safety of nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and diclofenac  has been the subject of considerable uncertainty and controversy. Now a new study published in JAMA raises specific concerns about the safety of these drugs in the highly vulnerable population of people who have had a recent myocardial infarction. Using data from several linked national […]

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January 14th, 2015

Ticagrelor Improves Outcomes After Myocardial Infarction

Larry Husten, PHD

For the first time, a very large trial has shown that dual antiplatelet therapy (DAPT) improves cardiovascular outcomes when given to patients 1 to 3 years after a myocardial infarction. Because DAPT has been shown previously to reduce the high risk of recurrent events for up to a year following an MI, it is considered to be standard […]

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November 16th, 2014

Prolonged Dual Antiplatelet Therapy Affirmed in DAPT

Larry Husten, PHD

The advent of drug-eluting stents dramatically reduced the restenosis rate associated with bare-metal stents but prompted new concerns about the rare but potentially lethal complication of stent thrombosis (ST). Cardiologists have relied upon dual antiplatelet therapy to prevent ST but there has been considerable uncertainty and controversy about the ideal duration of therapy. The Dual Antiplatelet […]

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May 28th, 2014

Prescription Delay Following Stent Implantation Is a Common and Deadly Problem

Larry Husten, PHD

After receiving a stent, many patients delay or fail to fill their prescription for clopidogrel or another antiplatelet agent. Now, a study published in the Journal of the American Heart Association offers evidence that this problem is widespread and often leads to serious consequences. Researchers analyzed data from all stent implantations performed in British Columbia from […]

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October 31st, 2013

Prolonged Dual Antiplatelet Therapy May Not be Necessary for Second-Generation Drug-Eluting Stents

Larry Husten, PHD

The precise duration of dual antiplatelet therapy (DAPT) following implantation of a drug-eluting stent (DES) has been the subject of considerable controversy. On the one hand, prolonged therapy may help prevent late stent thrombosis, which was particularly evident in first generation DESs. On the other hand, the risk of stent thrombosis may have diminished in […]

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September 19th, 2012

Studies Examine Less Burdensome Dual Antiplatelet Regimens

Larry Husten, PHD

Two new studies published in the Journal of the American College of Cardiology offer hope but not, yet, compelling evidence to support less burdensome requirements for dual antiplatelet therapy (DAPT) after drug-eluting stent (DES) implantation. In the first study, Spanish investigators followed 1622 consecutive patients who received a DES for 1 year. They found that 10.6% of the patients interrupted […]

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May 15th, 2012

Xience Stents Gain European Nod for 3-Month Dual Antiplatelet Therapy

Larry Husten, PHD

The biggest drawback to drug-eluting stents has been the requirement for prolonged dual antiplatelet (DAPT) therapy following stent implantation to prevent stent thrombosis and other potential complications. The precise length of DAPT has been the subject of considerable discussion and research. Now the Xience Prime and Xience V everolimus-eluting stents have received the CE Mark in […]

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November 7th, 2011

ACC and AHA Release New PCI and CABG Guidelines

Larry Husten, PHD

The AHA and the ACC have released updated 2011 guidelines for PCI and CABG. The guidelines are available online on the JACC website (here and here) and on the Circulation website. The new guidelines include for the first time a strong recommendation that hospitals adopt a “heart team” approach in choosing a treatment strategy for patients with coronary […]

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November 3rd, 2010

Do Your Patients Wait to Fill Their Plavix and Effient Prescriptions After Drug-Eluting Stent Implantation?

Chris Smith, RN

I recently read an article in the journal Circulation that contained an alarming finding about patients who receive drug-eluting stents. Apparently, 1 in 6 did not fill their clopidogrel prescriptions immediately after discharge from a hospital in one of three large integrated health care systems. The median delay was 3 days. Furthermore, during a median follow-up […]

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