December 5th, 2012
Aspirin Resistance May Not Be Real
Larry Husten, PHD
Is it resistance or pseudoresistance? According to a new study published in Circulation, aspirin resistance may be a myth, an artifact of the enteric coating of most aspirin tablets. The coating, which is designed to prevent gastrointestinal side effects caused by aspirin, may delay or conceal the effects of the drug, the study suggests, but the antiplatelet effects will […]
December 3rd, 2012
Selections from Richard Lehman’s Literature Review: December 3rd
Richard Lehman, BM, BCh, MRCGP
This week’s topics include the association between aldosterone-antagonist therapy and mortality and readmission among patients with HF and reduced EF, warfarin therapy after bioprosthetic AVR, and more.
November 4th, 2012
Platelet-Function Testing in Coronary Stenting: Frozen in Its Tracks
Gilles Montalescot, MD, PhD
An ARCTIC trial investigator discusses possible reasons why antiplatelet-drug and dosing adjustments, guided by platelet-function testing, did not improve clinical outcomes for stented patients.
November 4th, 2012
ARCTIC Blows a Cold Wind on Platelet Function Tests
Larry Husten, PHD
The use of platelet-function tests to monitor and guide antiplatelet therapy in PCI patients has sparked heated debate. Cardiologists have sought to reconcile biological plausibility with the absence of clinical evidence. Now the ARCTIC (Assessment by a Double Randomization of a Conventional Antiplatelet Strategy versus a Monitoring-guided Strategy for Drug-Eluting Stent Implantation versus Continuation One […]
March 15th, 2011
GRAVITAS Editorial: Why Invite the Fox into the Henhouse?
Richard A. Lange, MD, MBA and L. David Hillis, MD
Results from the GRAVITAS randomized trial, presented at the 2010 American Heart Association conference, have just been published in JAMA. They show that high-dose clopidogrel did not improve outcomes after percutaneous coronary intervention (PCI) in patients with “high on-treatment platelet reactivity” (i.e., during clopidogrel therapy), compared with clopidogrel given at conventional doses. Our interpretation at CardioExchange, reported at […]
November 16th, 2010
GRAVITAS: No Benefit for Clopidogrel Dosing Based on Platelet Function Test
Larry Husten, PHD
The GRAVITAS (Gauging Responsiveness With A VerifyNow Assay ─ Impact on Thrombosis and Safety) trial enrolled 2214 patients with high residual platelet reactivity, as assessed by the VerifyNow P2Y12 Test measured 12 to 24 hours after the procedure. (The manufacturer of the test, Accumetrics, sponsored the trial.) Patients in the trial were randomized to either high-dose clopidogrel […]
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