CardioExchange Archive

June 30th, 2014

Registry Study Offers Reassurance About Newer Drug-Eluting Stents

Larry Husten, PHD

Findings from a large ongoing registry study provide some reassurance about the long-term safety of new-generation drug-eluting stents (DES)  in patients with STEMI who undergo primary PCI. The results are published online in the Journal of the American College of Cardiology. SCAAR (Swedish Coronary Angiography and Angioplasty Registry) investigators analyzed data from 34,000 primary PCI patients who […]

---

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 […]

---

October 7th, 2013

Study Supports Loosening Guidelines for Surgery After Stent Implantation

Larry Husten, PHD

According to current guidelines, noncardiac surgery should be delayed for six weeks after bare-metal stent (BMS) implantation and for one year after drug-eluting stent (DES) implantation, though there is little good evidence to support these recommendations. Stent thrombosis caused by discontinuation of antiplatelet therapy in order to lower the risk of bleeding during surgery is the […]

---

June 28th, 2013

FDA Turns Back New Indication for Rivaroxaban to Prevent Stent Thrombosis in ACS Patients

Larry Husten, PHD

Johnson & Johnson said today that it had received a complete response letter from the FDA for the supplemental new drug application (sNDA) for rivaroxaban (Xarelto) for the prevention of stent thrombosis in patients with acute coronary syndromes (ACS). Earlier this year the FDA turned down for the second time the sNDA for the  general use of […]

---

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 […]

---

March 28th, 2012

A Great Take-Away Message

Jeremiah Depta, MD

A Fellow leaves ACC with a lifelong lesson from Dr. Antonio Colombo: Never accept a bad outcome as a stroke of bad luck, and the outliers (i.e. bad outcomes) are the cases where we can learn the most.

---

March 22nd, 2012

Large Meta-Analysis Finds Very Low Thrombosis Rates for Xience Stent

Larry Husten, PHD

A large new meta-analysis published in the Lancet provides the best evidence yet that the cobalt-chromium everolimus eluting (CoCr-EES) stents (Xience and Promus) have a significantly lower rate of stent thrombosis than bare-metal stents (BMS) and other drug-eluting stents (DES). Tullio Palmerini and colleagues analyzed data from 49 randomized trials comparing different stents in more than 50,000 patients. Odds ratios for 1-year […]

---

December 30th, 2011

CYP2C19 Genotyping: Down For The Count?

Richard A. Lange, MD, MBA and L. David Hillis, MD

The controversy over the use of genetic testing to guide antiplatelet therapy reminds us of a WWF (Worldwide Wrestling Federation) tag team match.   What we agree upon (the match rules): Clopidogrel is a prodrug activated by several enzymes, including CYP2C19, and common genetic variations alter CYP2C19 activity. Here’s where the wrestling match begins: Are the CYP2C19 genetic […]

---

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 […]

---

February 22nd, 2011

Study Links Stent Thrombosis to Circadian Variation

Larry Husten, PHD

Circadian patterns have long been known to influence the cardiovascular system, resulting in early morning peaks in blood pressure, heart rate, and certain hormone levels, as well as an increased risk for MI and sudden cardiac death. Now, in a study published in JACC: Cardiovascular Interventions, Karim Mahmoud and colleagues have found that coronary stent […]

---