January 14th, 2015
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 […]
September 15th, 2014
This week’s topics include prehospital ticagrelor in STEMI, ivabradine in stable CAD without clinical HF, FFR-guided PCI for stable CAD, and more.
September 4th, 2012
A large nationwide survey of MI survivors in Denmark provides new information about the efficacy of antiplatelet therapy with clopdiogrel in patients with diabetes. In a paper published in JAMA, Charlotte Andersson reports on 58,851 MI patients, 12% of whom had diabetes and 60% of whom received clopidogrel. As expected, diabetics had a worse outcome than nondiabetics: the composite […]
July 16th, 2012
Ticagrelor (Brilinta, AstraZeneca) gains equal standing with prasugrel (Effient, Lilly) and clopdiogrel in the newly released focused update of the ACCF/AHA guidelines for unstable angina and non-ST-elevation myocardial infarction (NSTEMI). The change had been widely anticipated since last year’s FDA approval of ticagrelor. “We have put it on equal footing with two other antiplatelet medications, clopidogrel […]
May 17th, 2012
For the second time in the past 6 months, a cardiology mainstay drug has lost patent protection and gone generic. Today, the FDA announced that it had approved several generic versions of clopidogrel (Plavix), the antiplatelet drug that for many years was the second best-selling drug in the world. Last November, the best-selling drug of all time, […]
May 11th, 2012
Harry Peled wonders whether intermediate-dose aspirin may simply be so effective that it obviates the need for a P2Y12-receptor antagonist.
November 7th, 2011
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 […]
September 21st, 2011
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 […]
July 28th, 2011
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% […]
July 25th, 2011
Three experts discuss whether — and with which patients — they will use ticagrelor in clinical practice.