Month: May 2018
Low Dose Rivaroxaban Plus Aspirin Reduces Major Adverse Limb Events in COMPASS A COMPASS subgroup analysis
According to a new subgroup analysis of the COMPASS trial published in the Journal of the American College of Cardiology, the prevention of Major Adverse Limb Events (MALE) is of utmost importance in patients with lower extremity Peripheral Arterial Disease (PAD) due to its poor prognosis. Additionally, it has been found that the aspirin and rivaroxaban 2.5mg twice daily combination leads to a significant reduction of Major Adverse Limb Events (MALE) in these patients.
Five year follow up on FFR guided PCI for Stable CAD – What Did We Learn From FAME2?
In the final follow up of the FAME 2 study, published in The New England Journal of Medicine, five year outcomes were reported comparing percutaneous coronary intervention (PCI) guided by fractional flow reserve (FFR) to medical therapy alone. The hypothesis had suggested FFR guided PCI would be superior to medical therapy as initial treatment in patients with stable coronary artery disease. Continue reading
Discharging Patients Is Safe, the Next Day After Minimalist TAVR
In a recent study published in the Journal of the American College of Cardiology (JACC), it was found that patients undergoing uncomplicated TAVR have a safe next-day discharge (NDD) profile with no difference in 30-day mortality rate in comparison to an increased length of hospital stay. In addition, the study also highlighted better 1-year clinical outcomes in patients as compared to non-NDD group. Continue reading
Greater Cholesterol Variability Is a Predictor for Atheroma Progression
“The variation in cholesterol levels is associated with an increase in the percentage of atheroma volume and worse clinical outcomes,” says a new meta-analysis in the European Heart Journal. Continue reading
Organizing and Actualizing a Polypharmacy
Dr. Fanikos Speaks at Brigham and Womens’ Hospital
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Coronary Sinus Reducer Implantation Improves Chronic Refractory Angina
A recent study published in the Journal of American College of Cardiology found that implantation of the coronary sinus Reducer is safe and is associated with a reduction of anginal symptoms and improvement of quality of life in patients with refractory angina who were not candidates for further revascularization. Continue reading
Dual Therapy Reduces Bleeding Compared with Triple Therapy in A-Fib after PCI
Antithrombotic therapy with vitamin K antagonist (VKA) and aspirin plus a P2Y12 inhibitor has been the cornerstone of medication regimen among stented patients with atrial fibrillation (AF) for decades. However, this traditional “triple therapy” (TAT) has been associated with a three to four-fold increased risk of bleeding. The ISAR Triple and WOEST Trial demonstrated that VKA in addition to one antiplatelet therapy was associated with a reduced risk of bleeding compared to the triple therapy. More recently, safety of non-Vitamin K oral anti-coagulant (NOAC)-based strategies, using a NOAC plus a P2Y12 inhibitor, has been compared to vitamin K antagonist (VKA)-based triple therapy, in the PIONEER AF-PCI and REDUAL PCI randomized trials; both of which have demonstrated that NOAC-based strategies are safer and provide an attractive alternative to VKA-based triple therapy among AF patients who undergo percutaneous intervention (PCI). However, none of these randomized controlled trials was powered to assess the efficacy of dual anti-thrombotic (DAT) strategies. The higher safety associated with DAT has brought this fresh treatment modality into the limelight. Continue reading
