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

EAGLES- A Randomized Clinical Trial Showing No Evidence of Smoking Cessation Treatments Association with MACE

EAGLES (Evaluating Adverse Events in a Global Smoking Cessation Study), a randomized clinical trial, published in the Journal of the American Medical Association, provides evidence that smoking cessation medications do not increase the risk of serious cardiovascular events in the general population of smokers. Continue reading

Preventing Heart Attack, Stroke, and Major Adverse Limb Events in Patients with Stable Atherosclerotic Vascular Disease

Dr. John Eikelboom Speaks at Brigham and Women’s Hospital

Preventing Heart Attack, Stroke, and Major Adverse Limb Events in Patients with Stable Atherosclerotic Vascular Disease Dr. John Eikelboom Speaks at Brigham and Women's Hospital

Thrombectomy Done Beyond 6 Hours has a Favorable Prognosis in Stroke Patients

In a recent study published in the New England Journal of Medicine, it was found that endovascular thrombectomy for ischemic stroke that is performed 6 to 16 hours after the onset of symptoms resulted in better functional outcomes than standard medical therapy alone among patients with a proximal middle cerebral artery or internal carotid artery occlusion. Continue reading

Does Marijuana Use Impact Cardiovascular Health?

With the increasing use and the legalization of marijuana in several states of USA, there is a need to evaluate its impact on the health. To explore this, a systematic review was recently published in Annals of Internal Medicine by Ravi et al. In the study, the investigators studied the association between marijuana use and cardiovascular outcomes. The authors concluded, “Evidence examining the effect of marijuana on cardiovascular risk factors and outcomes, including stroke and myocardial infarction, is insufficient”. Continue reading

Novel Echo Markers In Stroke Risk Stratification In AFib

The assessment of left atrial reservoir strain and P-wave to A’ duration on tissue Doppler imaging provides additional risk stratification for stroke after initial CHA2DS2-VASc scoring, according to a study published in the European Heart Journal, and may prove helpful in guiding decisions about anticoagulation for patients after the diagnosis of atrial fibrillation. Continue reading

Silent Cerebral Microbleeds During TAVR

Dr. Eric Van Belle and Dr. Serge Korjian Discuss