Although guidelines recommend ticagrelor in the context of acute coronary syndrome alone, 33% of the trial participants were in stable condition at the time of enrollment. © 2021 American College of Cardiology Foundation. Editorial: Ziada KM, Moliterno DJ. Duration of therapy: Aspirin plus a P2Y12 inhibitor (dual antiplatelet therapy [DAPT]) should be continued for ≥12 months, unless bleeding risk is a concern. Description: The goal of the trial was to compare the safety and efficacy of 1 month of dual antiplatelet therapy (DAPT) following percutaneous coronary intervention (PCI) with either the Resolute Onyx drug-eluting stent (DES) or with the BioFreedom drug-coated stent (DCS) among patients at high bleeding risk. 4. Copyright® 2021 Radcliffe Medical Media. JAMA 2019;321:2414-27. Only given to select patients with STEMI in the cath lab This is the first UK national guideline to concentrate on acute lower gastrointestinal bleeding (LGIB) and has been commissioned by the Clinical Services and Standards Committee of the British Society of Gastroenterology (BSG). Clinical Topics: Acute Coronary Syndromes, Anticoagulation Management, Invasive Cardiovascular Angiography and Intervention, Prevention, Atherosclerotic Disease (CAD/PAD), Anticoagulation Management and ACS, Interventions and ACS, Interventions and Coronary Artery Disease, Keywords: ACC19, ACC Annual Scientific Session, Acute Coronary Syndrome, Anticoagulants, Aspirin, Chromium, Cobalt, Coronary Artery Disease, Drug-Eluting Stents, Hemorrhage, Myocardial Infarction, Myocardial Ischemia, Percutaneous Coronary Intervention, Platelet Aggregation Inhibitors, Renal Insufficiency, Chronic, Secondary Prevention, Stents, Stroke, Thrombosis, Vascular Diseases. BARC 3 or 5 bleeding was low, but 1-month DAPT was also associated with a reduction in this outcome compared with 12-month DAPT. Questions: 1. How does this compliment existing data and what are the implications for practice? All rights reserved. 140, No. Watanabe H, Domei T, Morimoto T, et al. Generally, if tolerating DAPT at 1 year, continue for up to 3 years with one of the following: ASA 81mg daily + Ticagrelor 60mg BID (PEGASUS-TIMI-54 Trial) ASA 81mg daily + Clopidogrel 75mg daily (DAPT Trial) ASA 81mg daily + Prasugrel 10mg daily (DAPT Trial) GP IIB/IIIA inhibitors. publisher and the Radcliffe Group Ltd. The primary outcome, death, myocardial infarction (MI), stent thrombosis, stroke, TIMI major/minor bleeding at 1 year, occurred in 2.4% of the 1-month DAPT group compared with 3.7% of the 12-month DAPT group (p for superiority = 0.04). Effect of 1-Month Dual Antiplatelet Therapy Followed by Clopidogrel vs 12-Month Dual Antiplatelet Therapy on Cardiovascular and Bleeding Events in Patients Receiving PCI: The STOPDAPT-2 Randomized Clinical Trial. The design of this trial is like the GLOBAL LEADERS trial. A total of five randomized clinical trials (∼32 000 patients) were available. Major bleeding was significantly lower in the patients assigned to short DAPT followed by P2Y 12 inhibitor SAPT compared with those assigned to 12-month DAPT (HR 0.63). All rights reserved. The current US and European guidelines recommend DAPT for at least 12 months in acute coronary syndrome and for at least 6 months in stable coronary artery disease without high bleeding risk. Presented by Dr. Hirotoshi Watanabe at the American College of Cardiology Annual Scientific Session (ACC 2019), New Orleans, LA, March 18, 2019. Dual Antiplatelet Therapy: Is It Time to Cut the Cord With Aspirin? The STOPDAPT-2 trial showed that 1-month DAPT was superior to 12-month DAPT at preventing net adverse ischemic events. Final 1-year clinical follow-up was completed in January 2019. Congenital Heart Disease and Pediatric Cardiology, Invasive Cardiovascular Angiography and Intervention, Pulmonary Hypertension and Venous Thromboembolism, CardioSource Plus for Institutions and Practices, Nuclear Cardiology and Cardiac CT Meeting on Demand, Annual Scientific Session and Related Events, ACC Quality Improvement for Institutions Program, National Cardiovascular Data Registry (NCDR). Where views/opinions are Filmed on site at CRT 2019 by Radcliffe Cardiology. Home Circulation Vol. Oxford University Hospitals NHS Foundation Trust group. There was evidence of possible treatment interaction favoring 12 months of DAPT among those with chronic kidney disease. The Guidelines Development Group consisted of representatives from the BSG Endoscopy Committee, the Association of Coloproctology of … One of the biggest new 1968 Mustang parts was the 302 V-8 engine that was much more powerful and would replace the 289 V-8. TIMI major/minor bleeding at 1 year: 0.4% of 1-month DAPT group compared with 1.5% of 12-month DAPT group (p for superiority = 0.004) Bleeding Academic Research Consortium (BARC) 3 or 5 bleeding at 1 year: 0.5% of 1-month DAPT group compared with 1.8% of 12-month DAPT group (p for superiority = 0.003) a substitute for professional medical advice. What is the role of dual antiplatelet therapy after high risk transient ischaemic attack or minor stroke? One-month DAPT was noninferior to 12-month DAPT at preventing major adverse ischemic events and superior to 12-months DAPT at preventing TIMI major/minor bleeding. See … These EAU Guidelines offer practical evidence-based guidance on the assessment and treatment of men aged 40 years or older with various non-neurogenic benign forms of LUTS. Dr C. Michael Gibson (Beth Israel Deaconess Medical Center, Boston, MA, US) discusses Rivaroxaban 2.5 mg BID combined with DAPT for the prevention of death/MI/stroke - a patient level data meta-analysis of the ATLAS-ACS-2 TIMI-51 and the COMMANDER HF trials, Filmed on site at CRT 2019 by Radcliffe Cardiology. Invasive Cardiovascular Angiography and Intervention, Interventions and Coronary Artery Disease, P2Y12 Inhibitor Monotherapy vs. Dual Antiplatelet Therapy in Patients Undergoing Percutaneous Coronary Intervention, GLOBAL LEADERS: A Clinical Study Comparing Two Forms of Antiplatelet Therapy After Stent Implantation, Congenital Heart Disease and     Pediatric Cardiology, Invasive Cardiovascular Angiography    and Intervention, Pulmonary Hypertension and Venous     Thromboembolism, PCI with a cobalt chromium everolimus-eluting stent, Death, MI, stent thrombosis, or stroke at 1 year: 2.0% of 1-month DAPT group compared with 2.5% of 12-month DAPT group (p for noninferiority = 0.005), TIMI major/minor bleeding at 1 year: 0.4% of 1-month DAPT group compared with 1.5% of 12-month DAPT group (p for superiority = 0.004), Bleeding Academic Research Consortium (BARC) 3 or 5 bleeding at 1 year: 0.5% of 1-month DAPT group compared with 1.8% of 12-month DAPT group (p for superiority = 0.003), Definite or probable stent thrombosis: 0.3% of 1-month DAPT group compared with 0.07% of 12-month DAPT group (p for superiority = 0.21). Dr C. Michael Gibson (Beth Israel Deaconess Medical Center, Boston, MA, US) discusses Rivaroxaban 2.5 mg BID combined with DAPT for the prevention of death/MI/stroke - a patient level data meta-analysis of the ATLAS-ACS-2 TIMI-51 and the COMMANDER HF trials. Media. Percutaneous coronary intervention (PCI), also known as coronary angioplasty, is a nonsurgical technique for treating obstructive coronary artery disease, including unstable angina, acute myocardial infarction (MI), and multivessel coronary artery disease (CAD). Patients undergoing PCI were randomized to 1 month of DAPT followed by clopidogrel monotherapy for 5 years (n = 1,523) versus 12 months of DAPT followed by aspirin monotherapy for 5 years (n = 1,522). However, a few 68 Mustang parts were updated to meet new federal safety guidelines and make small improvements to the Mustang overall. JAMA 2019;321:2409-11. 2 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society in Collaboration With the Society of Thoracic Surgeons an agent of, the Oxford Heart Centre, the John Radcliffe Hospital or the It is not affiliated with or is Radcliffe Cardiology is part of Radcliffe Medical Media, an independent expressed, they are those of the author(s) and not of Radcliffe Medical Published content on this site is for information purposes and is not The goal of the trial was to evaluate 1-month dual antiplatelet therapy (DAPT) compared with 12-month DAPT among patients undergoing percutaneous coronary intervention (PCI). Immediate release: Oral: 75 to 100 mg once daily (ACC/AHA [Levine 2016]; Hennekens 2019; Mehta 2001). Specifically, does dual antiplatelet therapy with a combination of aspirin and clopidogrel lead to a greater reduction in recurrent stroke and death over the use of aspirin alone when given in the first 24 hours after a high risk transient ischaemic attack or minor … Click here to access the corresponding chapter in ESC CardioMed - Section 19 Diabetes mellitus and metabolic syndrome Guidelines on antithrombotic therapy after TAVI are scarce and no randomized evaluation has been performed to demonstrate what the optimal antithrombotic strategy is. Among patients undergoing PCI for stable and unstable cardiovascular disease, 1-month DAPT followed by clopidogrel monotherapy was superior to 12-month DAPT followed by aspirin monotherapy at preventing net adverse clinical events. CRT 2019: Rivaroxaban 2.5 MG Bid Combined With Dapt for the Prevention of Death/MI/Stroke. New 1968 Mustang parts was the 302 V-8 engine that was much more powerful and would replace the 289.! 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