TALOS AMI Trial 2021

 Patients having PCI for acute MI who had completed one month of DAPT with aspirin and ticagrelor without ischemic or bleeding events were randomly assigned to either continue that regimen or switch to aspirin plus clopidogrel for the next 11 months in this study.



According to the findings of this trial, among patients undergoing PCI for AMI who had completed 1 month of DAPT with aspirin and ticagrelor without incident, switching to aspirin + clopidogrel for the next 11 months met criteria for noninferiority and superiority compared to continuing with aspirin + ticagrelor.


This was mostly due to a decrease in significant bleeding, although ischemia episodes were also reduced quantitatively with a de-escalation technique.


De-escalation was carried out without the need for genotype testing or reload.


These are intriguing findings that are both therapeutically meaningful and cost-effective. The only limitation is that this trial only involved East Asian patients, therefore its applicability in the United States is unknown.


In the last few years, we've seen a number of intriguing studies in the DAPT space.


The TWILIGHT trial has indicated that it may be possible to continue ticagrelor monotherapy and discontinue aspirin after 3 months with no reduction in ischemic outcomes and a reduction in bleeding outcomes in patients having PCI.


Similarly, STOPDAPT-2 suggested that in patients receiving PCI for stable ischemic heart disease and ACS, clopidogrel monotherapy might be continued after 1 month.


Switching to prasugrel 5 mg daily after 1 month was preferable to continuing with prasugrel 10 mg daily in HOST-REDUCE-POLYTECH-ACS. As a result, more complete revascularization, even of lesions that appear angiographically severe but do not cause ischemia per se, may be beneficial.

Comments

Post a Comment

Popular posts from this blog

EMPEROR-Preserved 2021 (Empagliflozin in HFpEF)

 Empagliflozin is better than placebo in improving HF outcomes among patients with symptomatic stable HFpEF on good baseline GDMT, regardless of diabetes status, according to the EMPEROR-Preserved study. The trial's purpose was to see if empagliflozin was safe and effective in patients with symptomatic heart failure with preserved ejection fraction (HFpEF), regardless of diabetes. Design of the Study: Patients were randomly assigned to either empagliflozin 10 mg (n = 2,997) or a placebo (n = 2,991) in a 1:1 ratio. Geographic location, diabetes status, estimated glomerular filtration rate (eGFR), and left ventricular ejection fraction were all used to stratify the experiment (LVEF: more or less than 50 percent ). All of the patients were being treated for heart failure. 11,583 people were screened in total. The total number of students enrolled is 5,988. Follow-up period: 26.2 months (median) The average patient is 72 years old. 45 percent of the population is female. The major outc...
Read more

MASTER DAPT Trial 2021

 In terms of net adverse clinical events, the MASTER DAPT trial found that shortened antiplatelet medication was not inferior to regular antiplatelet therapy. Description: The trial's purpose was to compare shortened antiplatelet therapy to standard antiplatelet therapy in patients who had percutaneous coronary intervention (PCI) using a biodegradable-polymer sirolimus-eluting stent. Design of the Study:  Participants with symptomatic coronary artery disease who had PCI during the previous 30-44 days were randomly assigned to one of two groups: shortened therapy (n = 2,295) or standard therapy (n = 2,284). Among people who do not require oral anticoagulation: Participants in the abbreviated therapy group promptly discontinued dual antiplatelet therapy (DAPT) and continued single antiplatelet therapy. Participants in the conventional therapy group received DAPT for 5 months before switching to mono antiplatelet medication. Those with an indication for oral anticoagulation inclu...
Read more

CRAVE Trial 2021 (Coffee Intake)

 The CRAVE trial found that coffee drinking increased PVCs and decreased sleep but decreased atrial arrhythmias and boosted physical activity. "These findings add to the emerging evidence that those with supraventricular tachycardia or atrial fibrillation should not avoid coffee," researchers said.  The research, conducted by Gregory M. Marcus, MD, MA, FACC, included 100 non-Hispanic White people with a median age of 38. Each participant wore an ECG monitor, a diabetes monitor, and a Fitbit. Researchers utilized a smartphone app to collect geolocation data and genotyped participants' DNA for coffee metabolism-related SNPs. Participants were randomly assigned to drink or avoid coffee for 14 days, with daily SMS reminders.  Overall, coffee intake was related with a 54% increase in PVCs, 36 minutes less sleep per night, and 1,058 more Fitbit-based steps per day. Each extra cup of coffee was linked to 3% more daily premature atrial contractions and 18 minutes less sleep. No s...
Read more