Tag Archives: PCI

The COMBO™ dual therapy stent REDUCE (Short-term Dual Anti Platelet Therapy in Patients with ACS Treated with the COMBO Dual-therapy Stent), a physician-initiated, prospective, multi-centre, randomised study, was conducted in 36 hospitals in Europe and Asia, enrolling a total of 1,496 ACS patients. The study was designed to demonstrate non-inferiority of a strategy of short-term (three months) dual antiplatelet therapy (DAPT) compared to standard 12-month DAPT in patients with ACS treated with a dual-therapy stent. The stent used in the study COMBO™ (OrbusNeich) is a sirolimus-eluting stent with an abluminal biodegradable polymer matrix,

Approximately 20–30% of patients with AF, who are continuously taking an oral anticoagulant to reduce their risk of AF-related stroke, have coexisting coronary artery disease and may require PCI. The current practice of administering triple therapy with warfarin and two antiplatelet agents in patients with AF after a PCI is associated with high rates of major bleeding. RE-DUAL PCI tested an alternative treatment strategy: dual therapy with dabigatran and a single antiplatelet agent (P2Y12 inhibitor). Selected for one of the meeting’s hotline sessions and simultaneously published in the New England Journal of Medicine (https://doi.org/10.

PREVAIL not presented but eases safety concerns on Watchman The PREVAIL trial of a new device which closes the left atrial appendage in the heart (Watchman®, Boston Scientific) attracted huge controversy at the ACC meeting when it was removed from the programme within an hour of its presentation because of an embargo break by the sponsor, Boston Scientific. But the slides and a press release were still made available to the media, and preliminary results appear to suggest some reassurance on safety concerns generated in a previous study. The device, which is implanted via a trans-septal catheter-based delivery system, is already available in

New editorial board member Dr Ketan Dhatariya We are delighted to welcome Dr Ketan Dhatariya to our editorial board. Dr Dhatariya is a consultant in diabetes, endocrinology and general medicine at Norfolk and Norwich University Hospital, Norwich. He is also a senior lecturer at the University of East Anglia, and an assistant professor of medicine at St George’s University, Grenada, in the West Indies. He has published on a wide variety of diabetes- and endocrine-related subjects, including diabetes-related foot disease. He serves as meetings secretary for the Association of British Clinical Diabetologists, and medical secretary for the Spec

Highlights of this year’s European Society of Cardiology Congress, held in Stockholm, Sweden, from August 28th to September 1st included a new drug which benefits heart failure by slowing heart rate, and more exciting results from oral compounds that could replace warfarin in various indications. Highlights of this year’s European Society of Cardiology Congress, held in Stockholm, Sweden, from August 28th to September 1st included a new drug which benefits heart failure by slowing heart rate, and more exciting results from oral compounds that could replace warfarin in various indications. SHIFT: ivabradine shows benefit in heart failure

Introduction Developments along the way have included better patient selection, improved peri-procedural management of patients and, with newer-generation drugs and devices, better results. Recent hurdles have been confronted, including left main stem disease, complex bifurcation lesions and total chronic occlusions. Similarly, primary percutaneous coronary intervention (PCI) has become the treatment of choice in acute myocardial infarction. Challenges remain, however, including restenosis. The fine balance between thrombosis and haemostasis demands that we provide more effective and predictable antiplatelet strategies to optimise risk reduct

Introduction While primary PCI, rather than thrombolysis, is now the reperfusion treatment of choice for STEMI, the majority of patients coming for revascularisation in the UK have stable coronary disease or NSTE-ACS. In the treatment of NSTE-ACS, first principles involve the selection of patients for diagnostic angiography followed by either PCI or coronary artery bypass grafting (CABG). Rates of PCI are increasing annually in the UK, which, in part, is a reflection of greater awareness of coronary artery disease, its earlier diagnosis and treatment in the ageing population. This section looks at coronary intervention in general, how PCI act

Introduction The discovery of the thienopyridines, or ADP receptor antagonists, led to the development of more effective oral antiplatelet agents. Trials assessed dual antiplatelet therapy in high-risk patients versus aspirin alone and the significant benefits observed have resulted in dual antiplatelet therapy becoming a mainstay of treatment. As expected with more potent dual therapy, there is always a fine balance between prevention of thrombosis and bleeding risk. There are still many challenges to overcome. Many patients, such as those with diabetes or with a previous stent thrombosis, are at high risk for further infarction, indicating

So there I was, sitting in one of our twice-weekly multi-disciplinary team (MDT) meetings. I was proffering my sixpence worth on the merits of surgery (coronary artery bypass graft [CABG]) or percutaneous coronary intervention (PCI) (occasionally neither, and – rarely – both), as a succession of clinical data, scans of various types and coronary angiograms were laid before us. And I got to thinking, “is this the way it should be?” We have come a long way in tailoring treatment to patients. When PCI, or percutaneous transluminal coronary angioplasty (PTCA) as it was then, emerged as a young and promising technique in the late seventies

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