Tag Archives: ticagrelor

Introduction Bleeding post cardiac surgery carries significant patient mortality and morbidity including resternotomy, increased hospital stays, and blood product transfusion.1,2 Bleeding is more severe in patients who are taking pre-operative antiplatelet or anticoagulation medications that have not been stopped sufficiently in advance to minimise such risks. Current guidelines across Europe recommend stopping such agents at least two to five days prior to surgery; they also recommend delaying urgent surgery so that the risk of perioperative bleeding is minimised.3 However, this is not always possible in the setting of urgent and emergency c

European Society of Cardiology congress 2018, held in Munich Other news from the European Society of Cardiology Congress 2018 Not all HDL cholesterol is cardioprotective COMMANDER HF: rivaroxaban in heart failure… …and in VTE in the MARINER trial Is it safe for women with heart disease to become pregnant? Several new guidelines from the ESC were announced at the meeting: ESC guidelines on the management of cardiovascular diseases during pregnancy, first published in 2011, have been updated with a second edition in 2018 2018 ESC/EACTS (European Association for Cardio-Thoracic Surgery) guidelines on myocardial revascularisation 2018 ES

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.

Background Thrombus formation in the coronary tree is the principal cause of acute coronary syndromes (ACS).1 Following plaque rupture or erosion, platelets adhere to exposed ligands (collagen, von Willebrand factor [vWF]) under high-flow conditions and this leads to platelet activation. Following platelet adhesion and activation, multiple agonists are secreted, including thromboxane A2 (TXA2) and adenosine diphosphate (ADP). TXA2 further activates platelets and ADP amplifies and sustains platelets’ activation, particularly through platelet P2Y12 receptors.2 In view of the pivotal role of platelets in arterial thrombosis, blocking TXA2 pro

A new gene therapy that targets the heart and requires only one treatment session, has been found safe for patients with coronary artery disease, according to a successful trial carried out in Finland (doi: 10.1093/eurheartj/ehx352). The treatment enhances circulation in ischaemic heart muscle and the effects were still visible one year after treatment. The randomised, blinded, placebo-controlled phase 1/2a trial was carried out in collaboration between the University of Eastern Finland, Kuopio University Hospital and Turku PET Centre. The biological bypass is based on gene transfer in which a natural human growth factor, AdVEGF-DΔNΔC, a ne

Too much sitting increases coronary artery calcification Sitting for many hours per day is associated with increased coronary artery calcification, a marker of subclinical heart disease, a new study suggests. The study found no association between coronary artery calcification (CAC) and the amount of exercise a person gets, suggesting that too much sitting might have a greater impact than exercise on this particular measure of heart health. The results suggest that exercise may not entirely counteract the negative effects of a mostly sedentary lifestyle on coronary artery calcium. Presenting the study at the ACC meeting, Dr Jacquelyn Kulinski

NICE updates A new ‘Evidence Update’ has been produced by the National Institute for Health and Clinical Excellence (NICE), which summarises selected new evidence relevant to the NICE guideline on the management of chronic heart failure (CHF) in adults in primary and secondary care (clinical guideline 108).NICE says “Whilst Evidence Updates do not replace current accredited guidance, they do highlight new evidence that might generate a future changes in practice.”  It says it will welcome feedback from societies and individuals in developing this service. The update is available from www.evidence.nhs.uk/evidence-update-2. New guides

UK cholesterol awareness low Millions of people in the UK hold incorrect beliefs about the risks of cardiovascular disease (CVD), according to HEART UK research. The research, which tested 1,177 people on their knowledge and concerns about high cholesterol, revealed that more than 40% of respondents wrongly thought that raised cholesterol resulted from drinking too much, while almost 60% did not know that the condition can be inherited. Almost half the population have never had a cholesterol check and only 2% of those surveyed named high cholesterol as their biggest health concern. The top health worry for people was cancer, even though CVD i

Controversial salt paper published A new European study has caused controversy by suggesting that lowering salt intake may not be beneficial. The study, published recently in JAMA (May 4th 2011 issue), was conducted by a team from the University of Leuven, Belgium. They followed 3,681 participants who were free of cardiovascular disease at baseline for a median of 7.9 years, and found an inverse relationship between cardiovascular deaths and 24-hour sodium excretion (which correlates to salt intake), although systolic blood pressure was higher with higher salt intake. But an editorial in the Lancet (May 12th 2011 issue) criticises the study,

In the UK, ticagrelor will be priced at £54.60 for a 28-day supply. The National Institute of Health and Clinical Excellence is currently reviewing the data on ticagrelor and is expected to issue guidance in July 2011. The US Food and Drug Administration has, however, delayed approving ticagrelor. It has requested additional analyses of the PLATO trial.