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accoast trial prasugrel

Lale Tokgözoğlu
In patients with acute coronary syndromes not undergoing revascularisation, it is important to decrease ischemic and bleeding complications. TRILOGY-ACS study randomised patients with non-ST elevation acute coronary syndromes not undergoing revascularisation to clopidogrel or prasugrel. The primary endpoint of 30 day cardiovascular death, myocardial infarction or stroke was not different between the two groups in a median follow up of 17 months. A prespecified subgroup analysis showed that the subgroup with angiographically confirmed coronary artery disease benefited from prasugrel more...
October 2015: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
Marc Laine, Franck Paganelli, Laurent Bonello
Antiplatelet therapy is the cornerstone of the therapeutic arsenal in coronary artery disease. Thanks to a better understanding in physiology, pharmacology and pharmacogenomics huge progress were made in the field of platelet reactivity inhibition thus allowing the expansion of percutaneous coronary intervention. Stent implantation requires the combination of two antiplatelet agents acting in a synergistic way. Asprin inhibit the cyclo-oxygenase pathway of platelet activation while clopidogrel is a P2Y12 adenosine diphosphate (ADP)-receptor antagonist...
May 26, 2016: World Journal of Cardiology
Italo Porto, Leonardo Bolognese, Dariusz Dudek, Patrick Goldstein, Christian Hamm, Jean-François Tanguay, Jurrien Ten Berg, Petr Widimský, Nicolas Le Gall, Anthony J Zagar, LeRoy A LeNarz, Debra Miller, Gilles Montalescot
OBJECTIVES: This study assessed whether the choice of vascular access site influenced outcomes among non-ST-segment elevation myocardial infarction (NSTEMI) patients enrolled in the ACCOAST (A Comparison of prasugrel at the time of percutaneous Coronary intervention Or as pre-treatment At the time of diagnosis in patients with non-ST-segment elevation myocardial infarction NCT01015287). BACKGROUND: Transfemoral access (TFA) has been associated with the risk of bleeding and increased mortality that is elevated compared to transradial access (TRA) in acute coronary syndromes, although less consistently in NSTE acute coronary syndrome (NSTE-ACS) than in STE-ACS...
May 9, 2016: JACC. Cardiovascular Interventions
Dirk Sibbing, Adnan Kastrati, Peter B Berger
Dual antiplatelet therapy (DAPT) with aspirin and a P2Y12receptor inhibitor is the mainstay of treatment for acute coronary syndrome (ACS) patients, whether they undergo a percutaneous coronary intervention (PCI) or are managed medically. In recent years, the most appropriate timing for initiation and duration of P2Y12receptor inhibition has been a focus of great interest. Many observational studies and a single prospective trial (CREDO) utilizing clopidogrel had focused on whether pre-treatment with clopidogrel, i...
April 21, 2016: European Heart Journal
Laurent Bonello, Marc Laine, Laurence Camoin-Jau, Frederic Noirot, Régis Guieu, Françoise Dignat-George, Franck Paganelli, Corinne Frere
Pretreatment with a loading dose (LD) of clopidogrel or ticagrelor before percutaneous coronary intervention (PCI) in acute coronary syndrome (ACS) is supported by the guidelines, but debated following a recent meta-analysis on clopidogrel pretreatment and the ACCOAST trial. In this trial prasugrel pretreatment failed to reduce ischaemic events. The timing of optimal platelet reactivity (PR) inhibition of ticagrelor and prasugrel in non ST-elevation ACS (NSTE ACS) is yet undetermined. In the present study, we aimed to investigate the delay required to reach optimal PR inhibition in NSTE ACS following a LD of ticagrelor or prasugrel...
October 2015: Thrombosis and Haemostasis
Uwe Zeymer, Gilles Montalescot, Diego Ardissino, Leonardo Bolognese, Peter Clemmensen, Jean-Philippe Collet, Jose Lopez-Sendon, Petr Widimsky
The optimal time-point of the initiation of P2Y12 antagonist therapy in patients with non-ST elevation acute coronary syndromes (NTSE-ACS) is still a matter of debate. European guidelines recommend P2Y12 as soon as possible after first medical contact. However, the only trial which compared the two strategies did not demonstrate any benefit of pre-treatment with prasugrel before angiography compared to starting therapy after angiography and just prior to percutaneous coronary intervention (PCI). This paper summarizes the results of pharmacodynamic and previous studies, and gives recommendations for the initiation of P2Y12 antagonist therapy in NSTE-ACS in different clinical situations...
June 2016: European Heart Journal. Acute Cardiovascular Care
Gilles Montalescot, Jean-Philippe Collet, Patrick Ecollan, Leonardo Bolognese, Jurrien Ten Berg, Dariusz Dudek, Christian Hamm, Petr Widimsky, Jean-François Tanguay, Patrick Goldstein, Eileen Brown, Debra L Miller, LeRoy LeNarz, Eric Vicaut
BACKGROUND: After percutaneous coronary intervention (PCI) for non-ST-segment elevation myocardial infarction (NSTEMI), treatment with a P2Y12 antagonist with aspirin is recommended for 1 year. OBJECTIVES: The oral P2Y12 antagonists ticagrelor and prasugrel have higher recommendations than clopidogrel, but it is unknown if administration before the start of PCI is beneficial. METHODS: In the randomized, double-blind ACCOAST (A Comparison of prasugrel at the time of percutaneous Coronary intervention Or as pre-treatment At the time of diagnosis in patients with non-ST-segment elevation myocardial infarction) trial, 4,033 patients were diagnosed with NSTEMI and 68...
December 23, 2014: Journal of the American College of Cardiology
J Aalbers
No abstract text is available yet for this article.
May 2011: Cardiovascular Journal of Africa
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