Study reinforces benefits of long-term duel antiplatelet therapy for ACS patients
Findings help establish optimal duration of antiplatelet therapy for patients undergoing PCI
2021-04-28
(Press-News.org) WASHINGTON, D.C, (April 28, 2021) - An analysis of the prospective Fuwai PCI Registry, confirms long-term dual antiplatelet therapy (DAPT) is an optimal treatment option for acute coronary syndrome patients (ACS) following a percutaneous coronary intervention (PCI). The study shows long-term DAPT reduces ischemic events without increasing bleeding or other complications as compared to short-term DAPT treatments. The study was presented today as late-breaking clinical research at the Society for Cardiovascular Angiography &Interventions (SCAI) 2021 Scientific Sessions.
Following ACS, patients have a high risk of ischemic events, which impacts chances of survival. Patients are predisposed for blood clots within an artery for years after an ischemic event, suggesting that the pathobiology of recurrent events post-ACS differs from that of stable coronary artery disease (CAD) patients who have not offered a previous ischemic event. Therefore, ACS patients may be more likely to benefit from long-term secondary prevention strategy, like extended-duration DAPT.
DAPT with aspirin and a P2Y12 inhibitor is the cornerstone of management after an ACS. Current practice guidelines recommend treatment of ACS patients include more aggressive risk factor modi?cation and prolonged antiplatelet therapy, as well as DAPT for a minimum of 12 months following an ACS, regardless of whether or not PCI is performed. In addition to protecting against stent thrombosis in the culprit lesion, an important objective of long-term DAPT in patients with ACS is the prevention of future coronary ischemic events from nonculprit lesions, as demonstrated in earlier trials. With the improvement of stent device technology, studies evaluating the safety and efficacy of shortening DAPT to less than 12-months in patients with ACS undergoing PCI reported conflicting results .
The study included 4,875 high-risk "TWILIGHT-like" patients undergoing PCI. The high-risk patients were defined by at least one clinical and one angiographic feature based on TWILIGHT trial selection criteria, with ACS who were event free at 12 months after PCI from the Fuwai PCI Registry. The primary outcome was the composite of all-cause death, MI or stroke at 30 months while the Bleeding Academic Research Consortium (BARC) type 2,3 or 5 bleeding was key secondary outcome.
Results showed that slightly more than two-third of ACS patients remained on DAPT beyond 12 months after PCI. Extended DAPT compared with shorter DAPT reduced the composite outcome of all-cause death, MI or stroke by 63%. BARC type 2, 3, or 5 bleeding rates did not differ significantly in patients treated with DAPT longer than 12-months versus those treated with DAPT less than 12-months. The effect of long-term DAPT on primary and key secondary outcome across the proportion of ACS patients with 1-3, 4-5, or 6-9 risk factors showed a consistent manner.
"Our findings suggested that prolonged DAPT in ACS patients who present with a particularly higher risk for thrombotic complications without excessive risk." said Haoyu Wang, M.D., Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, China. "Not only did we see long-term DAPT was associated with a lower risk of a major cardiovascular event without an increase in bleeding events, but it it could be considered an effective strategy to balance the risk for bleeding and ischemia in high-risk patients with ACS. Our results reinforce prolonged DAPT in patients with acute coronary syndrome without excessive risk of bleeding should remain the standard of care."
Authors call for further analysis on high bleeding risk and ischemia patients and work to publish in additional publications across Asia.
INFORMATION:
About SCAI:
The Society for Cardiovascular Angiography and Interventions is a professional organization representing more than 4,000 invasive and interventional cardiology professionals in approximately 75 nations. SCAI's mission is to promote excellence in invasive/interventional cardiovascular medicine through physician education and representation, and advancement of quality standards to enhance patient care.
For more information about the SCAI 2021 Scientific Sessions, visit https://scai.org/scai2021. Follow @SCAI on Twitter for the latest heart health news and use #SCAI2021 to follow the latest discussions.
ELSE PRESS RELEASES FROM THIS DATE:
2021-04-28
Chinese scientists have made direct observations in face-centered cubic VCoNi (medium)-entropy alloys (MEA) and for the first time proposed a convincing identification of subnanoscale chemical short-range order (CSRO). This achievement undisputedly resolves the pressing question of if, what and why CSRO exists, and how to explicitly identify CSRO.
This work, published in Nature on April 29, was conducted by Prof. WU Xiaolei from the Institute of Mechanics of the Chinese Academy of Sciences (CAS) in collaboration with Prof. MA En's team from Xi'an Jiaotong University and Prof. ZHU Jing's team from Tsinghua University.
Multi-principal element alloys--also known as high (medium)-entropy alloys (HEAs/MEAs)--are a hot and frontier topic in multidisciplinary fields. In these ...
2021-04-28
Oxytocin and arginine vasopressin are two hormones in the endocrine system that can act as neurotransmitters and regulate -in vertebrates and invertebrates- a wide range of biological functions, such as bonding formation, breastfeeding, birth or arterial pressure. Biochemists in the pregenomic era, named these genes differently in different species, due to small protein coding differences.
A new study carried out by the University of Barcelona (UB) and the Rockefeller University, published in the journal Nature, has analysed and compared the genome of 35 species representing ...
2021-04-28
Researchers have discovered an explanation for why cerebral cavernous malformations (CCMs)--clusters of dilated blood vessels in the brain--can suddenly grow to cause seizures or stroke. Specifically, they found that a specific, acquired mutation in a cancer-causing gene (PIK3CA) could exacerbate existing CCMs in the brain. Furthermore, repurposing an already existing anticancer drug showed promise in mouse models of CCMs in improving brain-vascular health and preventing bleeding into the brain tissue.
Previous studies linked the initial formation of CCMs to various environmental factors, including ...
2021-04-28
The degree of acidity or alkalinity of a substance is crucial for its chemical behavior. The decisive factor is the so-called proton affinity, which indicates how easily an entity accepts or releases a single proton. While it is easy to measure this for molecules, it has not been possible for surfaces. This is important because atoms on surfaces have very different proton affinities, depending on where they sit.
Researchers at TU Wien have now succeeded in making this important physical quantity experimentally accessible for the first time: Using a specially modified atomic force microscope, it is possible to study the proton affinity of individual atoms. This should help to analyze catalysts on an atomic scale. The results have been published in the scientific journal Nature.
Precision ...
2021-04-28
COLUMBUS, Ohio - Tiny molecules called nanobodies, which can be designed to mimic antibody structures and functions, may be the key to blocking a tick-borne bacterial infection that remains out of reach of almost all antibiotics, new research suggests.
The infection is called human monocytic ehrlichiosis, and is one of the most prevalent and potentially life-threatening tick-borne diseases in the United States. The disease initially causes flu-like symptoms common to many illnesses, and in rare cases can be fatal if left untreated.
Most antibiotics can't build up ...
2021-04-28
ATLANTA--Processed diets, which are low in fiber, may initially reduce the incidence of foodborne infectious diseases such as E. coli infections, but might also increase the incidence of diseases characterized by low-grade chronic infection and inflammation such as diabetes, according to researchers in the Institute for Biomedical Sciences at Georgia State University.
This study used mice to investigate how changing from a grain-based diet to a highly processed, high-fat Western style diet impacts infection with the pathogen Citrobacter rodentium, which resembles Escherichia coli (E. coli) infections in humans. The findings are published in the journal PLOS Pathogens.
Gut microbiota, the microorganisms living in the intestine, provide a number of benefits, ...
2021-04-28
The scientific community is focusing its research into the multiple applications of Hydrogels, polymeric materials which contains a large amount of water, that have the potential to reproduce the features of biological tissues. This aspect is particularly significant in the field of regenerative medicine, which since a long time has already recognised and been using the characteristics of these materials. In order to be used effectively to replace organic tissues, hydrogels must meet two essential requirements: possessing great geometric complexity and, after suffering of a damage, being ...
2021-04-28
Researchers at the University of Bath investigating how virtual reality (VR) can help improve balance believe this technology could be a valuable tool in the prevention of falls.
As people grow older, losing balance and falling becomes more common, which increases the risk of injury and affects the person's independence.
Falls are the leading cause of non-fatal injuries in over 65-yearolds and account for over 4 million bed days per year in England alone, at an estimated cost of £2 billion.
Humans use three ways of keeping their balance: vision, proprioceptive (physical feedback from muscles and joints) and vestibular system (feedback from semi-circular canals in the ear). Of these, vision is the most important.
Traditional ways of assessing balance ...
2021-04-28
RESEARCH TRIANGLE PARK, N.C. -- New Army-funded synthetic biology research manipulated micro-compartments in cells, potentially enabling bio-manufacturing advances for medicine, protective equipment and engineering applications.
Bad bacteria can survive in extremely hostile environments -- including inside the highly acidic human stomach--thanks to their ability to sequester toxins into tiny compartments.
In a new study, published in ACS Central Science, Northwestern University researchers controlled protein assembly and built these micro-compartments into different shapes ...
2021-04-28
Boston - This year, more than 60,000 adults in the United States will be diagnosed with pancreatic cancer and, statistically, as few as 10 percent will survive five years after diagnosis, according to the American Cancer Society. Because pancreatic cancer is hidden deep within the body and often symptomless, it's frequently diagnosed after the disease has progressed too far for surgical intervention and/or has spread throughout the body. Research indicates that earlier detection of pancreatic tumors could quadruple survival rates; however, no validated and reliable tests for early detection of pancreatic cancer currently exist.
Now, researchers at the Cancer Research Institute at Beth Israel Deaconess Medical Center (BIDMC) have successfully created ...
LAST 30 PRESS RELEASES:
[Press-News.org] Study reinforces benefits of long-term duel antiplatelet therapy for ACS patients
Findings help establish optimal duration of antiplatelet therapy for patients undergoing PCI
