PA Medical News about Coronary Artery Disease Platelet Aggregation Inhibitors

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Dual antiplatelet therapy in coronary artery disease: A case-based approach
Cleveland Clinic Journal of Medicine, 11/03/09

Raymond C et al. – Current guidelines support dual antiplatelet therapy with aspirin and clopidogrel (Plavix) in a number of clinical scenarios, ie, in ST–segment–elevation myocardial infarction (MI), non–ST–elevation MI, and percutaneous coronary intervention. The guidelines are based on strong evidence from several large randomized clinical trials over the last 10 years. The authors present several cases to show how to put this evidence into day–to–day clinical practice.

Dual antiplatelet therapy is recommended after ST–elevation MI or non–ST–elevation acute coronary syndromes, with aspirin indefinitely and clopidogrel for up to 1 year.
Dual antiplatelet therapy is recommended for at least 1 month after placement of a bare–metal stent and for at least 1 year (or possibly indefinitely) after placement of a drug–eluting stent.
There is no compelling indication for clopidogrel in patients with chronic coronary artery disease.
Compared with clopidogrel, prasugrel (Effient) is associated with lower rates of MI, urgent target–vessel revascularization, and in–stent thrombosis, but at the cost of a higher risk of major bleeding.

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Early but not late stent thrombosis is influenced by residual platelet aggregation in patients undergoing coronary interventions
European Heart Journal, 10/13/09 Relevance Score: 93%

Management of acute coronary syndrome in a case of Behcets disease
Blood Coagulation & Fibrinolysis, 11/03/09 Relevance Score: 89%

Predictive Values of Post-Treatment Adenosine Diphosphate–Induced Aggregation and Vasodilator-Stimulated Phosphoprotein Index for Stent Thrombosis After Acute Coronary Syndrome in Clopidogrel-Treated Patients
The American Journal of Cardiology, 10/15/09 Relevance Score: 89%

Prevalence of Unresponsiveness to Aspirin and/or Clopidogrel in Patients With Stable Coronary Heart Disease
The American Journal of Cardiology, 10/21/09 Relevance Score: 88%

Systematic Review: Comparative Effectiveness of Angiotensin-Converting Enzyme Inhibitors or Angiotensin II-Receptor Blockers for Ischemic Heart Disease
Annals of Internal Medicine, 10/20/09 Relevance Score: 88%