Biggest Cardiology Stories of 2012 from Heart Wire

11:28 am Health Care, Medicine

Acute coronary syndromes

  1. The year 2012 has been a relatively quiet year for ACS, with the main trial in the field (TRILOGY ACS) showing a neutral result.
  2. Results coming in with new drugs such as rivaroxaban and vorapaxar showed reduced ischemic outcomes. We might not need aspirin anymore in ACS patients.
  3. While both rivaroxaban and vorapaxar cause increased bleeding when given on top of aspirin and clopidogrel, aspirin is probably the worst culprit here.
  4. And most cardiologists are reluctant to give three antithrombotic agents together, so there is strong feeling that the next direction we may have to follow is to drop aspirin.
  5. There is a great future for the new anticoagulants in ACS without aspirin.
  6. WOEST study, although not in ACS patents, suggested aspirin was not needed in stent patients receiving clopidogrel and an anticoagulant.
  7. One highlight this year in ACS was STEMI subgroup of RIVAL. Radial access was associated with a 2.2% reduction in death/MI or stroke and a 1.9% reduction in all-cause mortality when compared with femoral access. This should be practice changing.
  8. DEFER trial in STEMI patients should answer the question of whether we should open up the artery only with a balloon and aspiration catheter and put a stent in later (4 to 16 hours) or just put the stent in there when you open the artery.

Comments are closed.