Extending dual antiplatelet therapy with a thienopyridine beyond 1 year after drug-eluting stent placement significantly reduced major adverse cardiovascular and cerebrovascular events compared to placebo (4.3% vs. 5.9%), but increased moderate to severe bleeding.
RCT (n=9,961)
Placebo-controlled
Randomly assigned
Yes
Absolute Event Rate: 4.3% vs 5.9%
Absolute Risk Reduction: 1.6%
p-value: p=<0.001
The American Heart Association (AHA) Scientific Sessions were held in Chicago on November 15-19, 2014. The meeting attracted more than 17,000 participants, including physicians, research scientists, students, and paramedical personnel, from more than 100 countries. Sessions over the 5 days included comprehensive and unparalleled education delivered via more than 5,000 presentations, with 1,000 invited faculty members and 4,000 abstract presentations from world leaders in cardiovascular (CV) disease. There were 16 trials scheduled in 4 late-breaking clinical trial sessions. The Dual Antiplatelet Therapy study revealed that aspirin plus a thienopyridine beyond 1 year subsequent to placement of a drug-eluting stent, as compared with aspirin therapy alone, significantly reduced stent thrombosis and major CV and cerebrovascular events but was associated with increased risk of bleeding. The IMPROVE-IT research showed that, relative to simvastatin with placebo, simvastatin with 10 mg of ezetimibe daily led to a significantly lower primary combined endpoint in moderate- to high-risk patients, who stabilized following acute coronary syndrome. This was the first trial to demonstrate incremental clinical benefit by adding a nonstatin agent to statin therapy and reaffirmed the low-density lipoprotein (LDL) hypothesis stating that reducing LDL-cholesterol prevents CV events. Summaries and overviews of both the late-breaking trials and the sessions to which members of the Japanese Circulation Society contributed are presented.
Takashi Kohno (Wed,) conducted a rct in Drug-eluting stent (DES) placement (n=9,961). Thienopyridine (clopidogrel or prasugrel) vs. Placebo was evaluated on Major adverse cardiovascular and cerebrovascular events (composite of death, myocardial infarction, or stroke) (p=<0.001). Extending dual antiplatelet therapy with a thienopyridine beyond 1 year after drug-eluting stent placement significantly reduced major adverse cardiovascular and cerebrovascular events compared to placebo (4.3% vs. 5.9%), but increased moderate to severe bleeding.