Antithrombotic therapy in 2017

Advances in atherosclerosis, atrial fibrillation, and valvular disease

In 2017, several high-impact studies in thrombosis were published. Refinements were made in the optimal therapy for patients with stable atherosclerosis or with atrial fibrillation undergoing percutaneous coronary intervention. Risk scores to determine duration of antiplatelet therapy were developed. The potential risk of subclinical valve leaflet thrombosis was identified.

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Figure 1: Antiplatelet and anticoagulant pathways.

References

  1. 1

    Bosch, J. et al. Rationale, design and baseline characteristics of participants in the Cardiovascular Outcomes for People Using Anticoagulation Strategies (COMPASS) trial. Can. J. Cardiol. 33, 1027–1035 (2017).

    Article  Google Scholar 

  2. 2

    Eikelboom, J. W. et al. Rivaroxaban with or without aspirin in stable cardiovascular disease. N. Engl. J. Med. 377, 1319–1330 (2017).

    CAS  Article  Google Scholar 

  3. 3

    Connolly, S. J. et al. Rivaroxaban with or without aspirin in patients with stable coronary artery disease: an international, randomised, double-blind, placebo-controlled trial. Lancet http://dx.doi.org/10.1016/S0140-6736(17)32458-3 (2017).

  4. 4

    Anand, S. S. et al. Rivaroxaban with or without aspirin in patients with stable peripheral or carotid artery disease: an international, randomised, double-blind, placebo-controlled trial. Lancet http://dx.doi.org/10.1016/S0140-6736(17)32409-1 (2017).

  5. 5

    Cannon, C. P. et al. Design and rationale of the RE-DUAL PCI trial: a prospective, randomized, phase 3b study comparing the safety and efficacy of dual antithrombotic therapy with dabigatran etexilate versus warfarin triple therapy in patients with nonvalvular atrial fibrillation who have undergone percutaneous coronary intervention with stenting. Clin. Cardiol. 39, 555–564 (2016).

    Article  Google Scholar 

  6. 6

    Cannon, C. P. et al. Dual antithrombotic therapy with dabigatran after PCI in atrial fibrillation. N. Engl. J. Med. 377, 1513–1524 (2017).

    CAS  Article  Google Scholar 

  7. 7

    Costa, F. et al. Derivation and validation of the predicting bleeding complications in patients undergoing stent implantation and subsequent dual antiplatelet therapy (PRECISE-DAPT) score: a pooled analysis of individual-patient datasets from clinical trials. Lancet 389, 1025–1034 (2017).

    Article  Google Scholar 

  8. 8

    Makkar, R. R. et al. Possible subclinical leaflet thrombosis in bioprosthetic aortic valves. N. Engl. J. Med. 373, 2015–2024 (2015).

    CAS  Article  Google Scholar 

  9. 9

    Mangione, F. M. et al. Leaflet thrombosis in surgically explanted or post-mortem TAVR valves. JACC Cardiovasc. Imaging 10, 82–85 (2017).

    Article  Google Scholar 

  10. 10

    Chakravarty, T. et al. Subclinical leaflet thrombosis in surgical and transcatheter bioprosthetic aortic valves: an observational study. Lancet 389, 2383–2392 (2017).

    Article  Google Scholar 

Download references

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Correspondence to Deepak L. Bhatt.

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D.L.B. declares the following relationships. Advisory Board: Cardax, Elsevier Practice Update Cardiology, Medscape Cardiology, Regado Biosciences. Board of Directors: Boston VA Research Institute, Society of Cardiovascular Patient Care. Chair: American Heart Association Quality Oversight Committee. Data Monitoring Committees: Cleveland Clinic, Duke Clinical Research Institute, Harvard Clinical Research Institute (PORTICO DSMB), Mayo Clinic, Mount Sinai School of Medicine, Population Health Research Institute. Honoraria: American College of Cardiology (Senior Associate Editor, Clinical Trials and News, ACC.org), Belvoir Publications (Editor in Chief, Harvard Heart Letter), Duke Clinical Research Institute (clinical trial steering committees), Harvard Clinical Research Institute (RE-DUAL executive committee), HMP Communications (Editor in Chief, Journal of Invasive Cardiology), Journal of the American College of Cardiology (Guest Editor; Associate Editor), Population Health Research Institute (COMPASS steering committee, operations committee, publications committee, and US national co-leader), Slack Publications (Chief Medical Editor, Cardiology Today's Intervention), Society of Cardiovascular Patient Care (Secretary/Treasurer), WebMD (CME steering committees). Other: Clinical Cardiology (Deputy Editor), NCDR-ACTION Registry Steering Committee (Chair), VA CART Research and Publications Committee (Chair). Research Funding: Amarin, Amgen, AstraZeneca, Bristol-Myers Squibb, Chiesi, Eisai, Ethicon, Forest Laboratories, Ironwood, Ischemix, Lilly, Medtronic, Pfizer, Roche, Sanofi Aventis, The Medicines Company. Royalties: Elsevier (Editor, Cardiovascular Intervention: A Companion to Braunwald's Heart Disease). Site Co-Investigator: Biotronik, Boston Scientific, St. Jude Medical (now Abbott). Trustee: American College of Cardiology. Unfunded Research: FlowCo, Merck, PLx Pharma, Takeda.

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Bhatt, D. Advances in atherosclerosis, atrial fibrillation, and valvular disease. Nat Rev Cardiol 15, 71–72 (2018). https://doi.org/10.1038/nrcardio.2017.212

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