Acute Coronary Syndrome
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Acute Coronary Syndrome
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Predictors of Early Stent Thrombosis in Subjects With ACS: Design
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Independent Correlates of Early Stent Thrombosis
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PLATO: Ticagrelor Vs Clopidogrel in Subjects With Planned Invasive Strategy for ACS: Primary Endpoint
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PLATO: Ticagrelor Vs Clopidogrel in Subjects with Planned Invasive Strategy for ACS
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Clinical Guidelines
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NSTE-ACS
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Recommendations for Oral Antiplatelet Drugs: European Guidelines
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EARLY ACS: Results
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NSTEMI
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Recommendations for Oral Antiplatelet Drugs: European Guidelines
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Timing and Dose of GP IIb/IIIa Inhibitors and Clopidogrel: American Guidelines
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Timing and Dose of GP IIb/IIIa Inhibitors and Clopidogrel: American Guidelines (cont’d)
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DISPERSE-2: AZD6140
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EARLY ACS: Results
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Clinical Trials
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A-F
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Antithrombotic Trialists’ Collaboration 2002: Indirect Comparisons Effect of ASA Doses on Vascular Events in High-Risk Patients
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ACUITY: Composite Ischemia Endpoint
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CURE: Primary Endpoint—MI/Stroke/Cardiovascular Death
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CURE: Benefit of Clopidogrel Therapy at Various Time Intervals
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CURE: Long-Term Results by Management Strategy
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CURE: Bleeding Episodes Through Follow-Up
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ALBION: Dose Effect With Clopidogrel in ACS
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CLARITY-TIMI 28: Primary Endpoint: Occluded Artery (or Death/MI through Angio/HD)
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CLARITY-TIMI 28: Cardiac Death, Myocardial Infarction, Recurrent Ischemia --> Urgent Revascularization
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COMMIT: Effects of Clopidogrel on Death, Re-Myocardial Infarction, or Stroke
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COMMIT: Effect of Clopidogrel on Death in Hospital
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COMMIT: Effects of Clopidogrel on Death, Re-Myocardial Infarction, or Stroke by Delay and Fibrinolytic
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Bivalirudin Angioplasty Trial (BAT) and Final Analysis
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REPLACE 2 (PCI) and ACUITY (PCI Patients Only)
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ACUITY: Death, MI, Target Vessel Revascularization
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CV Death, MI, or Stroke Following PCI
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Frequency Distribution of Platelet Inhibition After Cessation of Daily Clopidogrel Therapy
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Adjustment of Clopidogrel Loading Dose Using the VASP Index: Effects on MACE
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Distribution of Responsiveness to Clopidogrel in 544 Individuals
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DISPERSE-2: AZD6140
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DISPERSE-2:Adjudicated Bleeding Rates Within 48 Hours
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DISPERSE-2:Nonbleeding Adverse Events
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PLATO: Can PLATelet Inhibition Be Optimized to Prevent Vascular Events?
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Cangrelor (AR-C69931MX)
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Cangrelor Phase 2 Clinical Data: Compared With Abciximab in PCI
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Clopidogrel/Cangrelor Interaction
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Adjustment of Clopidogrel Loading Dose Using the VASP Index: Effects on MACE
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Bivalirudin vs Low-dose UFH+GPI: Bleeding and 6-Month MACE
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Death, MI, and Stent Thrombosis in BMS and DES Patients With Diabetes
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COURAGE: PCI + OMT vs OMT
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Stent Thrombosis in ACUITY, Day 0 to 30
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Predictors of ST Within 30 Days
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EARLY ACS: Results
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BRAVE-3: Results
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CHAMPION PCI: Design
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CHAMPION PCI: Composite Endpoint of Death from Any Cause, Myocardial Infarction, or Ischemia-Driven Revascularization
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CHAMPION PCI: Major Bleedinga
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ARBITER 6–HALTS: Effect of Niacin ER or Ezetimibe on CIMT
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Results from ARBITER 6–HALTS: Effect of Niacin ER or Ezetimibe on CIMT
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ARBITER 6–HALTS: Methods and Final Results
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ARBITER 6–HALTS: Final Results
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G-L
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ISAR-REACT: Results, 30 Days
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ISAR-REACT: Death or MI, 12 Months
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ISAR-SWEET: Adverse Events, 30 Days
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ISAR-REACT 2: Efficacy Analysis
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HORIZONS AMI: Impact of Clopidogrel Loading Dose on Efficacy of Bivalirudin
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Genetic Variability in Platelet Response to ADP
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Genetic Variability in Platelet Response: Healthy Volunteer Crossover Study
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JUMBO-TIMI 26: 30-Day 1°Endpoint (Non-CABG Bleed) and (MACE)
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Improved ADP Blockade With Cangrelor in Clopidogrel-Treated Patients
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HORIZONS AMI: Impact of Clopidogrel Loading Dose on Efficacy of Bivalirudin
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JUPITER Primary Endpoint: Myocardial Infarction, Stroke, Unstable Angina/Revascularization, Cardiovascular Death
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JUPITER Secondary Endpoint–All-Cause Mortality
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HORIZONS-AMI: Primary Endpoints at 1 Year
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HORIZONS-AMI: Binary Restenosis at 13 Months
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M-R
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PCI-CURE: Early and Long-Term Clopidogrel in PCI Patients
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REPLACE-1: Treated Population
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REPLACE-2: Triple Ischemic Endpoint
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REPLACE 2:Endpoints, 30 Days
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REPLACE 2 (PCI) and ACUITY (PCI Patients Only)
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PCI-CLARITY Meta-Analysis of Clopidogrel Pretreatment CV Death or MI After PCI, 30 Days
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CV Death, MI, or Stroke Following PCI
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Persistent Platelet Inhibition Variability With Increasing Clopidogrel Loading Dose
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Out-of-Hospital 6-Month Post-PCI Outcomes Stratified by Reactivity in Patients on Consistent Clopidogrel Therapy
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PCI vs CABG for ACS
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PCI vs CABG for ACS (Cont'd)
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On-TIME 2: Secondary Endpoints
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On-TIME 2: Secondary Endpoints (cont’d)
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PLATO: Study Design
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PLATO: Primary Endpoint (Composite of Death from Vascular Causes, MI, or Stroke)
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PLATO: Rates of Major Bleeding at 12 Months
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MADIT-CRT: Study Design
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PCI PROVE-IT: Effect of Intensive Statin Therapy on MACE Among Subjects Undergoing PCI
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S-Z
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Time Course of Platelet Inhibition After Different Clopidogrel Loading Doses
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Time Course of Platelet Recovery After a Single Clopidogrel 600-mg Dose
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Triple Antiplatelet Therapy in Patients With Acute MI Undergoing PCI
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TRITON-TIMI 38: Intensive Antiplatelet Therapy and Rates of Thrombosis
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TRITON-TIMI 38: Intensive Antiplatelet Therapy and Rates of Thrombosis
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TRITON-TIMI 38: Intensive Antiplatelet Therapy and Rates of Thrombosis
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TRITON-TIMI 38: Subgroup Analysis of Antiplatelet Therapy Effect on Thrombosis
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TRITON-TIMI 38: Primary Endpoint:CV Death, MI, or Stroke
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TRITON-TIMI 38: Timing of Benefit (Landmark Analysis)
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TRITON-TIMI 38: Balance of Efficacy and Safety
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TRITON-TIMI 38: Bleeding Events Safety Cohort (n=13,457)
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TRITON-TIMI 38: Stent Thrombosis (ARC Definite or Probable)
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Triple Antiplatelet Therapy in Patients With Acute MI Undergoing PCI
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TRITON-TIMI 38: Intensive Antiplatelet Therapy and Rates of Thrombosis
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TRITON-TIMI 38: Early Stent Thrombosis
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TRITON-TIMI 38: Late Stent Thrombosis
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TRITON-TIMI 38: Subgroup Analysis of Antiplatelet Therapy Effect on Thrombosis
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TAPAS: Adverse Clinical Events at 1 Year
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TRITON-TIMI 38: Primary Endpoint in Diabetes Subset
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ZEST-AMI: Design
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ZEST-AMI: Rate of MACE at 12 Months
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Pharmacologic Treatment
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Aspirin
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Antithrombotic Trialists’ Collaboration 2002: Indirect Comparisons Effect of ASA Doses on Vascular Events in High-Risk Patients
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What Is the Most Effective Dose of Aspirin?
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CURE: Primary Endpoint—MI/Stroke/Cardiovascular Death
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CURE: Benefit of Clopidogrel Therapy at Various Time Intervals
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PCI-CURE: Early and Long-Term Clopidogrel in PCI Patients
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CURE: Bleeding Episodes Through Follow-Up
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COMMIT: Effects of Clopidogrel on Death, Re-Myocardial Infarction, or Stroke
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COMMIT: Effect of Clopidogrel on Death in Hospital
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TRITON-TIMI 38: Intensive Antiplatelet Therapy and Rates of Thrombosis
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TRITON-TIMI 38: Intensive Antiplatelet Therapy and Rates of Thrombosis
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TRITON-TIMI 38: Intensive Antiplatelet Therapy and Rates of Thrombosis
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TRITON-TIMI 38: Subgroup Analysis of Antiplatelet Therapy Effect on Thrombosis
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Triple Antiplatelet Therapy in Patients With Acute MI Undergoing PCI
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Bivalirudin vs Low-dose UFH+GPI: Bleeding and 6-Month MACE
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TAPAS: Adverse Clinical Events at 1 Year
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Death, MI, and Stent Thrombosis in BMS and DES Patients With Diabetes
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PCI vs CABG for ACS
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PCI vs CABG for ACS (Cont'd)
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Aspirin Noncompliance and Resistance
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Meta-Analysis: Effect of Any Aspirin on Endpoints
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Meta-Analysis: Effect of Aspirin Alone on Endpoints
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Thienopyridines
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Timing and Dose of GP IIb/IIIa Inhibitors and Clopidogrel: American Guidelines
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Timing and Dose of GP IIb/IIIa Inhibitors and Clopidogrel: American Guidelines (cont’d)
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CURE: Primary Endpoint—MI/Stroke/Cardiovascular Death
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CURE: Benefit of Clopidogrel Therapy at Various Time Intervals
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CURE: Long-Term Results by Management Strategy
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PCI-CURE: Early and Long-Term Clopidogrel in PCI Patients
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CURE: Bleeding Episodes Through Follow-Up
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ALBION: Dose Effect With Clopidogrel in ACS
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CLARITY-TIMI 28: Primary Endpoint: Occluded Artery (or Death/MI through Angio/HD)
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CLARITY-TIMI 28: Cardiac Death, Myocardial Infarction, Recurrent Ischemia --> Urgent Revascularization
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COMMIT: Effects of Clopidogrel on Death, Re-Myocardial Infarction, or Stroke
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COMMIT: Effect of Clopidogrel on Death in Hospital
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COMMIT: Effects of Clopidogrel on Death, Re-Myocardial Infarction, or Stroke by Delay and Fibrinolytic
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PCI-CLARITY Meta-Analysis of Clopidogrel Pretreatment CV Death or MI After PCI, 30 Days
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CV Death, MI, or Stroke Following PCI
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ISAR-REACT: Results, 30 Days
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ISAR-REACT: Death or MI, 12 Months
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ISAR-SWEET: Adverse Events, 30 Days
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ISAR-REACT 2: Efficacy Analysis
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Time Course of Platelet Inhibition After Different Clopidogrel Loading Doses
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Persistent Platelet Inhibition Variability With Increasing Clopidogrel Loading Dose
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Out-of-Hospital 6-Month Post-PCI Outcomes Stratified by Reactivity in Patients on Consistent Clopidogrel Therapy
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Frequency Distribution of Platelet Inhibition After Cessation of Daily Clopidogrel Therapy
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Time Course of Platelet Recovery After a Single Clopidogrel 600-mg Dose
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Triple Antiplatelet Therapy in Patients With Acute MI Undergoing PCI
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HORIZONS AMI: Impact of Clopidogrel Loading Dose on Efficacy of Bivalirudin
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Adjustment of Clopidogrel Loading Dose Using the VASP Index: Effects on MACE
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TRITON-TIMI 38: Intensive Antiplatelet Therapy and Rates of Thrombosis
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TRITON-TIMI 38: Intensive Antiplatelet Therapy and Rates of Thrombosis
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TRITON-TIMI 38: Intensive Antiplatelet Therapy and Rates of Thrombosis
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TRITON-TIMI 38: Subgroup Analysis of Antiplatelet Therapy Effect on Thrombosis
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Distribution of Responsiveness to Clopidogrel in 544 Individuals
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Genetic Variability in Platelet Response: Healthy Volunteer Crossover Study
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JUMBO-TIMI 26: 30-Day 1°Endpoint (Non-CABG Bleed) and (MACE)
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TRITON-TIMI 38: Primary Endpoint:CV Death, MI, or Stroke
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TRITON-TIMI 38: Timing of Benefit (Landmark Analysis)
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TRITON-TIMI 38: Balance of Efficacy and Safety
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TRITON-TIMI 38: Bleeding Events Safety Cohort (n=13,457)
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TRITON-TIMI 38: Stent Thrombosis (ARC Definite or Probable)
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DISPERSE-2: AZD6140
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DISPERSE-2:Adjudicated Bleeding Rates Within 48 Hours
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DISPERSE-2:Nonbleeding Adverse Events
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PLATO: Can PLATelet Inhibition Be Optimized to Prevent Vascular Events?
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Improved ADP Blockade With Cangrelor in Clopidogrel-Treated Patients
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Clopidogrel/Cangrelor Interaction
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Triple Antiplatelet Therapy in Patients With Acute MI Undergoing PCI
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HORIZONS AMI: Impact of Clopidogrel Loading Dose on Efficacy of Bivalirudin
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Adjustment of Clopidogrel Loading Dose Using the VASP Index: Effects on MACE
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TRITON-TIMI 38: Intensive Antiplatelet Therapy and Rates of Thrombosis
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TRITON-TIMI 38: Early Stent Thrombosis
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TRITON-TIMI 38: Late Stent Thrombosis
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TRITON-TIMI 38: Subgroup Analysis of Antiplatelet Therapy Effect on Thrombosis
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Bivalirudin vs Low-dose UFH+GPI: Bleeding and 6-Month MACE
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TAPAS: Adverse Clinical Events at 1 Year
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Death, MI, and Stent Thrombosis in BMS and DES Patients With Diabetes
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PCI vs CABG for ACS
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PCI vs CABG for ACS (Cont'd)
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On-TIME 2: Secondary Endpoints
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On-TIME 2: Secondary Endpoints (cont’d)
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COURAGE: PCI + OMT vs OMT
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BRAVE-3: Results
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Treating Clopidogrel Hypersensitivity With Antihistamines* and Corticosteroids*
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PLATO: Study Design
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PLATO: Primary Endpoint (Composite of Death from Vascular Causes, MI, or Stroke)
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PLATO: Rates of Major Bleeding at 12 Months
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CHAMPION PCI: Design
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CHAMPION PCI: Composite Endpoint of Death from Any Cause, Myocardial Infarction, or Ischemia-Driven Revascularization
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CHAMPION PCI: Major Bleedinga
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CV Outcomes and Mortality Among Subjects Using Clopidogrel With PPI: Design
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CV Outcomes and Mortality Among Subjects Using Clopidogrel With PPI
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GP IIb/IIIa inhibitors
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GP IIb/IIIa Inhibitor Overview: 30-Day Death and MI
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Timing and Dose of GP IIb/IIIa Inhibitors and Clopidogrel: American Guidelines
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Timing and Dose of GP IIb/IIIa Inhibitors and Clopidogrel: American Guidelines (cont’d)
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ACUITY: Composite Ischemia Endpoint
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REPLACE-1: Treated Population
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REPLACE-2: Triple Ischemic Endpoint
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REPLACE 2:Endpoints, 30 Days
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REPLACE 2 (PCI) and ACUITY (PCI Patients Only)
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ACUITY: Death, MI, Target Vessel Revascularization
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ISAR-REACT: Results, 30 Days
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ISAR-REACT: Death or MI, 12 Months
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ISAR-SWEET: Adverse Events, 30 Days
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ISAR-REACT 2: Efficacy Analysis
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HORIZONS AMI: Impact of Clopidogrel Loading Dose on Efficacy of Bivalirudin
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Cangrelor Phase 2 Clinical Data: Compared With Abciximab in PCI
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Bivalirudin vs Low-dose UFH+GPI: Bleeding and 6-Month MACE
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TAPAS: Adverse Clinical Events at 1 Year
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On-TIME 2: Secondary Endpoints
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On-TIME 2: Secondary Endpoints (cont’d)
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Reasons for Discontinuation of Clopidogrel
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Stent Thrombosis in ACUITY, Day 0 to 30
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Predictors of ST Within 30 Days
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Clinical Outcomes in Patients With Stent Thrombosis (Within 30 Days)
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EARLY ACS: Results
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HORIZONS-AMI: Primary Endpoints at 1 Year
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HORIZONS-AMI: Binary Restenosis at 13 Months
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Antithrombotic Therapies
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ACUITY: Composite Ischemia Endpoint
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Bivalirudin Angioplasty Trial (BAT) and Final Analysis
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REPLACE-1: Treated Population
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REPLACE-2: Triple Ischemic Endpoint
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REPLACE 2:Endpoints, 30 Days
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REPLACE 2 (PCI) and ACUITY (PCI Patients Only)
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ACUITY: Death, MI, Target Vessel Revascularization
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ISAR-REACT 2: Efficacy Analysis
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HORIZONS AMI: Impact of Clopidogrel Loading Dose on Efficacy of Bivalirudin
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Cangrelor Phase 2 Clinical Data: Compared With Abciximab in PCI
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HORIZONS AMI: Impact of Clopidogrel Loading Dose on Efficacy of Bivalirudin
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Bivalirudin vs Low-dose UFH+GPI: Bleeding and 6-Month MACE
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Novel agents
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TRITON-TIMI 38: Subgroup Analysis of Antiplatelet Therapy Effect on Thrombosis
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DISPERSE-2: AZD6140
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DISPERSE-2:Adjudicated Bleeding Rates Within 48 Hours
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DISPERSE-2:Nonbleeding Adverse Events
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PLATO: Can PLATelet Inhibition Be Optimized to Prevent Vascular Events?
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Cangrelor (AR-C69931MX)
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Improved ADP Blockade With Cangrelor in Clopidogrel-Treated Patients
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Cangrelor Phase 2 Clinical Data: Compared With Abciximab in PCI
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Clopidogrel/Cangrelor Interaction
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Triple Antiplatelet Therapy in Patients With Acute MI Undergoing PCI
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TRITON-TIMI 38: Intensive Antiplatelet Therapy and Rates of Thrombosis
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TRITON-TIMI 38: Early Stent Thrombosis
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TRITON-TIMI 38: Late Stent Thrombosis
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TRITON-TIMI 38: Primary Endpoint in Diabetes Subset
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PLATO: Study Design
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PLATO: Primary Endpoint (Composite of Death from Vascular Causes, MI, or Stroke)
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PLATO: Rates of Major Bleeding at 12 Months
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CHAMPION PCI: Design
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CHAMPION PCI: Composite Endpoint of Death from Any Cause, Myocardial Infarction, or Ischemia-Driven Revascularization
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CHAMPION PCI: Major Bleedinga
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Dosing
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CURE: Primary Endpoint—MI/Stroke/Cardiovascular Death
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Triple Antiplatelet Therapy in Patients With Acute MI Undergoing PCI
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HORIZONS AMI: Impact of Clopidogrel Loading Dose on Efficacy of Bivalirudin
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Adjustment of Clopidogrel Loading Dose Using the VASP Index: Effects on MACE
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Bivalirudin vs Low-dose UFH+GPI: Bleeding and 6-Month MACE
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Platelet Function Testing
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Inhibition
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Time Course of Platelet Inhibition After Different Clopidogrel Loading Doses
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Persistent Platelet Inhibition Variability With Increasing Clopidogrel Loading Dose
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Frequency Distribution of Platelet Inhibition After Cessation of Daily Clopidogrel Therapy
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Time Course of Platelet Recovery After a Single Clopidogrel 600-mg Dose
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Smoking and Platelet Function
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Hyporesponsiveness
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Out-of-Hospital 6-Month Post-PCI Outcomes Stratified by Reactivity in Patients on Consistent Clopidogrel Therapy
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Distribution of Responsiveness to Clopidogrel in 544 Individuals
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Genetic Variability in Platelet Response to ADP
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Genetic Variability in Platelet Response: Healthy Volunteer Crossover Study
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Clopidogrel/Cangrelor Interaction
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Adjustment of Clopidogrel Loading Dose Using the VASP Index: Effects on MACE
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Platelet Reactivity
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Adjustment of Clopidogrel Loading Dose Using the VASP Index: Effects on MACE
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Improved ADP Blockade With Cangrelor in Clopidogrel-Treated Patients
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Clopidogrel/Cangrelor Interaction
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Slides with Commentary
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Slides with Commentary
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TRITON-TIMI 38: Intensive Antiplatelet Therapy and Rates of Thrombosis
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TAPAS: Adverse Clinical Events at 1 Year
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On-TIME 2: Secondary Endpoints
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On-TIME 2: Secondary Endpoints (cont’d)
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COURAGE: PCI + OMT vs OMT
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TRITON-TIMI 38: Primary Endpoint in Diabetes Subset
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JUPITER Primary Endpoint: Myocardial Infarction, Stroke, Unstable Angina/Revascularization, Cardiovascular Death
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JUPITER Secondary Endpoint–All-Cause Mortality
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Reasons for Discontinuation of Clopidogrel
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EARLY ACS: Results
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HORIZONS-AMI: Primary Endpoints at 1 Year
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Stents
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Bare metal
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TRITON-TIMI 38: Intensive Antiplatelet Therapy and Rates of Thrombosis
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TRITON-TIMI 38: Intensive Antiplatelet Therapy and Rates of Thrombosis
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TRITON-TIMI 38: Intensive Antiplatelet Therapy and Rates of Thrombosis
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TRITON-TIMI 38: Subgroup Analysis of Antiplatelet Therapy Effect on Thrombosis
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TRITON-TIMI 38: Stent Thrombosis (ARC Definite or Probable)
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TRITON-TIMI 38: Intensive Antiplatelet Therapy and Rates of Thrombosis
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TRITON-TIMI 38: Early Stent Thrombosis
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TRITON-TIMI 38: Late Stent Thrombosis
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TRITON-TIMI 38: Subgroup Analysis of Antiplatelet Therapy Effect on Thrombosis
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Death, MI, and Stent Thrombosis in BMS and DES Patients With Diabetes
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Reasons for Discontinuation of Clopidogrel
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Stent Thrombosis in ACUITY, Day 0 to 30
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Predictors of ST Within 30 Days
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Clinical Outcomes in Patients With Stent Thrombosis (Within 30 Days)
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HORIZONS-AMI: Primary Endpoints at 1 Year
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HORIZONS-AMI: Binary Restenosis at 13 Months
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Drug-eluting
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TRITON-TIMI 38: Intensive Antiplatelet Therapy and Rates of Thrombosis
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TRITON-TIMI 38: Intensive Antiplatelet Therapy and Rates of Thrombosis
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TRITON-TIMI 38: Intensive Antiplatelet Therapy and Rates of Thrombosis
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TRITON-TIMI 38: Subgroup Analysis of Antiplatelet Therapy Effect on Thrombosis
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TRITON-TIMI 38: Stent Thrombosis (ARC Definite or Probable)
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TRITON-TIMI 38: Intensive Antiplatelet Therapy and Rates of Thrombosis
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TRITON-TIMI 38: Early Stent Thrombosis
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TRITON-TIMI 38: Late Stent Thrombosis
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TRITON-TIMI 38: Subgroup Analysis of Antiplatelet Therapy Effect on Thrombosis
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Death, MI, and Stent Thrombosis in BMS and DES Patients With Diabetes
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Reasons for Discontinuation of Clopidogrel
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Stent Thrombosis in ACUITY, Day 0 to 30
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Predictors of ST Within 30 Days
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Clinical Outcomes in Patients With Stent Thrombosis (Within 30 Days)
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ZEST-AMI: Design
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ZEST-AMI: Rate of MACE at 12 Months
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