CardioScripts Classic – Antiplatelets in ACS [Part 1]

0:00-0:27: Intro

0:28-1:04: Welcome back and Introduction of Dr. Dunn

1:05-6:18 Foundation of antiplatelet therapy with aspirin in ISIS-2 trail and VA Cooperative Study.  What is up with that subgroup analysis?

6:19-10:39: Percutaneous intervention joins conversation develops and STARS trial compares Aspirin alone, aspirin + warfarin, aspirin + ticagrelor in the setting of stenting.

10:40-13:57: The twelve-month duration and DAPT is established as standard of care in ACS with CURE and PCI-CURE.

13:58-23:37: More potent P2Y12 inhibitors evolve DAPT approach with TRITON (prasugrel), PLATO (ticagrelor).  But what are their niches (TRILOGY-ACS).

23:38-24:24: Episode 1 closing

References:

  • ISIS-2 Collaborative Group. Randomized Trial of Intravenous Streptokinase, Oral Aspirin, Both, or Neither among 17187 Cases of Suspected Acute Myocardial Infarction. The Lancet 1988;332:349-360.
  • Lewis HD, et al. Protective Effects of Aspirin against Acute Myocardial Infarction and Death in Men with Unstable Angina — Results of a Veterans Administration Cooperative Study. N Engl J Med 1983;309:396-403.
  • Leon MB, et al. A Clinical Trial Comparing Three Antithrombotic-Drug Regimens after Coronary Artery Stenting (STARS). N Engl J Med 1998; 339:1665-1671.
  • Yusuf S, et al. Effects of Clopidogrel in Addition to Aspirin in Patients with Acute Coronary Syndromes without ST-Segment Elevation (CURE). N Engl J Med 2001;345(7):494-502
  • Mehta SR, Yusuf S, Peter RJG, Bertrand ME, et al. Effects of pretreatment with clopidogrel and aspirin followed by long-term therapy in patients undergoing percutaneous coronary intervention: the PCI-CURE study. Lancet 2001;358:527-533.
  • Wiviott SD, Braunwald E, McCabe CH, et al. Prasugrel versus clopidogrel in patients with acute coronary syndromes. N Engl J Med. 2007;357(20):2001-2015.
  • Wallentin L, Becker RC, Budaj A, et al. Ticagrelor versus clopidogrel in patients with acute coronary syndromes. N Engl J Med. 2009;361(11):1045-1057.
  • Roe MT, et al. Prasugrel versus Clopidogrel for Acute Coronary Syndromes without Revascularization (TRILOGY-ACS). N Engl J Med 2012; 367:1297-1309

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