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Antithrombotic drugs in cardiovascular medicine: a year in review

Ibrahim, Homama,b; Rondina, Matthewa,b; Welt, Frederick, G.P.a,b

Current Opinion in Cardiology: July 2018 - Volume 33 - Issue 4 - p 369–374
doi: 10.1097/HCO.0000000000000530
CLINICAL TRIALS: Edited by Neal S. Kleiman

Purpose of review To provide an up to date review of the most recent randomized clinical trials in the field of antithrombotic drugs for cardiovascular diseases.

Recent findings In 2017, low-dose anti-Xa treatment added to aspirin proved to be more efficacious than either treatment alone in patients with stable atherosclerotic disease despite the increase in nonfatal bleeding events. Furthermore, anticoagulation strategy during coronary interventions was again tested in a registry-based trial and showed comparable efficacy and safety between heparin alone and bivalirudin. Data from safety trials demonstrated lower risk of bleeding with dual antithrombotic therapy compared with triple antithrombotic therapy following coronary intervention, albeit these trials were underpowered for efficacy. Although still in its infancy, the role of antithrombotic treatment following transcatheter aortic valve replacement (TAVR) has been investigated in small trials with evidence that a single antiplatelet drug may be noninferior to dual antiplatelet therapy with a better safety profile.

Summary In this review, we discuss the most recent clinical trials investigating antithrombotic drugs for cardiovascular diseases published in 2017.

aDepartment of Internal Medicine, University of Utah

bGeorge E. Wahlen VAMC, Salt Lake City, Utah, USA

Correspondence to Homam Ibrahim, MD, Department of Internal Medicine, University of Utah, 30 North 1900 East, 4A100, Salt Lake City, UT 84132, USA. Tel: +1 801 585 3939; fax: +1 801 581 7735; e-mail: homamibr@yahoo.com

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