Oral Anticoagulation and Preventing Stent Thrombosis

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Presentation transcript:

Oral Anticoagulation and Preventing Stent Thrombosis

Unadjusted Kaplan-Meier Survival Curves for STEMI vs NSTEMI

ATLAS ACS 2—TIMI 51: Rivaroxaban

All-cause mortality, non-fatal MI, non-fatal stroke, and severe recurrent ischemia (%); all patients received ASA +/- clopidogrel

Primary Safety Endpoint: Major and CRNM bleeding at 6 months

Stent Thrombosis: ATLAS ACS 2—TIMI 51 and APPRAISE-2

The Thrombin Paradox

ATLAS ACS 2—TIMI 51: Mortality

Abbreviations ACE = angiotensin-converting enzyme ACS = acute coronary syndrome ADP = adenosine diphosphate AF = atrial fibrillation APPRAISE-2 = Apixaban for Prevention of Acute Ischemic Events 2 aPC = activated protein C ASA = aspirin ATLAS ACS 2—TIMI 51 = Anti-Xa Therapy to Lower Cardiovascular Events in Addition to Standard Therapy in Subjects with Acute Coronary Syndrome–Thrombolysis in Myocardial Infarction 51 BID = twice daily CI = confidence interval CRNM = clinically relevant, non-major CURE = Clopidogrel in Unstable Angina to Prevent Recurrent Events DAPT = dual antiplatelet therapy ESTEEM = Efficacy and Safety of the Oral Direct Thrombin Inhibitor Ximelagatran in Patients With Recent Myocardial Damage HR = hazard ratio i = inactive ISTH = International Society of Thrombosis and Haemostasis

Abbreviations (cont) MI = myocardial infarction NSTE-ACS = non-ST segment elevation acute coronary syndrome NSTEMI = non ST-segment elevation myocardial infarction PAR-1 = protease-activated receptor QD = once daily RE-DEEM = Randomized Dabigatran Etexilate Dose Finding Study in Patients With Acute Coronary Syndromes Post Index Event With Additional Risk Factors for Cardiovascular Complications Also Receiving Aspirin and Clopidogrel: Multi-centre, Prospective, Placebo Controlled, Cohort Dose Escalation Study ROCKET-AF = Rivaroxaban With Warfarin for the Prevention of Stroke and Non-Central Nervous System Systemic Embolism in Patients With Non-Valvular Atrial Fibrillation RUBY-1 = Study Evaluating Safety, Tolerability and Efficacy of YM150 in Subjects With Acute Coronary Syndromes STEMI = ST-segment elevation myocardial infarction TF = tissue factor